I had a root canal done 3.5 months ago on tooth #15, the toot hurt for about a week when I noticed I started to develop other syptoms. The gum around the toot that I had a root canal on started to burn. Over time the burning sensation spreded to my gums and my tongue all on the left side of the mouth, I went to see many oral surgents, dentists and no one can figure out what is causing the burning sensation.
My gums look good, not swollen or red. Couple days ago I decided to extract the tooth that the root canal been done on. Its been 6 days after the extraction and the burning sensation is still present but shifted towards the center of the mouth, the tongue and the gums in the center. The other problem is that the canals/roots were overfilled with sealant during the root canal procedure and when I was extracting the tooth the oral surgent couldnt reach for that material to clean it out and said It is in the mixillary sinus and If I want to get it out of there I need a separate surgery for that. The materials that been used on RCT are Cavit(temporary filling) Gutta percha, and tubli seal (zinc, oxide, eugenol). I am going to see an allergist in 2 days to see if maybe I have an allergic reaction to tubli seal, since the material is still in sinus. Other symptoms that I developed together with the burning pain after RCT are jaw pain, clogged ear(left side) now its spreaded to the right one, ear pain, and a week ago I started having dificulty breathing. Went to emergency twice because of the chest pain/tightness/difficulty breathing. No one can figure our what is going on and I am in constant burning pain. My question is can I have all these symptoms due to an allergic reaction to any of the dental materrials, or there might be other underlying issue behind all of this. If any of you have any thoughts on this, I would greatly appreciate them all! Thanks

Heres the xrays of the tooth after root canal treatment and after the extraction.

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Hi Hanna,

The post op xray is inferior diagnostically. A panoramic radio-graph or dental ct scan would be better.

Also, on the pre op x-ray you had an impacted wisdom tooth behind the rc tooth. On the post op x-ray that tooth is not present. Was that wisdom tooth extracted?

Yes, there is evidence of remnants of rc filling material, but it's difficult to determine the exact location of it from this poorly angled film. Also, there may be some retained root tips. A panoramic xray or dental CT scan would be warranted for proper diagnosis.

The burning pain could have more than one origin with sinus inflammation likely being at the top of that list. Inflammation occurs from the retained rc material which is a constant irritant, similar to having a splinter embedded in your finger. The floor of your sinus hang down low which when inflamed, irritated or infected could contribute to odd sensations in your maxillary jaw, palate and sinus as well as pressure in your ear.

Yes, you could be reacting negatively (allergic type symptoms) to the rc filling material. But it is more likely that the material is acting like a chronic irritant, like a splinter.

The chest pain, tightness, uncomfortable breathing... could be anxiety.

Either ask the oral surgeon to take a panoramic xray and/or dental ct scan or consult with a different oral surgeon to have those things done for a more thorough and definitive diagnosis.

Please let us know how you're doing.
Bryanna

Thank you so much for replying!! Yes, i extracted the wisdom tooth 2 weeks ago and tooth number #15 a week ago.

I saw you replied in BOLD to other people so I will do the same in our conversation.

The post op xray is inferior diagnostically. A panoramic radio-graph or dental ct scan would be better.

I DO HAVE PONORAMIC RADIO-GRAPH THATS BEEN TAKEN BEFORE THE TOOTH EXTRACTION AND I DO HAVE A DENTAL CT, ALSO TAKEN BEFORE THE EXTRACTION.

Also, on the pre op x-ray you had an impacted wisdom tooth behind the rc tooth. On the post op x-ray that tooth is not present. Was that wisdom tooth extracted?

YES, I EXTRACTED THAT TOOTH BECAUSE THOUGHT MAYBE IT WAS GIVING ME ALL THE SYMPTOMS THAT I HAVE, BUT THE SYMPTOMS DIDNT GO AWAY, SO I AM ASSUMING IT WASNT THE CAUSE OF IT ALL.

Yes, there is evidence of remnants of rc filling material, but it's difficult to determine the exact location of it from this poorly angled film. Also, there may be some retained root tips. A panoramic xray or dental CT scan would be warranted for proper diagnosis.

SO WOULD YOU SUGGEST ME TO DO ANOTHER CT SCAN?

The burning pain could have more than one origin with sinus inflammation likely being at the top of that list. Inflammation occurs from the retained rc material which is a constant irritant, similar to having a splinter embedded in your finger. The floor of your sinus hang down low which when inflamed, irritated or infected could contribute to odd sensations in your maxillary jaw, palate and sinus as well as pressure in your ear.

I WENT TO ALLERGIST TODAY TO SEE IF MAYBE I HAVE AN ALLERGIC REACTION TO THIS MATERIAL WHICH REMAINS AFTER THE EXTRACTION, WE WILL DO THE TEST FOR ALLERGY IN ABOUT 2 WEEKS FROM NOW. SO, IF THE ALLERGY TEST COMES BACK NEGATIVE, DO YOU THINK IT CAN STILL IRRITATE THE SURROUNDING TISSUES AND GIVE ME ALL THESE SYMPTOMS? WOULD YOU SUGGEST ME TO CLEAN THIS MATERIAL OUT? ALSO, IS THERE A WAY TO CHECK FOR SINUS INFLAMATION? I AM SORRY, I KNOW VERY LITTLE ABOUT DENTISTRY THAT'S WHY TRYING TO FIGURE OUT WHAT I SHOULD DO NEXT.

Yes, you could be reacting negatively (allergic type symptoms) to the rc filling material. But it is more likely that the material is acting like a chronic irritant, like a splinter.

The chest pain, tightness, uncomfortable breathing... could be anxiety.

WENT TO EMERGENCY ROOM RECENTLY AND THEY TOLD ME I PROBABLY HAVE AN ACID REFLEX WHICH RISES UP AND THATS WHY I MIGHT HAVE CHEST PAIN/TIGHTNESS/DIFFICULTY BREATHING. CAN THAT BE THE CASE?

Either ask the oral surgeon to take a panoramic xray and/or dental ct scan or consult with a different oral surgeon to have those things done for a more thorough and definitive diagnosis.

SO IF THE REMAINING MATERIAL IS IN THE MIXALLARY SINUS, IS THERE A WAY TO GET IT OUT OF THERE? CAN THAT IMPROVE MY SYMPTOMS? I UNDERSTAND IT IS HARD TO CONSULT IN DISTANCE BUT I WILL APPRECIATE ANY THOUGHTS/HELP SINCE I'VE CAME TO THE POINT WHERE I DON'T KNOW WHAT ELSE TO DO. AGAIN, THANK YOU SO MUCH FOR REPLYING!

Heres the ponoramic xray that has been taken before the tooth #15 and #16 extraction.

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Hanna,

Were you informed that you have the same dental problem occurring on the other side of your upper jaw in your root canaled second pre molar? The rc filling material was pushed through the root of that tooth also. How long ago was that rc done? You also have an impacted wisdom tooth in that quadrant, similar to the one you recently had removed on the other side. In fact, the wisdom teeth are almost a mirror image of each other.

You have very large sinuses. Which could be normal for you and/or that could indicate generalized sinus inflammation. Do you a history of allergies, sinus congestion, post nasal drip, colds, or infections?

Anytime you have a root canaled tooth, you will have inflammation, chronic bacteria within the dentin tubules of the tooth and some degree of ischemia in the surrounding areas, there are no exceptions to that. With upper teeth, and in your case having large sinuses, the roots of your posterior teeth are in very close proximity to the floor of your sinus. So any tooth problems in your upper arch are likely to cause symptoms in possibly the sinus, maxillary bone, palate, ears, etc.

It is never ideal to retain any amount of rc dental materials that were pushed up beyond the apex of the tooth during a root canal procedure. That material will be a constant irritant and source for bacterial growth.

The previous dental ct scan, if it included the right side of your head can help determine the location of the rc material pushed through that present rc tooth. Your dentist may try to convince you to have an apicoectomy surgery to remove that material while leaving the tooth in your head. That surgery may or may not remove all of the material as visual access will be difficult. However, that surgery will likely increase the inflammation associated with the rc tooth itself and ultimately the tooth will need to be extracted. Ideally, if you extract that tooth, the surgeon can use that access wound to remove the remnants of rc material.

A new panoramic xray may be diagnostic enough or a dental ct scan of your entire upper arch would show the location of the rc material in the left side (post extraction) and the rc material in the right side above that rc tooth. So the oral surgeon wouldn't be guessing where it is.

The burning sensation crossing over your palate from your left to your right could be what is called referred pain. This is when the bundles of irritated nerves communicate with each other. In your case, you have 2 areas of nerve irritation, one on each side of your mouth.

Regarding the ER visit with your breathing episode.... could be GERD but could also be anxiety induced GERD or a vagus nerve reaction to stress induced anxiety.

I hope your oral surgeon is willing to discuss this with you thoroughly enough to help you make an informed decision.

Bryanna

Were you informed that you have the same dental problem occurring on the other side of your upper jaw in your root canaled second pre molar? The rc filling material was pushed through the root of that tooth also. How long ago was that rc done? You also have an impacted wisdom tooth in that quadrant, similar to the one you recently had removed on the other side. In fact, the wisdom teeth are almost a mirror image of each other.

THE RIGHT SIDE UPPER TOOTH WITH ROOT CANAL BEEN DONE ABOUT 10 YEARS AGO, IT NEVER BOTHERED ME, SO I WAS NEVER CONCERNED ABOUT IT.
YES, I WILL BE EXTRACTING THE UPPER RIGHT WISDOM TOOTH AS WELL.

You have very large sinuses. Which could be normal for you and/or that could indicate generalized sinus inflammation. Do you a history of allergies, sinus congestion, post nasal drip, colds, or infections?

NO, I DONT HAVE A HISTORY OF ALLERGIES, SINUS CONGESTION, POST NASAL DRIP, COLDS, OR INFECTIONS. SO, THE FACIAL/SINUS PRESSURE, CLOGGED EAR IS DEFINITELY SOMETHING NEW TO ME, WHICH IS VERY UNCOMFORTABLE SINCE I HAD IT FOR ALMOST 4 MONTHS NOW.

Anytime you have a root canaled tooth, you will have inflammation, chronic bacteria within the dentin tubules of the tooth and some degree of ischemia in the surrounding areas, there are no exceptions to that. With upper teeth, and in your case having large sinuses, the roots of your posterior teeth are in very close proximity to the floor of your sinus. So any tooth problems in your upper arch are likely to cause symptoms in possibly the sinus, maxillary bone, palate, ears, etc.

It is never ideal to retain any amount of rc dental materials that were pushed up beyond the apex of the tooth during a root canal procedure. That material will be a constant irritant and source for bacterial growth.

SO, MY BEST OPTION WOULD BE TO CLEAN EVERYTHING OUT, RIGHT?

The previous dental ct scan, if it included the right side of your head can help determine the location of the rc material pushed through that present rc tooth. Your dentist may try to convince you to have an apicoectomy surgery to remove that material while leaving the tooth in your head. That surgery may or may not remove all of the material as visual access will be difficult. However, that surgery will likely increase the inflammation associated with the rc tooth itself and ultimately the tooth will need to be extracted. Ideally, if you extract that tooth, the surgeon can use that access wound to remove the remnants of rc material.

THE REASON I DECIDED TO EXTRACT TOOTH #15 WAS BECAUSE I WAS TOLD THAT THE ONLY WAY TO CLEAN OUT THE OVERFILLED MATERIAL WAS TO REMOVE THE TOOTH OUT AND CLEAN EVERYTHING OUT WITH IT. HOWEVER, I AM NOT SURE WHY THE SURGENT WASNT ABLE TO REMOVE ALL OF IT. IF WE LOOK AT THE PRE AND POST XTRAYS WE CAN SEE THAT THE MATERIAL HAS SHIFTED A LITTLE, SO I AM WONDERING IF MAYBE THE SURGENT WOULD TAKE MORE TIME TO TRY TO CLEAN IT OUT MAYBE HE COULD OF REACH FOR IT?

A new panoramic xray may be diagnostic enough or a dental ct scan of your entire upper arch would show the location of the rc material in the left side (post extraction) and the rc material in the right side above that rc tooth. So the oral surgeon wouldn't be guessing where it is.

SO THE CT SCAN CAN ACTUALLY SHOW THE EXACT LOCATION OF LEFT MATERIAL?
WE DID DO A CT BEFORE THE EXTRACTION AND THE SURGENT STILL WASNT SURE HOW FAR UP WAS THE MATERIAL

The burning sensation crossing over your palate from your left to your right could be what is called referred pain. This is when the bundles of irritated nerves communicate with each other. In your case, you have 2 areas of nerve irritation, one on each side of your mouth.

EVEN IF THE RIGHT ROOT CANALED TOOTH DOESNT BOTHER ME?

Regarding the ER visit with your breathing episode.... could be GERD but could also be anxiety induced GERD or a vagus nerve reaction to stress induced anxiety.

I hope your oral surgeon is willing to discuss this with you thoroughly enough to help you make an informed decision.

THANK YOU!!

HI so sorry for what you are going through. I recently had two root canals and am also experiencing pain and burning in the socket and gums. My xrays look great though and I had an Endo do the work.

Yes there is a significant overfill in your tooth that has extended outside of the Apical area. I read a study where a woman was having pain post root canal and she went all over seeking help. Ended up getting some teeth pulled and her xray showed further up in the jaw remenents of something. They retrieved them to find several file tips and leaked gutta purcha. Once removed all her pain went away.

I think it would be wise to get these pieces removed they dont look to far up in the jaw. The burning moving through your mouth is strange. Maybe if you get the pieces removed and still feel the pain you can investigate a facial nerve issue? I do feel your pain literally

Thank you so much for replying!!! Yes, the pain is really bad and its been there ever since I had a root canal procedure, for about 4 months now(. I am considering a surgery on removing the left material, but just wanted to seek other people opinion since I can't really get any helpful information from doctors because no one can really tell what is going on and where the burning sencation can come from. But thank you so much for taking time to reply!! I hope you feel better too!!❤