tooth extraction when root is in sinus cavity
 

title says it all eh:eek:

Bryanna, what can one expect when this is the case?

thanks

:hug:

oh no!!! :eek: :eek: :eek: :eek: :eek: :eek:

please don't tell me you have this?

i had one taken out. do want to im me about it? or pm? ( i think my extra :eek: might give you a hint :( )

yeppers

it is me who has it
this is the one that was so outchy

gotta decide what to do
PM, IM, post here or whatever will help me decide on this:o

i had mine surgicaly removed...through the roof of my mouth.

serious pain. all i could eat was baby food for weeks.

to this day i still have sinus issues. all the migrains i get...go up my nose into my eyeball. nice visual huh? :wink: getting ice...ice cream..anything real cold on my pallette...is a no no. very sensitive.

i'm sure things have changed. i was 12 when i had the surgery. i wasn't even told that this was going to happen. was just told that i was going to the dentist. being put under without my consent or knowledge was very tramatic. oh...mine was done on dec 22...i slept through christmas. had pinapple baby food food for dinner. :(

are they going to put in a bridge? for me...it was done to make room for my teeth. i had 4 baby..and 4 permanent teeth taken out at the same time before i got braces.

Hi Chemar,
First, don't panic. This situation is far more common than people realize. Even if a root of a tooth were not in the sinus cavity, but an infection from a tooth had spread to the sinus, there would be a perforation in the sinus membrane. A sinus infection can also perforate the sinus membrane and infect the oral cavity.

A radiograph only shows a two dimensional picture of the tooth and a skewed version of it's location near or in the sinus. The only way to tell how far it actually is into the sinus, is during the extraction.

I emphasize this heavily............ The main thing here is to have a dentist who is comfortable and very familiar with extracting teeth like this. Do not hesitate to ask how often your particular dentist deals with this situation. When it is done by someone who has alot of experience with sinus exposures and you faithfully follow their post operative instructions.... the chances of post op complications are bascially non existent.

During all extractions (especially if the tooth is infected or previously had a root canal) ........ it is imperative that the surgeon thoroughly debride the tooth socket removing the periodontal ligament and then irrigate the area with copious amounts of saline. Depending on the size and location of the sinus perforation, sometimes the sinus needs to be closed surgically and sometimes it doesn't.

Again........ an experienced surgeon and your strict compliance with post operative instructions will minimize post op complications drastically!

I hope this information was helpful to you. Feel free to ask any questions that are concerning you and I'll see if I can help. Keep us posted on how you're doing!

Bryanna

ps....... just a gentle word of advice...... be careful not to let anyone's negative experience influence your already heightened anxiety. Most people who have post op complications following this type of dental surgery: either had an incompetent surgeon; had not prepared themselves for the surgery and/or did not follow post op instructions. ~'.'~

Curious,
From what you have described, your situation is completely different than Chemar's. At 12 years old, you had either "retained" premolar baby or adult teeth that had either never come down through the gum or due to overcrowding, those teeth were coming through the palate as there was no room for them to fit into your small upper jaw.

Since Chemar is an adult, my interpretation of her post is that her tooth is fully erupted, but the root(s) may be located in or near her sinus cavity. A truly different situation and surgery altogether.

Chemar, please correct me if I have misinterpreted you ~'.'~

Bryanna

thanks Bryanna and Curious

yes, I remember you telling me that now Curious :hug: ...just didnt equate it with this :o so heeding all cautions and also of course your words of wisdom and experience too Bryanna:)

Ok, I am middle aged and this tooth broke a while ago. When I went to have it removed (I never ever ever will have a root canal again ever ever never:eek: :D )..........anyways, the dentist (a couple of them in a row in fact) refused to extract and all wanted to do more of the kind of work that has left my teeth in the state they are but that is another story!!:mad:
There primary reasons for not extracting was that they felt it could be "saved" (yeah right! ) and that it was "rooted in the sinus cavity"
So, as it wasnt bothering me, I have lived with it. A month ago it began to have like an itchy/burny pain and I found what I hope is a good dentist willing to extract it and others back there that should go. He has treated infection (clindamycin) and we need to start a plan of extraction now. No root canals needing out...front teeth are all fine as are some back ones

sooooooooo

there's the story:o

ACK. Yikes. All the best with this problem, Chemar. I'll be thinking of you.
I have a similar problem going on with one of my old molars. :eek:
can I say this here on the dental thread???........ I HATE teeth. :)

Chemar,
I know this is not what anyone wants to hear. Believe me, I address this very issue every day with people and I see the disappointment and fear in their expressions.

Literally, 9 out of 10 people can relate to your story. Dentists are taught to convince the patient that teeth should be "saved" irrelevant of how infected or broken down they may be. However, that word "save" simply means "retain". Root canals, apicoectomies, amputated roots do nothing to "cure" an infected tooth. Teeth start out as live body parts and once the nerve becomes infected, it rapidly spreads to other parts of the tooth called the dentin tubules which are also filled with nerve material. These tubules are microscopic, therefore, they cannot be cleaned out and antibiotics cannot kill the various strains of bacteria that develop because there is no way to culture it to know what's growing in there. The nerve material inside the tubules becomes necrotic and remains infectious. In addition to that, our teeth get their nutrition from the blood supply that circulates through the nerves, just like it does in every other part of our body. Once the nerves are severed, as they are when they are removed from the inside of the roots, the circulation stops. It is very common for people to end up with 2, 3, 4 root canaled teeth in a row as the infection has spread through the bone. Depending on the persons immune system, the infection can spread rapidly or take months to years before it shows up radiographically.

Chemar, never hesitate to question your dentist about his experience extracting teeth near or in the sinus cavity. He may be the nicest guy in the world.............. but he needs to know how to deal with a sinus perforation irrelevant of how small or large it may be. Most general dentists DO NOT know how to repair a sinus perf, nor do they have the material to repair it. It takes special training and experience to know what to do. Oral surgeons see sinus perfs all of the time, so they are ready and able to repair it.

I have seen so many "mistakes" because the patient didn't question the dentist and because the dentist didn't want to offer to refer them out for fear of losing the patient for restorative work. Please make sure you ask what his experience is with sinus perforations and how he would handle it.

I know this is scary........ I realy do. But in the right hands, you will be fine!!

Bryanna

Chermar
 

I'm going through this now i'm 60,have Micro Valve Prolapse,and
Sjogren's Syndrone,so all infection must be taken care of before
anything can be decided. And i'm in fear of Dentist's in a big way.
Lot's of dental problems with Sjogren's :eek: indeed. Sue

thanks for the info Bryanna:hug:

yes, i plan to ask and check thoroughly before I allow any work done

Hi Sue,
People with Srojen's syndrome generally have alot of dental problems due to the lack of saliva they have. Our teeth and gums need to constantly bathe in healthy saliva which helps to remove debris, reducing the incidents of decay and gum disease.

There are various products on the market to help restore saliva flow and reduce the irritation to the gum tissue. Have you tried any with much success? One product that I have found that realy seems to help alot is Xylitol. Our patients use Spry products and Xylo~sweet. I have no business affiliation with any company, I just see the positive results with the patients that use these particular products on a daily basis.

Mitral-Valve Prolapse is a Valvular heart condition where one of the heart valves closes improperly and allows regurgitation of the blood. It is a very common condition and there are varying degrees of severity. Not all patients with MVP need to premedicate with antibiotics prior to dental treatment. It depends on the patients particular valvular condition, their overall health and what type of dental procedure they are having done. Patients with MVP should see their cardiologist regularly to monitor their condition so they know what changes (if any) are taking place so precautions can be taken if necessary.

Sue, your fear of the dentist is sooooooooooo common and completely understandable as far as I am concerned! As a child, I had horrible dental experiences and even though I am in the profession.......... I still have my issues with being in the dental chair.

Too many dentists take a patients comfort for granted and make us feel like we are just suppose to subject ourselves to pain and discomfort in the dental chair. It is hard to keep our mouths open while someone is drilling in our head as we are drowning on what feels like gallons of water.......... am I right?? It just takes a little bit of effort and compassion to help a patient feel comfortable.

Many dental offices now offer various "distractions" for the patient like sound proof headphones and overhead screens to watch DVD's or televsion. Patients do really well when they can mentally place themselves someplace else while sitting in the dental chair. Have you tried any of those things?

Hope you can find a way to get past your fear enough to get your dental work done ~'.'~

Bryanna

Chemar,
Great! Please keep us posted on how you're doing!
Bryanna

Hey Cheri...
 

I just had a tooth removed which extended into my sinus cavity three weeks ago, and had no complications at all. You and I are near the same age (as is our friend the monkey :D ) so I wouldn't worry too much if I were you. What is that thing that Winston Churchill said? "The greatest thing we have to fear is fear itself." And dentists, of course. (Sorry Bryanna :p ) Good luck with your procedure!

Idealist

thanks Idealist :)

that's very reassuring to hear. Thankfully all is peaceful in my ole mouth right now phew! but I know it has to be done soon. Dentist just wants to be sure any lingering infection is totally gone before starting the work on the chompers:D

Hi Chemar,
It is important to understand that the tooth itself, is infected. The antibiotic will not cure the infected tooth because, the bacterial strains of infection inside the tooth are various and some strains will not be sensitive to any particular antibiotics that you are taking. The symptoms subside, temporarily, because the antibiotic calms down the inflammation.

Many dentists prefer to have their patient on an antibiotic for certain infections prior to performing oral surgery as a precautionary measure to help make the surgery a little easier and less riskier for the patient. In many cases, it is usually wise to undergo the oral surgery while you are still on the antibiotic.

If you have generalized infection, like periodontal disease and/or several infected teeth..... the same principal about taking antiobitics holds true. The medication will not cure the infection, it will simply subside the symptoms until the actual source of the infection is removed. If someone tries to avoid the actual dental treatment by taking repeated doses of antibiotics, the infection will proliferate and new strains of bacteria will develop.

I'm giving you (and others) this information because all too often people will be SO relieved to have the pain gone that they mistakenly think the infection is gone too.

Please keep us posted on how you're doing!

Bryanna

Hi Idealist!
No apology for fearing dentists necessary!! Not only have I had some awful dental experiences myself, but I've seen more than I care to remember!! I realy wish things were different ~'.'~

Glad to hear that your extraction went well!!

Bryanna

thanks Bryanna :)

yes, my dentist agrees that the problem is not cured just because I feel better
*awwww geeeee* :winky:

I also have to time things well re business/family

but yes

the offending teeth will eventually be removed to clear the problem

no way. you know i was born at the END of 1963. hmph...some old man thinking he is MY age. :rolleyes:


hehe

nope! You two are juniors!! :D
I, my dear, was born in the fifties:cool:

Gosh, thank you for telling me about this thread. Though I must say I am extremely tense just reading it.

The information is good.

I was scared last year when I told a friend about the infection around my old dental implants and she asked why the dentist hadn't given me an antibiotic...

When I didn't have any idea it made me nervous.

I know that the vitamin C that I'm taking is holding the infection in check.

When I don't take it (that was quite awhile ago that I ceased for a short while) the infection gets a lot worse, at least that's what I blame for the swelling that happens and the intense pain that accompanies it.

I just found myself saying, "Oh.... darn it!" I had really been hoping that the vitamin C could lick the infection... I mean, it is so much reduced.

It does scare me.

Well, thank you VERY much for directing me to this thread. I appreciate it.

I'm going to have 3 grams of C right now...

:)

(Seriously)

(((((((((((Sue)))))))))))

Hi Sue,

I hope this reply is informative to you and doesn't cause you any distress, but it needs to be said here that vitamin C cannot lesson or eliminate an infection in the jawbone. I am a firm believer in supplementing with vitamin C and lots of it!! It's great that you take it daily and realize the important health benefits from doing so. However, if you have an infection in your jawbone, especially around a dental implant, the vitamin C is not holding it in check.

Your symptoms of swelling and pain subside when you take the vitamin C because the supplement stimulates your immune system to send out white blood cells, etc. to the site of the infection temporarily reducing the inflammation, thus reducing the pain. The longer an oral infection is present, the more proliferated it becomes because the jawbone is extremely vascular allowing the infectious bacteria to travel via your blood into your main organs.

As I said before, this is not to distress you but to inform you of the seriousness of any chronic oral infection. It may behoove you to do some research on oral infections and how they affect other areas of the body if they are not eradicated.

I hope you and anyone else reading this takes this message seriously as I have personally witnessed life altering situations due to chronic oral infections.

The best of health to you,
Braynna

ack! well, it is done...this morning the offending tooth with it's neighbors on either side of it were extracted.:eek:

I am one lopsided Chemar right now but all went well and I am following all instructions with care

phew, glad it is over:o

Hey Chemar!
Well YEH! for you! I too am glad that this day is finally over for you. I know you have been anticipating it for quite some time now.

It is very important to follow the post op instructions. What really helps to keep the area clean of debris and also aids in the healing is the warm salt water rinses. As I'm sure your instructions say, begin rinsing with warm salt water 24 hours from when you had your teeth extracted. The first two days of rinsing you just want to "gently" swish the salt water around and then by the third day, rinse a little more vigorously. Rinse 3-4 times a day, especially before you go to bed at night. We recommend that our patients rinse with salt water for at least 2-3 weeks post op........ sometimes longer if the patient tends to build up alot of plaque. This rinsing really does wonders to heal the extraction sites!

I also have patients that tell me they use the homeopathic, Arnica, under their tongue to reduce pain and swelling. This worked so well for some, that they never needed a pain pill! They take it every 4 hours or less, depending on their level of discomfort, for about 3-5 days. It does not interfere with any meds so it can be combined with whatever else you are taking. Arnica is actually used post operatively for various surgical cosmetic procedures because it reduces inflammation and promotes tissue healing. So it's great at healing the gum tissue as well!

I also wish to emphasize that a nutritious diet, along with some extra vitamin C will help you feel well and it will speed the healing along.

Please keep in touch and let us know how you are doing!

Bryanna

thanks Bryanna :hug:

yes, I got the homeopathic arnica pillules a few days ago, and have been taking them since shortly after the extractions, and started rinsing with the salt water this morning, which the dentist agreed is the #1 post op treatment


I am actually very pleased overall as with a row of three extractions I anticipated a lot of pain and honestly havent experienced much, even sleeping relatively well last night with just half a pain pill

Not only pleased to have the infected teeth gone, but also pleased to have the mercury fillings they had in them outa me too:p

Hi Chemar!
Well excellent! I always remind our patients to keep up with the salt water rinsing even though the area seems to feel ok. Sounds like that is already what you intend on doing!! Generally but not always, the third to fourth day post op can be when the most discomfort occurs. This is when the body accepts the trauma and the immune system starts to send those healing cells in abundance! Just keep doing the rinses and the arnica several times a day and the areas will heal just fine!

I meant to ask...... was there a sinus exposure??

Bryanna

Hi Bryanna
yes, the root was partially in the sinus cavity, and she did some "cleaning, tidying and mending in there" is the way she described it, but it seems to have been not as severe as dentists in the past made it sound. I also have sutures in the gum. I go back Wednesday next week for a checkup, and for her to see if I would be ready for the other side where thankfully only minor extraction needed and no roots where they shouldnt be!
It's a bit stinging still but not the throbbing pain I anticipated so we will see what the next few days bring on....at least I am ready with lots of healthy soft foods, arnica, supplements and kosher salt water:p and,,,tho I am always loathe to take any...if needed the pain pills, which she insisted I keep here, just in case it got real ouchy. hope I wont need 'em.

a special thanks to you again Bryanna:hug:
The care you show us all here, and the time you take to explain and help really played a big part in helping me to summon up the courage to just go get this done. Thank you :)

Oh Chemar.... you are very welcome ~'.'~

I know the information that I give can be a bit overwhelming.... but I always hope that whomever is reading it will see the relevance of being better informed. I want everyone to do well and have more positive dental experiences!!

Sounds like you are off to a great start! Let us know how it goes next week ;-)

Bryanna

so far so good :)

still no pain and honestly the most irritating thing is the sutures.....

seems to be healing well and that ick taste has gone too

keeping up with the rinsing and the arnica pills

:D

Hi Chemar!
SO glad to hear that you are doing so well!!
At your post op appt.... tell the dentist the sutures are irritating and depending on how healed the area is, they may be able to be removed!

Keep up the rinsing for at least another 2 weeks......... even if the sutures are removed to keep the area clean and promote healing.

Thanks for updating us............. hopefully all will remain well!

Bryanna

ok

stage 2 of the multiple extractions done yesterday:eek:

and only two more molars bottom left to come out about 2 weeks time, which will then have eliminated the six bothersome ones. I sooooo wish the dentists in the past had just extracted these when I requested.......woulda saved me so much agony and $$..never mind enduring that root canal that fell apart eventually:rolleyes:
All the broken teeth were ones filled with metal amalgams too so I am glad to be rid of those.....interestingly when they broke, it wasnt the globs of mercury laden stuff that fell out but the actual tooth enamel around it....

anyway, yesterday's, altho only one extraction, was a lot more ouchy than the three last week mainly cos it had a sickle shaped root. The dentist was very pleased that it came out in one piece as she had warned that those sometimes break and that she would then have to "go in after the piece of root" ......:eek::eek::eek:
were my prayers answered or what!!:Bow::)

My wunnerful lady dentist said the sutures from last week would soon dissolve and that she preferred to leave them in place, and she was very pleased with the way that side is healing, as it was a very complex extraction.

Gotta tell ya tho, even tho I could not ask for a more careful and expert dentist, I will be VERY glad when this is over:o

Hey Chemar!
This is great news!! I want to pat you on the back for following through with everything and I am so happy that you are having such a positive experience!

The anticipation of dental surgery is never easy for anyone........ not even for those of us in the business! You are more than half way there and this time next month, the anticipation will all be over and you will be ridden of infected teeth and all of your mercury fillings......... Your body will thank you more than you realize ~'.'~

You mention how your mercury filled teeth had broken and that it was the filling material that was left and the enamel that broke off. This is very typical because the mercury fillings expand and contract with temperature which causes pressure on the enamel causing it to weaken and crack. During this weakening process, the margins of the mercury filling open and bacteria is able to get inside and underneath the filling causing decay. Nearly 100% of the time, when an old mercury filling is removed, there is quite a bit of tooth decay underneath it.

Chemar........ you're doing great! Keep up with the rinses and arnica ~'.'~

Bryanna

Are Roots of some teeth always in the sinus cavity?
 

Dear Sue--I am with you. Terrified of dentists and have major tooth problems.Then I can switch back to the open insurance plan where you can get good dentists, not "mall dentists" to make my dentures. BUT here's the thing. AND this question if for EVERYONE in this thread or out. Now I am terrified of doing ANYTHING! Obviously they are going have to remove all my teeth at least on top. Does this mean that it is definitely going to involve extraction of teeth with roots in the sinus cavity? Fear of the dentures are enough. I think I would rather not have any teeth than to go through what is described here. I just had a tooth extracted that should have been near the sinus cavity and just the novicaine shots sent me through the ceiling. I was in pain for over a week and the roof of my mouth seemed to burned like if you had eaten pizza right out of the oven. Anyway--are there teeth that always have roots in the sinus cavity. I am from chronic pain and I cannot take any more meds or get meds from the dentist, so when I have "Extra pain" the meds won't cover it.
Thanks to anyone out there who can answer, and Sue--hope all goes well for you.
Miranda

Hi Miranda,
To answer your question....
Does this mean that it is definitely going to involve extraction of teeth with roots in the sinus cavity?
No, not all upper back teeth have roots in the sinus. Depends on the anatomy of your sinuses and the length of the roots of your teeth.

Sinus exposures are not uncommon during extractions of maxillary posterior teeth. They are usually not a cause for concern and can easily be repaired. Sometimes the perforation into the sinus is so small that it just heals on it's own.

There are usually two (rare) situations that would be of concern:
One is if a tooth were severely abcessed and the the infection had invaded deep into the sinus cavity.
The second would be if the root of a tooth were broken off during an extraction and it was pushed up into the sinus.

Both of these situations are rare and not something that you should worry about. If you had an abcess that caused a severe infection into the sinus cavity, your dentist would have already told you about it.

The novocaine shots that you said were painful may have been when you were given an injection in the palate. Extraction of upper teeth requires a palatal injection and they can be a bit ouchy. However, this area numbs up very quickly so the subsequent injections in that area should not be uncomfortable.

The burning pain that you described in the roof of your mouth could have been an irritation in the surgical area from something you ate. Or, you could have developed a canker sore in that area, which is very common after oral surgery for some people.

Have you ever tried homeopathy for pain relief? I have lots of patients who have great success using Arnica, Belladonna, Hypericum, Ruta, or Staphysagria. Each of these does something a bit different and not all are necessary to take. A google search on each of these which regard to dental anxiety and oral surgery pain, could give you some insight into which one may be helpful to you.... if you choose to try it.

Hope this information is helpful to you.
Bryanna

:eek:
last hurdle tomorrow and the broken mercury laden left bottom 3 molars are gonna depart.

phew! Must say I came close to calling in today to postpone:o but I will be brave and get this over with.

I am already feeling the increased energy and improvement in a lot of little areas with the top offenders out so this encourages me to see it thru

sure wish it was already this time tomorrow tho:D

Hey Chemar!

NO postponing this last visit........ you already know the relief you will feel when it's ALL over with! You definitely can do this!!

I am glad to hear that you are feeling well and see improvment in certain things since having the other bad teeth removed......... like I said earlier...... your body will thank you more than you know!

Are you managing eating ok? That can sometimes be the biggest hassle when healing from oral surgery, especially when the extracted teeth are in various areas. It sounds like you are doing terrific and you definitely deserve a great big KUDOS for seeing this through and taking good care of yourself during the process. You are a great inspiration to others ~'.'~

We'll be thinking about you tomorrow......... everything will be fine!

Bryanna

I'm baaaaaaaack:D

actually
I must admit that the bottoms werent nearly as bad as the tops! even the shots were less icky.

so it is done YAY!! and when I am all healed up I will go check out the partials people. All my other teeth seem ok for now so hopefully will stay so.

Chatting with the dentist today she said how she has clearly noticed speedier and better healing after extractions in those who are diligent with the salt water rinsing starting on day after extraction and going till all is fully healed up...at least a month she said.


So thanks again Bryanna for the advice and the encouragement and to all who helped me pluck up the courage to see this thru:grouphug:

Hey Chemar.........Woo Hoo!! You did it.......many hands are clapping for you!!!

I agree with your dentist about the salt water rinsing. It makes a HUGE difference in the overall healing of the surgical site and it also helps reduce pain that first week after the surgery because it helps reduce inflammation. When I see patients for their post op check, I can tell immediately upon looking at the site if they are rinsing or not irrelevant of what they tell me ~'.'~.

Keep us posted on how things are going and let us know when you start the process of getting your partial dentures!

Bryanna

happy to report all is healing really well, and oh how good not to be bothered by the outchiness that those teeth used to periodically bring! I definitely also have increased stamina and think the infection was likely causing fatigue

sooo glad I did it! just a little fear and discomfort for a really positive outcome. :p