dental infection with possible sinus involvement
 

Hello,
I am new to this site, and hopeful of some helpful info.
Approx. 7 yrs. ago I was having an upper molar prepared for a crown when my dentist said "opps". He went too deep and exposed the nerve/pulp on the side of my tooth. A patch was applied. The crown was later applied. I shortly after developed a bad infection that came out with a large lump on the roof of my mouth. It was treated with antibiotics. I ended up seeing an endodontist and had a root canal. A short while later I developed another infection with a lump above that tooth. The endo operated again thinking I was reacting to the filling material saying it had gone a bit past the end of the tooth. He did say their was a cyst which he removed. For years now, a few times a year I get an infection which I thought was a sinus infection. It settles down but seems to come back. Now my dentist is saying I need the tooth removed as the infection is eatting away the bone in my jaw.
I saw an ears/nose/throat specialist to see if my sinus could be re-infecting this tooth. the dr. said I have a bad deviated sepum, a cyst in passage and the drainage tubes are mostly blocked. So my sinuses do not drain properly. I will have surgery in Jan 2013 to correct this.
Can someone please advise me as to whether or not they think my sinus could be causing all this problem with my tooth. I would like to keep my tooth if possible, but am worried about the ongoing infections. They seem to be getting worst and more frequent.
Sorry for the long post, but needed to give all the dtails for best answer possible.
Thank you,
Sydney

Hi Syd,

FYI... I am in the dental field and I can answer your question.

That tooth is definitely a chronic source of infection. From your description it has been infected for 7 years and to be honest, there is no dental procedure, including root canals or apicoectomies, that can cure an infected tooth. The infection has obviously spread to your sinus cavity causing chronic sinus infections. Just so you know, this is very typical of an infected tooth... your case in seen daily in every dental office.

The only way to attempt to cure your sinus infection is to remove the tooth... remove the cyst and bone surrounding the tooth... and have sinus surgery to remove all of the visible infection. Correcting your deviated septum is secondary to all of this. If you do not remove the tooth, you will keep the source of the infection which is the tooth and your sinus surgery will be unsuccessful.

Because of the long term chronic infection with this tooth and due to degree of your sinus infection... your oral and nasal surgery should be combined at the same surgery. This is when both the oral surgeon and the ENT surgeon work together at the same time. Doing one without the other is a huge risk of infecting the surgical site of whichever one is done first.

Please keep in mind..... nothing can cure the infected tooth. To keep this tooth under any circumstances means to "retain" an infected tooth that will continue to infect your sinus and deteriorate your bone. Also, it is important to know that the roots of our upper teeth are only 4 inches away from our brain. Long term infections in upper teeth can and will cause an infection of the brain.... which is a very difficult condition to cure.

Please think very carefully about your situation so you can make the healthiest decision possible.

Hope all goes well... Please let us know how you're doing.
Bryanna

Dear Syd
 

Welcome to Neuro Talk. I know Bryanna to be extremely knowledgable in the dental field. She is 100% correct about that tooth, being the source of the infection. I have asked her serveral times about my own dental issues, and the guidance saved me time, money and extra pain. I did not "retain" my infected teeth, as they were the problem. I didn't vote for a root canal to begin with, and really got some good advice from a oral surgeon who did agree. I wish you all the best. ginnie

thank you
 

Thank you Bryanna for a quick response. It is my regular dentist who wants to remove my tooth. I suspect just a extraction....no surgery. Can I not just have the tooth removed and then would the infection not clear up with antibiotics? Would the sinus not clear up also if the source of re-infection is removed? The sinus being 80% blocked and the pea sized cyst, (in the nasal passage) also the drainage tubes are mostly a breathing issue which the ears/nose/throat specialist hopes to improve.
Sydney

Thanks ginnie for your reply. I appreciate the comments. Time to take care of this tooth once and for all!
Sydney

Syd,

I would advise against your general dentist removing this tooth. Due to the proliferation of this long standing infection, it is a surgical extraction that will involve removal of diseased bone, tissue and in all probability there will be some sinus involvement. MOST general dentists are not trained in handling this type of extraction and their surgery will be incomplete. The "source" of the infection has been this tooth, however, it has become much more than that. To keep the tooth means to keep the ongoing infection because irrelevant of what is done to this tooth, it will remain infected. Hopefully I have made that clear....... ? The infected bone and tissue has to be surgically removed as much as possible in order for an antibiotic to be effective. Antibiotics will not cure the infection by itself even after the tooth is removed because it cannot undue the damage that has already been done.

The sinus also needs to be surgically debrided in order for an antibiotic to be effective because the diseased tissue needs to be removed in order for the antibiotics to work properly.

You can arrange the mutual surgery with your ENT or an oral surgeon. This is the most complete way to deal with your infection. If you have the surgeries at separate times, you risk infecting the surgerized site. Please consult with your ENT and an oral surgeon for their opinions.... but please reconsider NOT having your general dentist perform this extraction.

Please keep in touch..
Bryanna

thank you again
 

Thanks again Bryanna,
My daughter is an RDT and I have spoken to her about your recommendations. I wanted to get a neutral opinion....that being you. She agrees with you 100 %. I only found out last week from my ENT the extent of the damage. I am waiting for my daughter to ask her colleaques for some names of highly qualified oral surgeons for me to contact and make the arrangements for surgery. She also agrees the surgeries must be done together.
Thank you for giving me an honest and straight opinion.
Very much appreciated.
Sydney

Hi Syd,

What is an RDT? Is that a radiation certification?

I'm glad she agrees!! Hopefully she can help coordinate this surgery for you.

I have strongly stressed the importance of having this taken care of properly because I have seen countless patients who have not known any better than to just go along with their dentist ....to only end up with additional surgeries and lingering problems for years.

I wish you the best of care... please keep us up to date on how things are going!!

Be well...
Bryanna

Rdt
 

A RDT is a registered dental technician. My daughter works in a lab and creates the dentures, crowns, appliances, etc.
I see my ENT specialist on Tuesday to discuss and hopefully have him arrange for the needed surgeries.
Thanks for giving some direction with this issue.
Sydney

Hi Syd,

Oh, okay.. cool!

Let us know how the consult goes on tuesday. Hopefully he will be on board with the coordination of the surgeries and help things to go smoothly for you.

Will check back in here next week looking for your update!

Be well,
Bryanna