tooth extraction when root is in sinus cavity [Archive]

Bryanna

06-16-2007, 02:46 PM

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. ~'.'~

Bryanna

06-16-2007, 02:56 PM

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

Chemar

06-16-2007, 03:51 PM

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

Lara

06-16-2007, 05:38 PM

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. :)

Bryanna

06-16-2007, 06:54 PM

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

shiney sue

06-16-2007, 07:10 PM

Chemar

06-17-2007, 07:30 AM

thanks for the info Bryanna:hug:

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

Bryanna

06-18-2007, 10:47 AM

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

Bryanna

06-18-2007, 10:48 AM

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

Idealist

06-24-2007, 09:52 PM

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

Chemar

06-25-2007, 02:38 PM

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

Bryanna

06-26-2007, 02:00 PM

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

Bryanna

06-26-2007, 02:04 PM

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

Chemar

06-27-2007, 07:44 PM

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

Curious

06-27-2007, 07:58 PM

Chemar

06-28-2007, 04:37 PM

You and I are near the same age (as is our friend the monkey :D )

Idealist

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

ConsiderThis

07-22-2007, 11:15 PM

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
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)))))))))))

Bryanna

07-26-2007, 05:45 PM

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

Chemar

09-24-2007, 11:04 AM

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

Bryanna

09-24-2007, 05:39 PM

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

Chemar

09-25-2007, 08:13 AM

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

Bryanna

09-25-2007, 12:15 PM

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

Chemar

09-25-2007, 12:31 PM

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 :)

Bryanna

09-25-2007, 07:37 PM

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

Chemar

09-29-2007, 02:44 PM

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

Bryanna

09-30-2007, 10:11 PM

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

dorrie

09-30-2007, 11:11 PM

Hi Cheri! Glad to know that you are recovering well. I spent alot of time throughout my life drinking, as you know. Before I turned 30 I was malnourished enough for it to have effected my teeth.....my liver did better than my teeth! The dentist could not save them....I had them all taken out. It was quite something....my mouth was so infected that weeks of antibiotics could not get rid of all the infection and they ended up turning up the gas on my to pull the last of them out. I have had dentures since. I do not miss the toothaches or the migranes that came with them! Anyways:Talkative: enough from me...Glad you are doing ok..:hug:

Chemar

10-04-2007, 08:40 AM

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

Bryanna

10-05-2007, 11:09 AM

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

Miranda Arden

10-07-2007, 12:16 PM

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

Bryanna

10-09-2007, 10:44 PM

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

Chemar

10-15-2007, 06:47 PM

: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

Bryanna

10-15-2007, 08:04 PM

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

Chemar

10-16-2007, 11:17 AM

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:

Bryanna

10-16-2007, 03:35 PM

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

Chemar

10-30-2007, 05:52 PM

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

pkeen

05-08-2008, 08:26 PM

Hi all , found the forum while searching for info on a situation i have. I have been reading about some of you with roots into the sinus cavity, and that is why i am here. Today i saw a dentist for a tooth ach and it is an upper wisdom tooth that he says the roots protrude into the sinus cavity. He says it will be $275 for the extraction and $600 to repair the membrane . What is involved in this prosess ,it sounds odd to me , or should i find another dentist ? Thx! pkeen

minymo

05-11-2008, 04:17 PM

title says it all eh:eek:

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

thanks

What matters is how good is the dentist. You could google his name.

I had one wisdom tooth pulled when I was 17 by family dentist. No problems there. The other three in one go when I was 24. No problem there either, only this was done surgically by a professor who used the opportunity to teach young dentists. You know, the best thing that ever happened to me was to become a patient that young dentists practiced on in a university setting? I paid like a quarter of the usual amount for a solid gold tooth and crown, had 4 of them around age 24 because my rich parents refused to let me have proper dental care. Anyway, after that, I had no more problems for 25 years, whereas I had been in pain from age 12.

So as far as I can see, a professor showing off and surgery versus pulling by a dentist is the way to go.

Nibbles

05-18-2008, 03:57 PM

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.

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.

Hi Bryanna, I hope you're still around :) I've been to a dental surgeon (after much debating with medical specialists and a CT scan) for what they've finally agreed is a severely abcessed tooth that has invaded deep into the sinus cavity.

I'm booked in for surgery on the 27th, I'm just wondering if you can tell me anything about what to expect/are there any risks associated with this surgery?

The doctor doing the work comes highly recommended, and seems to really know his stuff, but isn't very good at explaining what to expect :(

I'd really appreciate any insight you or anyone else can give.

Bryanna

05-19-2008, 10:20 PM

Hi Nibbles,

I assume that you are seeing an oral surgeon or a dentist who performs ALOT of oral surgery?

Sometimes dentists do not fully explain a procedure to a patient because every case is a little bit different and they don't want the patient to get "stuck" on something they said and needlessly worry. Sometimes a dentist will get the feeling that a patient would prefer to not know too much and other times the dentist is just not that good at explaining things!

It sounds like you have had an ongoing problem that took alot of steps to get properly diagnosed. I'm glad that the CT scan was done and showed the area of infection. What were your symptoms and did you have any dental pain?

This type of situation can be a bit complicated depending on how much of the sinus has been affected by the infection. Although the CT scan shows a detailed picture, the surgeon won't know the extent until he removes the tooth. It is sometimes difficult to eradicate a long standing sinus infection from a tooth even once the tooth is removed. Antibiotics will be prescribed until he feels the infection has cleared.

As for the surgery itself, it's similar to any other extraction it just may take a little longer to debride the area and close the sinus membrane. It should not be painful to you during the procedure. Post operative pain is different for everyone and it depends on the surgery and your threshold of pain. The risks of this type of surgery are the inability to close the sinus due to the infection and a constant draining occurs. This eventually needs to be remedied because it will cause a chronic infection and can cause you to feel unwell. Another risk is breaking off a root tip in the sinus. If this occurs, then the root tip should be found and removed or the area will not heal properly. Both of those risks are very small and you should not concern yourself about either of them!!

It is imperative that you follow the surgeons home care instructions to the T. It is also very wise to prepare your diet ahead of time so you will have plenty of nutritious foods to eat and drink. Your immune system will need to be healthy while healing. Many times after we have surgery whether we are in pain or not, we just don't feel like doing anything........... so prepared meals that are easy to cook are ideal! Eat light and often, non spicy, no sugar, soft foods high in protein if possible. Drink lots of water and don't use a straw.

Homeopathic remedies that seem to be very helpful are hypericum, arnica, ruta, aconite, gelsemium, ledum, and phos. Sometimes you can purchase these together in one pill. This remedy helps to relieve anxiety, tissue and nerve trauma, bleeding, soreness and brusining. We use a formula with all of these ingredients called Pre Dental Procedure by Arrowroot. It is meant to be started the day before, then the day of and then continued for a few days after the procedure.

Arnica pellets can be used alone after the surgery as a pain killer and tissue healer. Our patients take it about 4 times a day for at least a week post operatively and some say they experience no pain or swelling!!!

If you are a smoker, now is the time to stop. Smoking can prevent the area from healing which could lead to multiple surgeries to close the sinus.

Please let us know how you are doing ~">"~

Bryanna

Hi Bryanna, I hope you're still around :) I've been to a dental surgeon (after much debating with medical specialists and a CT scan) for what they've finally agreed is a severely abcessed tooth that has invaded deep into the sinus cavity.

I'm booked in for surgery on the 27th, I'm just wondering if you can tell me anything about what to expect/are there any risks associated with this surgery?

The doctor doing the work comes highly recommended, and seems to really know his stuff, but isn't very good at explaining what to expect :(

I'd really appreciate any insight you or anyone else can give.

Nibbles

05-20-2008, 12:44 AM

Thank you so much for your reply Bryanna :)

I've been having severe headaches for about three years (which is around about the time that I had an extremely bad cavity filled- the dentist at the time wanted to avoid doing a root canal, even though the cavity was very deep. I was happy to save the money so I didn't object ;) )

I started noticing a rotting smell, and I was getting dizzy spells a few months after. I went to the Dr who suggested a sinus infection and gave me antibiotics. It cleared up for a while, then same thing, same diagnosis.

Long story short, it all started getting worse about 6 months ago- I was so run down and sick, infections were cropping up all over- I had a lump the size of a fist on the back of my head under my hair, and several infected lumps on my legs and face. I was getting reoccuring strep infections. The tooth was so painful and headaches so severe that I was waking up in agony every night.

Since the tooth hurt I thought I'd go back to the dentist and get the root canal in the hope that it would solve some of these issues. The dentist that I saw was the head of the practice, he took an exray and insisted that it was a really bad sinus infection, nothing to do with the tooth.

I went back to the dr. He gave me more antibiotics and ran some blood tests, and I asked him to please refer me to a specialist for the sinus problems. Came back that I had glandular fever, a severe iron deficency.

When I went to the sinus specialist, he sent me for the CT, and referred me to the dental surgon. It looks like (from the scan) well over half the sinus is bad :( And you can see the tooth in the sinus.

The dental surgon seems really good, and he does quite a few of these. I think I'm just freaking out a bit- I feel like I've been sick forever. This has really knocked me flat and is driving me crazy- I can't keep things straight in my head most days because I have such a headache/spacey/tired feeling.. I cannot wait to get this fixed.

Thank you again. I really appreciate all the advice, I'll pick up some arnica before next week, and I've let hubby know he is my slave for the recovery time *evilgrin*

What is the average recovery time for something like this? I've taken 4 days off work, and then have another 2 days over the weekend- do you think that is too much, or too little, or appropriate?

Bryanna

05-21-2008, 12:05 AM

Hi Nibbles,

You have certainly had a very rough time. I am so glad you posted here because this is what can happen when an infected tooth remains in the mouth. Other infections can crop up anyplace in or on the body as the immune system becomes burdened. Infected teeth in the upper arch of the mouth can cause sinus infections. It is NOT uncommon for people to be misdiagnosed and repeatedly treated with antibiotics for sinus infections when the tooth or teeth are what is causing the sinuses to be infected. As long as the infected tooth is present the other areas of infection will not get better until the infected tooth is removed.

We have alot of little membranes in our sinus cavity. Chances are that this tooth has infected the area of the sinus around the tooth root. Once the tooth is removed, the area of infection will be visible to the surgeon and he can clean it out and repair the membrane. Keep in mind that this is done all of the time, it's nothing new. Hopefully, he will have the access he needs to do that through the oral cavity. Sometimes (rarely) the person requires additional sinus surgery to remove the infection. Did he talk to you about that at all? I'm sure he will do everything he can to try to avoid any additional surgeries. You do have a complicated situation but rest assured that the surgeon deals with this situation all of the time and he is prepared to deal with yours.

You will feel SO much better when that tooth is gone and your body has an opportunity to heal that area. Your immune system will be SO happy!!!

Please follow his instructions and make sure you eat nutritiously and drink lots and lots of water post operatively!!

The time you have reserved from work should be adequate. It really all depends on how extensive the infection is in the sinus. If you stay healthy post operatively, your healing time will be quicker. You will be on antibiotics for awhile. If you are not supplementing with a probiotic, it would be very wise to do so. Antibiotics destroy all of the good bacteria in the intestines which can lead to long term intestinal issues and actually slow down the healing process. In our office we recommend a probiotic called Culturelle. You can buy it online at culturelle.com or in a large drug store. It is best to start taking it now and then continue for at least a few months post operatively. For optimal health, it is best to supplement with a probiotic daily for life so the intestinal bacteria has a large abundance of good bacteria for times of stress and so forth.

Please keep us informed of how you are doing ~'.'~

Bryanna

Thank you so much for your reply Bryanna :)

I've been having severe headaches for about three years (which is around about the time that I had an extremely bad cavity filled- the dentist at the time wanted to avoid doing a root canal, even though the cavity was very deep. I was happy to save the money so I didn't object ;) )

I started noticing a rotting smell, and I was getting dizzy spells a few months after. I went to the Dr who suggested a sinus infection and gave me antibiotics. It cleared up for a while, then same thing, same diagnosis.

Long story short, it all started getting worse about 6 months ago- I was so run down and sick, infections were cropping up all over- I had a lump the size of a fist on the back of my head under my hair, and several infected lumps on my legs and face. I was getting reoccuring strep infections. The tooth was so painful and headaches so severe that I was waking up in agony every night.

Since the tooth hurt I thought I'd go back to the dentist and get the root canal in the hope that it would solve some of these issues. The dentist that I saw was the head of the practice, he took an exray and insisted that it was a really bad sinus infection, nothing to do with the tooth.

I went back to the dr. He gave me more antibiotics and ran some blood tests, and I asked him to please refer me to a specialist for the sinus problems. Came back that I had glandular fever, a severe iron deficency.

When I went to the sinus specialist, he sent me for the CT, and referred me to the dental surgon. It looks like (from the scan) well over half the sinus is bad :( And you can see the tooth in the sinus.

The dental surgon seems really good, and he does quite a few of these. I think I'm just freaking out a bit- I feel like I've been sick forever. This has really knocked me flat and is driving me crazy- I can't keep things straight in my head most days because I have such a headache/spacey/tired feeling.. I cannot wait to get this fixed.

Thank you again. I really appreciate all the advice, I'll pick up some arnica before next week, and I've let hubby know he is my slave for the recovery time *evilgrin*

What is the average recovery time for something like this? I've taken 4 days off work, and then have another 2 days over the weekend- do you think that is too much, or too little, or appropriate?

Magi

09-05-2008, 12:23 PM

After 13 months and numerous visits to the dentist for tootaches, I am considering (leaning more toward) having my #3 molar removed as it has an obvious and deep penetratrion to my sinus. My dentist has encouraged me to "save" the tooth as it appears to be healthy and teeth #1 and #2 have previosuly been removed. His suggestion was to have a root canal and subsequent crown. I understand the reasoning for necessity in chewing, however, I suffer from headaches and sinus infections at a rate of nearly 1 per month/6 weeks. The last 4 have been very severe in nature and almost debilatating as it is hard to function with a migraine type of headache and all the pleasures of runny nosy, sore throat, ear-aches, dizziness, and the added bonus of infections in the roof of my mouth and gums behind my upper right teeth. My question is basically will it be a huge detriment to me in the future (I'm 35 years old) if I demand to have the tooth extracted? I like my dentist, I think he knows what he's talking about BUT is it really necessary to go through a root canal/crown (and the expense) when I should just have the tooth removed? I do have an appointment scheduled with a dentist who specializes in endodontics (he was referred by my dentist). Should I keep this appointment or head straight to an oral surgeon? I guess I'm really just looking for justification of what I want to have happen =/

Thanks for taking the time to read.

Bryanna

09-05-2008, 02:49 PM

Hi Magi,

You are faced with a complex situation. However, I can simplify it for you but only you can make the best decision for you.

A root canal is done in an attempt to TEMPORARILY retain a tooth in your mouth. Once the root canal is done, the tooth is nonvital (dead) due to the severing of the nerve which connected the tooth to your blood supply. Keep in mind that every living organ and body part including teeth require nourishment from the blood supply to be healthy. During a root canal, some of the nerve material is removed from the larger canals but the millions of microscopic canals inside the tooth that are not accessible will continue to harbor nerve material that becomes necrotic due to the lack of nourishment because of the lack of blood supply to the inside of the tooth.

I emphasize temporarily because most dentists do not inform their patients of this fact. They also do not inform patients of the necrotic material that remains in the tooth nor what this necrosis eventually does to the jawbone surrounding the tooth. In your case, your sinuses would also be affected by this necrosis going on in the tooth and bone.

It does not matter what specialist you see to perform the root canal procedure.... it does not matter what instrument is used or not used.... even laser root canals can only debride the large canals because a laser beam can only travel in a straight line and the microscopic canals are windy, curvy, loopy and incredibly tiny. Even the best of the best cannot sterilize a tooth so it is ridden of all of the necrotic nerve material, it's just not possible.

So in a sense, you currently have a chronic sinus condition that is undoubtedly going to be very hard to get rid of, but not impossible if all of the irritants are removed. Keeping a dead tooth in or near a chronically infected sinus may keep your sinus condition at status quo or could make it worse.

Chewing will be a challenge, at least temporarily if you decide to remove that molar. But you may be able to replace it with a removable appliance or a dental implant some time in the future.

I leave you with this one last thought.....
Countless literature informs us that there is no place in the body that it is medically or scientifically acceptable to keep a dead body part. If you are curious about that, ask your endodontist why it is then acceptable and healthy to keep a dead tooth in our mouth which is the opening to our entire immune system?

I know this is a difficult decision. But sometimes we just have to step away from the symptom and evaluate what the condition is doing to our overall well being.

Please keep us posted on how you are doing! We wish you all the best!

Bryanna

After 13 months and numerous visits to the dentist for tootaches, I am considering (leaning more toward) having my #3 molar removed as it has an obvious and deep penetratrion to my sinus. My dentist has encouraged me to "save" the tooth as it appears to be healthy and teeth #1 and #2 have previosuly been removed. His suggestion was to have a root canal and subsequent crown. I understand the reasoning for necessity in chewing, however, I suffer from headaches and sinus infections at a rate of nearly 1 per month/6 weeks. The last 4 have been very severe in nature and almost debilatating as it is hard to function with a migraine type of headache and all the pleasures of runny nosy, sore throat, ear-aches, dizziness, and the added bonus of infections in the roof of my mouth and gums behind my upper right teeth. My question is basically will it be a huge detriment to me in the future (I'm 35 years old) if I demand to have the tooth extracted? I like my dentist, I think he knows what he's talking about BUT is it really necessary to go through a root canal/crown (and the expense) when I should just have the tooth removed? I do have an appointment scheduled with a dentist who specializes in endodontics (he was referred by my dentist). Should I keep this appointment or head straight to an oral surgeon? I guess I'm really just looking for justification of what I want to have happen =/

Thanks for taking the time to read.

Magi

09-22-2008, 11:09 AM

Well, I met with the Endodontist who barely examined me (he didn't look at the tooth directly) and told me the tooth looked good based off the xray from my regular dentist. I now wish I had kept a copy of that xray to post here. He stated that all teeth penetrate the sinus cavities in that manner. This one was well into the sinus, not near it, but actually in it. However, it has been close to 2 months, I still have the same toothache/headache and general pain in that are of my mouth (behind the tooth in the gums). I just feel at my wits end here. If I have the tooth removed because I "feel" like it needs to be but it doesn't correct the issues, what then? I wonder if when tooth #2 was removed my sinus cavity was perforated causing an opening to remain untreated. Could that be the cause of this? If so would an ENT specialist be capable of repairing it after so much time has passed (12 years)?

Bryanna

09-22-2008, 07:04 PM

Hi Magi,

It is difficult for conventionally trained dentists to think outside of their basic training. Unfortunately, they are not taught about the whole body connection, they are taught to be tooth carpenters. Unless they have sought additional education about how the teeth/oral health affects the rest of the body, they rarely look past the "tooth" of the matter.

Perhaps you misunderstood him or he misspoke because it is absolutely not true that ALL teeth penetrate the sinus cavity. If that were the case, then every person who has ever had a tooth extracted would have a sinus exposure....... completely false. In some people, the upper posterior molars are in or near the sinuses. In others, there is little to no correlation between the teeth and their sinuses.

The teeth and sinuses can be in close proximity for a variety of reasons.

1) Rarely but sometimes large sinuses and/or long rooted posterior teeth in healthy people.

2) Missing teeth in the upper molar region of the mouth will cause the sinuses to eventually hang lower as they fill up the space that was once a tooth.

3) Normal size sinuses that have become inflammed or infected will swell. As they become larger, they press down on the roots of the correlating upper molars. The inflammation/infection can be severe enough where the membrane perforates and infects the tooth/teeth.

4) The infection from a tooth can proliferate into the sinus through a perforation in the membrane which will cause the sinus to swell.

There is a strong correlation between chronic sinus infections and tooth infection. As there is just as strong a correlation between a tooth infection and a sinus infection. ENT's are more likely to discuss this issue than a conventionally taught dentist. The reason being is because the ENT has performed sinus surgery on people who have had sinus infections that were clearly tooth related.

Yes, there is always a possibility that when #1 or 2 was removed that there was a sinus perforation and due to infection or necrotic tissue left behind, the membrane never closed completely. The fact that you had the other two molars removed indicate that there was some type of infection going on up there 12 years ago. The fact that you still have chronic issues in that area of your mouth along with chronic sinus infections in spite of removing those teeth may mean that you have an unresolved long term infection going on in that area of your mouth.

Our bodies are marvelous at fighting infection. But when a bad strain of bacteria overwhelms a particular site of the body, the immune system cannot ward it off any longer so the bacteria travel in the bloodstream to another area of the body to set up shop there until that area becomes saturated and the process continues. The healthy mouth has over 400 different strains of bacteria, both good and bad. So most oral infections are of a variety of different strains of bacteria and as they grow, new bacteria join in. This is the body's way of continually trying to kill off the invaders but it can only do that successfully for a short period of time.

I would seek the opinion of an ENT who would take a CT scan of the sinus. This may be very helpful in determining the cause of the problem. Make sure you explain your tooth concerns to him because the CT scan ordered for dental/sinus problems is different than a normal CT scan.

I think your intuition is telling you something is not right and to ignore this tooth or treat it with a root canal may not be in your best interest.

Please keep us posted on how you are doing! I know this is very difficult, please try to stay positive and forge ahead with your intuition!!

Bryanna

Well, I met with the Endodontist who barely examined me (he didn't look at the tooth directly) and told me the tooth looked good based off the xray from my regular dentist. I now wish I had kept a copy of that xray to post here. He stated that all teeth penetrate the sinus cavities in that manner. This one was well into the sinus, not near it, but actually in it. However, it has been close to 2 months, I still have the same toothache/headache and general pain in that are of my mouth (behind the tooth in the gums). I just feel at my wits end here. If I have the tooth removed because I "feel" like it needs to be but it doesn't correct the issues, what then? I wonder if when tooth #2 was removed my sinus cavity was perforated causing an opening to remain untreated. Could that be the cause of this? If so would an ENT specialist be capable of repairing it after so much time has passed (12 years)?

rams

02-03-2009, 11:05 PM

Bryanna

02-04-2009, 07:15 PM

Hi Rams,

Well I can see that you've been doing some reading! Good for you!

The procedure to remove the root tip depends on where it is located in your sinuses. The Caldwell luc is considered a very invasive procedure and is typically done to remove tumors or large cysts. Sometimes, the combination of the caldwell luc and transnasal endoscopy can be done which is a bit less invasive because the endoscopy is the primary entry from which the matter is removed.

Generally, a root tip that has been pushed into the sinuses is first monitored with panoramic xrays and then a CT scan to see the exact location and to see if a cyst has developed around the root tip. Sometimes no treatment is needed and other times it is best to surgically remove it. If the root tip ends up with a growth of tissue around it like a barrier, it could block off some of the natural openings in the sinuses causing infection and difficulty breathing through that side of your nose.

If it were me, I would have the area monitored periodically to see if any changes are taking place and also be aware of any symptoms of blockage or infection.

If the root tip is not far up into the sinus, then it may be surgically removed with a minor caldwell luc procedure. But it is imperative that a surgeon who is well versed and well skilled in this type of procedure be sought to do it.

Please let us know what you decide to do........ all the best to you!!

Bryanna

Bryanna,

Reading your post, I have one of those "rare" situations to worry about.

During an extraction of my upper molar (nearest to wisdom tooth) the dentist lost the tip of the root. It appears he pushed it into the sinus cavity while trying to extract it.

The root tip is about 1/4 inch long (sized by looking at what is missing from the tooth).

Questions:

1) Is it possible to leave this alone unless it causes problems.

2) If it must be removed is there a better procedure than a Caldwell-luc.

I have researched this on the internet and the normal procedure seems extremely invasive just to remove a small piece of root.

3) Or what would you recommend?

rams

02-04-2009, 10:36 PM

Many Thanks,

Similar to what I had planned, have it xrayed to find out where it is at and go from there.

But you have given me more insight on what to watch out for... thanks again.

deborahann24

02-28-2009, 11:33 PM

I began reading this thread because i am experiencing something quite similar. I just learned The roots of my teeth are in my sinus cavaty, which now makes it clear to me why I am so miserbale when i have sinusitus, which is often. Having said this, my dentist told me I absolutley needed a root canal dfor a fractured tooth because removing the tooth would cause the rest of my teeth to begin to drift. The problem is, the only other time I've had a root canal(two years ago) I was in so much pain afterweards I was in bed for three days , with towels and scarves wrapped around my head tightly in order to alieviate the pain. I dread going through this again, as the entire procedure(done in two parts) was absolutley terrible. The surgeon had to stop every few minutes because my motuh, being so small, kept giving him problems as I could'nt keep it open long or wide enough without choking.

The dentist tells me that the root canal is a must because I have one tooth already missing next to the tooth in question, and having two teeth missing, according to her, is unnacceptable due to drifting of teeth. But if i have it removed couldn't I get a bridge or some sort of other procedure to replace the two missing teeth? She told me no, but perhaps I misunderstood her?
Any help would be appreciated so very much. I guess I'm asking is it wrong for me to ask the tooth be removed? I've been made to feel it is. But, the thought of another root canal, after what I went through is making me absolutley frightened.

Bryanna

03-01-2009, 02:48 PM

Hi deborahann,

Generally, not all of the upper posterior teeth are in the sinuses. Perhaps a tooth or two, but not all of them. Unless you have abnormally large sinuses and/or abnormally long rooted teeth...... were you told they are ALL in the sinuses? Could you be speaking about one tooth in particular?

It is totally unfair, unwarranted and illegal to tell a patient that they must have a root canal. First of all, a root canal does nothing to cure a fractured tooth. The fractured area will remain fractured and microscopically open to bacteria. A fractured tooth is not salvagable, not even temporarily with a root canal.

Secondly, teeth do tend to shift in an unnatural pattern when there is a missing tooth next to it. However, this depends on where the tooth is in your mouth. Which tooth are you referring to?

Thirdly, you may be a candidate for a removable partial denture. Are you missing any teeth on the other side in the top of your mouth? A fixed bridge is not a good idea in most cases when there are two teeth missing side by side. This would be called a 4 unit bridge..... the teeth on both sides of the spaces would be crowned and 2 fake crowns would be sodered to the anchor crowns. The reasons this type of 4 unit bridge is not a great idea is because first..... the span is too long in the middle which puts alot of pressure on the anchor teeth. Secondly, if anything goes wrong with either anchor tooth, then the entire bridge would have to be remade and additional teeth would have to be crowned to hold yet another longer span bridge.

Even if you are not missing teeth on the other upper side of your mouth, there is an appliance called a Nesbitt that may work in your case. This is a small removable partial denture that just snaps into the space where the missing teeth are. It has gum colored clasps that snap along the gumline on the "anchor" teeth and 2 white false teeth adhered in a gum colored acrylic in the space. It is meant to hold the space open and prevent the "anchor" teeth from shifting. If your dentist is not familiar with this type of appliance, then I would seek someone else who is. You could do that by calling different dental offices and specifically asking if they make Nesbitt's that replace 2 missing teeth side by side.

The experience that you had with your previous root canal treatment is horrible! When that happens, it means that there is still alot of bacteria in that tooth and the pain is from the pressure of the inflammation. The only way this pain subsides is either the tooth is removed or the bacteria has managed to find a temporary escape out of the tooth. However, the bacteria is still harboring in the tooth and the escape route is something that does not resolve, the bacteria is always draining there. By any chance is this root canaled tooth in your upper jaw...... near a sinus?

You have every right to not feel pressured into doing any particular thing. There are usually options and you should be told what they are and how they can affect your other teeth and your overall health. It sounds to me like this dentist just wants you to do what she says and ask no questions. I would seek another dentist ..............

I'm sorry you are having this trouble... I wish I could help you make it all better. But you really should seek some options and weigh out the pros and cons of all of them so you can decide what is best for you.

Please keep us posted on what's going on........ we're here if you have any questions!

Bryanna

I began reading this thread because i am experiencing something quite similar. I just learned The roots of my teeth are in my sinus cavaty, which now makes it clear to me why I am so miserbale when i have sinusitus, which is often. Having said this, my dentist told me I absolutley needed a root canal dfor a fractured tooth because removing the tooth would cause the rest of my teeth to begin to drift. The problem is, the only other time I've had a root canal(two years ago) I was in so much pain afterweards I was in bed for three days , with towels and scarves wrapped around my head tightly in order to alieviate the pain. I dread going through this again, as the entire procedure(done in two parts) was absolutley terrible. The surgeon had to stop every few minutes because my motuh, being so small, kept giving him problems as I could'nt keep it open long or wide enough without choking.

The dentist tells me that the root canal is a must because I have one tooth already missing next to the tooth in question, and having two teeth missing, according to her, is unnacceptable due to drifting of teeth. But if i have it removed couldn't I get a bridge or some sort of other procedure to replace the two missing teeth? She told me no, but perhaps I misunderstood her?
Any help would be appreciated so very much. I guess I'm asking is it wrong for me to ask the tooth be removed? I've been made to feel it is. But, the thought of another root canal, after what I went through is making me absolutley frightened.

Hobokinite

06-03-2009, 07:00 PM

I guess I am a professional worrier and procrastinator.

I had a root canal and didn't crown the tooth in time. It has now cracked. Seeing regular dentist tomrrow to see if it can be saved, but my gut says no.

It is the 2nd premolar and I remember it goes up into the sinuses.

I know Bryana said not to worry, but my sinus are bad already from allergies and a long bout of Lyme Disease. My sinuses are usually ful of gunk about now -- Pollen season.

If I need an extraction, I wil see an oral surgeon.

I have been doing things to help my sinuses that I fear I can't do if I get an extraction - like using a neti pot to wash out the sinuses, using nose sprays, etc.

Any advice???

Bryanna

06-04-2009, 08:39 PM

Hi Hobokinite,

No, I am a professional worrier and procrastinator....... please get in line!!!

By now you have probably been to your dentist.... what did he say?

You have good reason to be concerned about hanging onto this tooth, perhaps moreso than someone with a different medical history.

Here's why...
Chronic sinus problems mean chronic inflammation..... lyme disease means chronic inflammation and root canaled teeth are chronically inflammed. So to try and treat one while the others are still present is not going to be very successful. So it may come down to which of these issues can be eliminated the easiest so the process of healing can begin.

It is not wise to use a neti pot or any sinus spray if you have an inflammed tooth in or near your sinuses. Doing so can cause even greater inflammation because there is no place for the pressure of the inflammation to release itself. It is like trying to blow air into an already full balloon.

A couple of ideas...........

One...... consider the option of removing the root canaled tooth as a means of eliminating one source of chronic inflammation. That tooth can be replaced with either a permanent bridge or a removable appliance. Your dentist can explain both of those options to you. It would probably not be wise to replace that tooth with a dental implant due to your chronic sinus issues. At least not until you get a handle on reducing the sinus problem.

Two..... do you have other root canals in any other upper teeth? Inflammed teeth will inflame sinuses. Infected teeth will spread infection to the sinuses. It can be a vicious cycle of inflammation between the sinuses and the non vital teeth. SO when allergy season starts......... the already weakened areas of the sinuses are more prone to becoming even more inflammed. The mucus is the bodies way of trying to rid itself of the irritants.

Three.... have you ever tried accupuncture for your sinus problems? I know of several people, including my husband, who have had great success in reducing their allergies with regular accupuncture treatment.

Four.... if you decide to have the tooth removed....... do not use a neti pot or nasal spray until the extraction site has healed closed because either one could prevent the site from closing. This could take a couple of months depending on how quickly you heal.

What are you using in your neti pot and what's in the nose spray? Have you always had seasonal allergies?

Bryanna

I guess I am a professional worrier and procrastinator.

I had a root canal and didn't crown the tooth in time. It has now cracked. Seeing regular dentist tomrrow to see if it can be saved, but my gut says no.

It is the 2nd premolar and I remember it goes up into the sinuses.

I know Bryana said not to worry, but my sinus are bad already from allergies and a long bout of Lyme Disease. My sinuses are usually ful of gunk about now -- Pollen season.

If I need an extraction, I wil see an oral surgeon.

I have been doing things to help my sinuses that I fear I can't do if I get an extraction - like using a neti pot to wash out the sinuses, using nose sprays, etc.

Any advice???

ThomasJ

08-12-2009, 07:16 PM

Hello Brianna, I just had a upper left side tooth pulled and the Dentist said the root broke off and is in my sinus cavity. She took 2 x-rays and couldnt see it. Then she sent me to a Oral Surgeon. He took one x-ray and couldnt see it! I'm really concerned. Why isnt an x-ray showing the root? I'm freaking out and I need help.

laurynnn

11-15-2009, 11:45 AM

Hello,
I hope Bryanna can help me on this, at least to make me feel less... afraid.
I have had a problem on my upper jaw for a while now, the gum will swollen (only have this in the morning when I wake up) and when I press it a yellow stuff comes out. So I thought this is an infection... due to the fact that I moved to Canada from Spain a couple of years ago, I didn't go to the dentist until my papers were ready.
So I told my dentist about it and he sent me to a Maxillo-facial surgeon. My dentist was saying I'm missing a tooth. My parents never took me to the dentist when I was small so I told him nothing had ever been removed from my mouth.
So I went to the surgeon and he took some x-rays. Apparently, one of my teeth never came out, it seems to be located very close to the sinus and he said that if there is infection it has to be removed....
he also told me that he couldn't guarantee 100% that I wasn't going to have problems with the sinus after, and that he has dealed with problems like this a few times.
he has 30 years experience, I mean, I'm not worried about that, but since he said he has to go through the sinus and that is tricky to remove it when it is in that location... I'm literally freaking out...
I've been reading some people's posts here and in other forums, and they have had some serious problems after surgery.
The operation is next wednesday... how worried should I be?
please reply before wednesday!
thank you.

Bryanna

11-15-2009, 02:31 PM

Hi laurynn,

Your description of your dental problem indicates an infection in what is called a retained tooth up in your maxilla bone and it's possibly partially located in your sinus cavity as well. This is a very different issue from the other posts discussed on this thread here. Your tooth is not present/visible through the bone or gum tissue because it never came down with your other teeth. The other questions here are about teeth that are present (visible) in the mouth and their roots are located in or near the sinus. Different issue altogether.

Your oral surgeon has performed this type of surgery many hundreds of times in 30 years of practicing dentistry. It is a complicated procedure in that he needs to get adequate access to the tooth in order to remove it and that is a bit tricky considering where it is. Depending on how far up it is and how close to the sinus it is will determine if he has to enter the sinus or not. Again, he is well versed on this procedure and will know what to do when he gets in there. Any incisions he makes will be sutured closed and post operatively you will need to take a few days to rest and take extra good care of yourself. It is important to plan a nutritious soft diet ahead of time so it's one less thing to think about at the time. Make sure you have plenty of water to drink and a really great natural homeopathic pain reliever is called Arnica Montana. It can be bought online or at a health food store. It comes in small vials and the pellets are put under the tongue every few hours. You can actually start taking it twice a day a few days before the surgery. Homeopathy is very helpful in reducing swelling and pain for all oral surgery if it is taken properly. The pellets should never be touched, use the cap of the vial to place them under your tongue and you should not eat or drink for one hour after you take them.

As for the post operative problems with your sinuses...... that all depends on how extensive the infection is into the sinus.... how much of it he can remove..... how much of the sinus is affected by the infection.... and your body's own natural healing abilities. It is imperative to be healthy during the healing phase of this surgery. Avoid illness as best as you can, keep yourself well nourished and well hydrated with water...... avoid sugary foods, hard to digest foods, and empty carbs because they all lower the immune system.

I know this is scary but you will be ok. Are you being put to sleep for the procedure?

Bryanna

Hello,
I hope Bryanna can help me on this, at least to make me feel less... afraid.
I have had a problem on my upper jaw for a while now, the gum will swollen (only have this in the morning when I wake up) and when I press it a yellow stuff comes out. So I thought this is an infection... due to the fact that I moved to Canada from Spain a couple of years ago, I didn't go to the dentist until my papers were ready.
So I told my dentist about it and he sent me to a Maxillo-facial surgeon. My dentist was saying I'm missing a tooth. My parents never took me to the dentist when I was small so I told him nothing had ever been removed from my mouth.
So I went to the surgeon and he took some x-rays. Apparently, one of my teeth never came out, it seems to be located very close to the sinus and he said that if there is infection it has to be removed....
he also told me that he couldn't guarantee 100% that I wasn't going to have problems with the sinus after, and that he has dealed with problems like this a few times.
he has 30 years experience, I mean, I'm not worried about that, but since he said he has to go through the sinus and that is tricky to remove it when it is in that location... I'm literally freaking out...
I've been reading some people's posts here and in other forums, and they have had some serious problems after surgery.
The operation is next wednesday... how worried should I be?
please reply before wednesday!
thank you.