Question:
First of all, this is a slightly long story as it starts about ten years
ago. When I was 22 years old, I had a dentist who told me that I had
periodontitis and that it required gum surgery. I submitted and
followed all the directions. Several weeks later, I developed an
absessed tooth in one of the molars (6 year molar on the upper left
side) that had been in the middle of the surgical site that had been
sealed up. The dentist admitted that it was likely that this was
because of the previous infection and it not being able to drain
properly. Well, I had the tooth pulled since I was a student and could
not come near affording the money required for the root canal and cap
that I would need. Two days after having the molar removed (and the
wisdom tooth at the back so it wouldn't bother the remaining tooth), I
developed an absess in the remaining tooth. He wouldn't pull it, so I
ended up with a root canal in that tooth. He was also absolutely
incredulous that a tooth that was perfectly fine two days before - no
cavity, etc now had an absess - to the point that when I called him and
told him I had one, he denied that I did have one and I quote "There is
no way that you can have an absessed tooth. It just doesn't work that
way." but that he would reluctantly meet me at his office on a Sunday
to check it out anyway. Needless to say, I was right.
Am I completely off my rocker? Do I need to be more persistent with my
health care professionals to get them to look into this much more
seriously?
Answer:
Odontogenic (this means cause by an abscessed tooth) sinus
infections are quite familiar to dentists and ENTīs. A relation between the
tooth and the sinus maxillaris is very likely. A cure could be
1) removal of the responsible tooth
2) epicotomy of the responsible tooth.
Itīs also imaginable that -during the root canal treatmen- a small amount of
root canal sealant has leaked into the sinus, thus causing the infection. It
can happen easily, because the roots of the upper molars can reach into the
sinus and are in many cases only separated from it by a thin layer of
respiratoric epithel.
If I was in your place, I would go for # 2. Itīs not easy to do, but an oral
surgeon should be able to do it successfully.
Sinusitis is known to sometimes originate from dental disease. It is very
unusual for patients to need 4 sinus surgeries. You may want to visit my
website, and also get another opinion from another ENT or allergist who
specializes in treating difficult sinusitis.
I was just talking to our hygenist about this type of situation. She told me
that during root planings & scalings it is possible to *clip* a lateral axcess
canal, thus opening the site to possible infection that COULD lead to a root
canal. No fault of the hygenist (?)....but I was wondering.. is this really
the case, how often does this happen, AND is there any way (other than to NOT
have the RP's) to avoid this occurance. OR is this a pretty typical thing to
happen, but the chain of events that would lead to a RCT pretty rare?
