Does this sound like a Dental or Sinus Problem?

Question

I'm seven months pregnant. Six weeks ago I had severe pain in my upper left teeth, so I made an emergency dental appointment with a new dentist because I didn't have a dentist. He couldn't find anything wrong and assumed I wasn't in a lot of pain because "I wasn't crying" (exact words from the dentist). He told me to keep taking Tylenol because it seemed to be working for me. The next day I had trouble breathing through my left nostril and green stuff starting dripping out. I spent three weeks clearing it out with saline spray, which my husband recommended. I've never had allergies or sinus problems before, but he has it all the time. Now I have a bubble that is oozing green stuff over the site of where my wisdom tooth should be. Should I try another dentist or should I try a doctor? I can't tell if a sinus problem is causing dental problems or vice versa.

Thank you for all your answers. I have an appointment for another dentist on Tuesday so I'll have to wait and see what he finds.

Answer 1

souns like an abcess call a dentist

Answer 2

I'm a dentist.

I could be wrong, but what you're describing sounds like a fairly serious problem.

Let me describe the anatomy of your midface just briefly:

Your upper teeth are held in the maxillary bone. Your maxillary sinuses sit right above your upper molars, extending as far anteriorly as the second premolars. Generally, the sinus is closest to the first and second molars (so close, in fact, that removing these teeth often results in leaving a hole into the sinus!).

Sinusitis and sinus infections can and do cause generalized pain of the upper teeth. Similarly, dental infections can cause pain of the midface and sinuses.

The fact that you had a stuffed left nare (nostril) and green stuff dripping out is a fairly good indicator that you had some sort of infectious process going on in your left maxillary sinus. If the doctor you had pressed on your midface about an inch below your eye, it would have been very tender. It still might be.

The fact that you are now seeing a bubble inside your mouth oozing the same green stuff is what worries me, as it very well might mean that the infection has broken through the Shneiderian membrane that lines the maxillary sinus, broken through the maxillary bone that forms part of the lateral wall of the sinus, and broken through the mucosa or keratinized tissue that lines the opposite side of the maxillary bone. That is just one possibility. Maybe it is the opposite: maybe it is a dental infection that spread to your sinus. There are other disease processes that come to mind as potential explanations for your signs and symptoms...some of them infections, and some of the not so simple.

Moreover, since this infection has been going on for quite some time (if in fact it is an infection), you may have developed something known as an oral-antral fistula, which is an epithelialized connection or path between your mouth and sinus, and is much tougher to treat.

At this point, you should be referred to an oral and maxillofacial surgeon or an otolaryngologist (ENT). Either one would be suitable for addressing the issue. Needless to say, the oral/max surgeon will be more able to identify dental causes of your problem, while the ENT will be better able to identify upper respiratory causes of the disease.

If you were my patient, the very first thing I'd do is put you on a ten-day course of Amoxicillin. But that's just me.

Answer 3

Since you said that you have a "bubble oozing green stuff at the site where [your] wisdom tooth should be" and also that you have "green junk dripping out" of your nose, I would suggest that you see a dentist or an oral surgeon. For whatever reason, it sounds like you have an "oral-antral fistula." (Maybe you can search this term on the internet...) You will not resolve the sinus infection until this fistula is repaired and that would be within the realm of an oral surgeon or a general dentist who is capable of this type of surgery. If you were not pregnant, I would get you on Zithromax for at least five days and then do the surgery. This would probably still be my choice, but only in consultation with your OB/GYN. Zithro is a "Class B" risk for use during pregnancy. [B: Animal studies show no risk or adverse fetal effects but controlled human 1st trimester studies not available or do not confirm; no evidence of 2nd or 3rd trimester risk; fetal harm possible but unlikely.]

In any event, you clearly have an infection and I believe that the OB/GYN would say that any risk to your baby from the antibiotics outweigh the risk of developing a systemic infection. (For what it's worth, green is usually associated with a pseudomonal infection for which I'd consider Cipro or another quinolone, but they _have_ shown adverse effects to the fetus in animal studies.)

I'd have to ask WHY there was a communication between your mouth and sinus, though. This usually only happens following removal of an upper tooth and you did not mention any recent extractions. If you have not had any extractions, let's just say that it is "curious indeed."

Answer 4

properly sinus or enamel you've an infection is what it sounds like. both way your going to get an antibiotic. usually non-obligatory dental artwork is defered till after delivery except in dental emergencies. i am going to understand you concern of drugs, yet antibiotics are available college b, it really is danger-free. you'll in no way come across a medicine labeled something a lot less bc to be labeled something a lot less means they teted it on preganant human women it really is a criminal offense contained in the U. S.. So what this suggests (being pregnant classification b) its been examined on pregnanat animals and shown to be danger-free. also your concern of drugs, would have some unintentional consequences, that an infection can develop and spread and influence your newborn. So flow to a document and get dealt with. do not danger your well being or your childs well being.

Answer 5

You've got infection there - no doubt about it. Where it started isn't really important now. The important thing is to get it cleared up! Infections so close to your brain are nothing to mess around with. Your dentist sounds like an idiot, so why don't you try finding an ear/nose/throat doc? If they're decent, they can help you even if it started out as a tooth abcess, because it's clearly in your sinuses now. Act fast!

Answer 6

A quick check is to bend over from the waist, if the pressure in your sinus gets worse it is your sinus, however, green stuff in your mouth is very bad especially since you are pregnant. It is safe to have x rays done, just ask for 2 aprons for paranoia sake. It does sound dental related. try a nother dentist that one was a jerk!!!!

Answer 7

it could be both, sinsus can cause dental pain and swelling especially on the upper teeth, but your dentist should have taken an xray then refer you to endodontist for second opinion to see if you need a root canal if he could not find a problem. When you have a bubble on the gum it usually means an abcess but you should always get second opinion,you may need antiobotic since it could be both.you need to make sure you have regular checkups while you are pregnant with your dentist to help keep your gums healthy.

Answer 8

umm that sounds serius FIND A DOCTOR cuz it sounds like your sinus is leaking down into your mouth. instead of down the back of your throat. But i dont no cuz im only 15 but ti sounds like good advice dont it?? well hope you feel better God bless.

PS: could you e-mail what was wrong when you find out if its not too much trouble plz

Answer 9

if dentist took x-rays and still says no problem there then yes it probly is sinus,go to doc.get antibiotics soon,if your pregnant you dont want to put the babys health at risk with this infection.

Answer 10

sounds like a sinus infection i had that be for and the pain was also on one of my eye brows it was weird but antibiotics cleared it up fast even Excedrin aspirins are good they are for sinus pain .

Answer 11

Try talking to your ob/gyn about who to see. Maybe they could help you if it is a sinus infection.

When I was pregnant, I had two sinus infections. It is no fun.

Good luck!!