Jump to content


Do you want up to date information about Scleroderma? Check out our Medical pages at www.sclero.org for all your Scleroderma questions!


Photo

? About Tooth Extraction W/ Possible Sinus Involvement


  • Please log in to reply
22 replies to this topic

#1 emmie

emmie

    Senior Silver Member

  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 30 November 2006 - 05:03 PM

Hi all,

I know we have a thread about dental problems going. I've been avoiding posting on it because I didn't want to jinx myself. Well, it didn't work! ended up going to the dentist because I had a toothache that started Mon. afternoon. It was pretty bad from then until this a.m. when it actually felt better. I almost cancelled my apppointment, but as it turns out I am glad I didn't.

It seems I have an infection under a crown in the gums, up into the roots and possibly into the sinus up there. I guess it is so bad that a root canal is out of the question. My dentist doesn't want to risk pulling it himself because from the looks of the x-ray the sinus is probably involved. He is sending me to the oral surgeon.

He put me on antibiotics; the earliest I could get in to the oral surgeon is Sat. morning. I also take 2000mg of cellcept daily. Can anyone out there give me any ideas what "sinus involvement" means? I do much better when I'm prepared for possibilities that might develop and don't than to be taken by surprise.

Thanks!
xoxo emmie

#2 CFMBabs

CFMBabs

    Silver Member

  • Bloggers
  • PipPipPipPip
  • 180 posts
  • Location:England

Posted 30 November 2006 - 10:30 PM

This is so close to what I've been experiencing and actually I still am experiencing pain after a tooth extraction.
What you describe is how I would have put the situation about my sinuses as it felt as though the pain was coming directly from there. Sinuses are the passages which run mainly around the nose, throat and up into the head. When you have a cold for instance, the headache, stuffy feeling or tenderness of the face are actually your sinuses. I guess if you have an infection it may well have spread to the sinuses which is what I thought had happened to me. I had pain in my face, ear and head which was just awful. Turns out that my bottom tooth had been dislodged by the new bridge I had placed above and is now loose. I'm still on painkillers and still get pain mainly at night.
I guess that an innocent trip to the dentist can turn nasty with our condition and I totally empathise with you.
Good luck with your surgeon and I hope he sort things out for you!

Best wishes
Barbs xxx

#3 Claudia-DR

Claudia-DR

    Senior Bronze Member

  • Members
  • PipPipPip
  • 78 posts
  • Location:The Caribbean

Posted 01 December 2006 - 02:12 AM

Hi Emmie! I too dread dental issues.

About 5 months ago I had a molar extracted and it healed very nicely. I did stop taking the Cellcept for about 3 weeks prior to the procedure.

You may wish to ask your rheumatologist about that.

I'm sorry though I don't know about sinus involvement.

Healing wishes your way!

Claudia

#4 LisaBulman

LisaBulman

    Platinum Member

  • Members
  • PipPipPipPipPipPipPipPipPipPip
  • 1,135 posts
  • Location:Massachusetts

Posted 01 December 2006 - 02:48 AM

Hi Emmie,
Oh I am so sorry about your tooth! OUCH! Well as you know I am a big chicken so I congratulate you from going to the dentist in the first place. I don't have any insight on your sinus problem but please let us know what the oral surgeon has to say.

Hugs and healing to you.....
Lisa
Lisa Bulman
(Retired) ISN/SCTC List Coordinator
(Retired) ISN Sclero Forums Assistant Manager
(Retired) ISN Assistant News Guide
(Retired) ISN Fundraiser
International Scleroderma Network (ISN)

#5 Heidi

Heidi

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 573 posts

Posted 01 December 2006 - 03:03 AM

Hi Emmie,

I am so sorry to hear about your tooth and having to go to an oral surgeon. It sounds painful. I do hope the oral surgeon is able to help you and all is healed up quickly and with relatively little pain. I will be thinking of you on Saturday. Please do let us know when you can how it all turned out.

Warm wishes,
Heidi

P. S. What are you hearing from your insurance company about Ivig treatments? Any chance that you will get to start those again soon?

#6 janey

janey

    Platinum Member

  • ISN Support Specialists
  • PipPipPipPipPipPipPipPipPipPip
  • 2,118 posts
  • Location:New Mexico

Posted 01 December 2006 - 04:26 AM

Emmie,
YUK! I'm glad you finally went to the dentist to find out what was going on. Better to catch that infection now than later. It sounds bad enough as it is. I hope the antibiotics knock the infection out. Back in February I was having a lot of tooth pain and I too had an infection around a molar that was anchoring a bridge. It hadn't spread into the sinus cavity, thank goodness, so the antibiotics were able to knock out the infection. I did end up getting a root canal once the infection was gone. The endodonist was able to drill through the bridge to get to the root, thus saving the tooth and the $$$$ bridge. I've had no problems since.

BTW - I did do a search on sinus involvement and scleroderma and couldn't find a connection or anything about sinus problems being a common symptom.
The only thing I did find was this article in Media news 2004: Chronic Sinusitis Sufferers Have Enhanced Immune Responses to Fungi. "This study is the first to show a possible immunologic basis for chronic sinusitis, an important starting point to better understand the etiology of the illness" Nothing really relative to your situation.

I hope the antibiotics are fast working and you get some relief SOON.

Big Hugs
Janey Willis
ISN Support Specialist
(Retired) ISN Assistant Webmaster
(Retired) ISN News Director
(Retired) ISN Technical Writer for Training Manuals
International Scleroderma Network (ISN)

#7 Shelley Ensz

Shelley Ensz

    Root Administrator

  • ISN Root Admin
  • PipPipPipPipPipPipPipPipPipPipPipPip
  • 3,261 posts
  • Location:Minnesota

Posted 01 December 2006 - 01:35 PM

Hi Emmie,

I think that "sinus involvement" means that the infection may be near to and possibly in the sinus cavity. An oral surgeon can take greater care in dealing with it than a normal dentist. And on the positive side, oral surgeons often use anesthesia which might mean that you get to sleep right on through the whole procedure.

I've had oral surgeons who have worked on things right in the office, but I had to be hospitalized to have my four infected and impacted wisdom teeth taken out. But usually you can get excited when they refer you to an oral surgeon as generally they make more of an effort to eliminate the pain factor and they are capable of handling more complex situations.

Good luck with your dental adventure. It may make you lisp for awhile...but in emails, we'll never be able to tell. I hope you feel better soon. And then you can dare dare double dare Lisa to follow in your footsteps, before her Official ISN Soccer Tooth (stay tuned for pending video) gets any worse.
Warm Hugs,

Shelley Ensz
Founder and President
International Scleroderma Network (ISN)
Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#8 emmie

emmie

    Senior Silver Member

  • Topic Starter
  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 01 December 2006 - 06:23 PM

Thanks everyone. You are the BEST! Thanks for the info and encouragement.

Lisa, I really can't in honesty take any credit for being courageous. My fear of dental work is what motivates me to go. I have horrendous teeth and gums (a bonus of AI disease in my humble opinion). I have lost count of the number of root canals and crowns I have. I had extensive gum grafting due to receeding gums done in 2003. A lot of that is back to where it was prior to the surgery. I have my teeth cleaned every 3 months. I brush and floss religiously. And it is all motivated by FEAR!!! I sit in the chair all numbed up with the nitrous on totally tensed trying to get my head in "some other place" half the time with tears streaming down my face....it is not pretty. So I can totally relate. I just want you to know that I am not brave. But you MUST make the phone call. I will hold your hand in cyber space.

Heidi--No word yet from insurance on the IVIG. My appeal is in. My neuro wrote a very good letter and sent lots of great info. The RN from his office is wonderful. She has a rep from a company that works with my insurance company and has a good relationship with them trying to get them to agree to doing the IVIG at home. We'll see......So much waiting and in the mean time......Also go back for my 6 month PFT and see the pulmonologist this week. My DLCO was down a little the last time. Hopefully no changes. Thanks for asking.

One good thing, I'm glad the tooth appt. wasn't today. We''re in the Chicago area. Glad I didn't have to tramp out in the snowy windy mess this morning. Took my husband more than twice as long to get to work!

Again, thank you all.

xoxo emmie

#9 emmie

emmie

    Senior Silver Member

  • Topic Starter
  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 03 December 2006 - 05:04 AM

The naughty tooth is gone and all went well. No sinus problems, just lots of decay and infection up there (yucky).

Lisa, did you make the call?? I'll be honest, I was a bit of a wreck--okay, I was a total wreck--but I did it. We have to take care of ourselves including the dreaded dental stuff. Let us know how you're doing with it.

emmie

#10 Heidi

Heidi

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 573 posts

Posted 03 December 2006 - 05:47 AM

Hi Emmie!

I am so glad to hear that your ordeal is now over and no sinus problems! I do hope the infection clears quickly for you!

Warm wishes,
Heidi

#11 Guest_Sherrill_*

Guest_Sherrill_*
  • Guests

Posted 06 December 2006 - 10:51 AM

Well, I suddenly joined the ranks yesterday of those who are having teeth pulled! Ugh!

On Tuesday night I crunched down on something, and heard and felt a tooth crunch below the gumline! It was the tooth next to my eye tooth at the top, right hand side. No 4, the dentist called it.

Actually I had been having problems with this one for some time, so it wasn't surprising, but disappointing nevertheless. Several of my teeth have, over the past few years, been suffering from something called cervical root resorption. This causes the root just below the gumline, to slowly disappear in a circle round the tooth! If nothing is done about it, it eventually "ringbarks" the tooth and the crown falls off, while the root stays in the gum! Incidentally, it is also probably the sclero which is causing this. I'm attacking my own teeth!

My dentist has been doing his best, and when a tooth shows symptoms of this, he does a root canal on it, as destroying the nerve is *supposed* to stop this. He then goes in below the gumline and fills the part which has disappeared. This has worked with some, but the one which has just broken didn't perform as expected.

My own dentist is away, and I had another one yesterday. ( I actually have an appointment with my own on the 18th! The tooth might have waited! :o) She was a good dentist, though I really gave her a problem. She gave me a great local as I barely felt a thing. But I had fractured the root very deeply, so first of all the crown came off. Then one of the two roots came out, but the other one, which was the fractured one, had to be literally dug out in many small bits with all sorts of instruments including the drill!

It took quite some time, and just as she nearly had the last little bit, the suction stopped working! The nurse tried to fix it, but it went in reverse and sprayed blood and water over me! So when I came out my husband remarked it looked as though I had visited the butcher's rather than the dentist! :rolleyes: The poor nurse was mortified, but it washed out OK when I got home. It required the help of another dentist and two other nurses to fix it with the help of a bucket! :lol: In the meantime I was lying there with my mouth full of gauze! Once that was fixed the dentist had to find the last little bit of root all over again, as it was deep, and the suction failure meant she couldn't see a thing, as it was bleeding quite a bit. Once she got going she found the tissues has started swelling, so this made it more difficult, but after 2 Xrays, she finally managed to drill it out!

I'll have to say it's rather disconcerting to have someone burrowing away far up in your cheek! But here's the interesting bit, which has been discussed on this message thread......... She told me NOT to blow my nose for a week! :huh: The reason for this was that the roots of the tooth came VERY close to the sinuses under my eyes, which drain down into the nose. If I blow my nose the pressure difference could cause a rupture/fracture between where the tooth came out and my sinuses, with the resulting risk of infections going either way. So for a week I'm going to need a peg on my nose!

I'm also on a course of antibiotics to *hopefully* prevent me getting a dry socket, as it was definitely a "traumatic extraction" which can increase the possibility of getting a dry socket.

Needless to say I will be following all her directions, but here's the funny one......... the antibiotics I am on usually make me sneeze and cause my nose to run, so the next week may be *interesting*! :rolleyes:

#12 debonair susie

debonair susie

    Platinum Member

  • ISN Support Specialists
  • PipPipPipPipPipPipPipPipPipPip
  • 1,638 posts
  • Location:(United States)

Posted 06 December 2006 - 11:19 AM

emmie,
I'm glad you have your tooth extraction behind you. I also hope you are doing well.

Lisa? Any news about yours?

Sherrill,
WOW!!! You really had an experience, didn't you?! I hope the week goes by without incident, in regard to your extraction. It's bad enough to have to go to the dentist, but when things go as they did for you, it only reminds us how tough/strong you really are!
I wish you a good recovery.
Hugs, Susie
Special Hugs,

Susie Kraft
ISN Support Specialist
ISN Chat Host
International Scleroderma Network (ISN)

#13 Heidi

Heidi

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 573 posts

Posted 06 December 2006 - 11:38 AM

Oh, my Sherrill!

What an ordeal! I can't believe you had to go through all of that. I will be sending lots of positive thoughts your way.....for NO runny noses, NO sneezing fits, and NO dry socket. Please do keep us posted on how you are doing.

Warm wishes,
Heidi

#14 Guest_Sherrill_*

Guest_Sherrill_*
  • Guests

Posted 06 December 2006 - 02:48 PM

Susie and Heidi,

Thank you for your concern. So far so good........ I haven't needed any painkillers since last night, or even during the night, and it's nearly 24 hours now. Hope it stays that way. :)

I will be starting warm saline mouth rinses soon, 3-4 times per day. But I won't be vigorous with them as it would dislodge the clot and leave me at risk again for dry socket! The clot helps protect from bacteria.

The tooth hasn't left a huge gap on the outside, but it certainly feels huge on the inside! My own dentist will have to decide what to do about it as he is the "crown and bridge expert" of the practice.

Susie, it's good to see you posting again. Like you I am a bit intermittent also. Lately I have been having spells of energy, when I do things like replying to messages, then not long after I become really fatigued again. First thing in the morning is my worst time when I am really tired. Probably to do with just finishing the dialysis, and maybe needing my breakfast, though sometimes it's hard to motivate myself to eat, but I feel better when I do.

#15 emmie

emmie

    Senior Silver Member

  • Topic Starter
  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 06 December 2006 - 06:04 PM

Sherill,

I am sitting here with my mouth hanging open just horrified after reading about your experience. I would have been a basket case shaking in tears begging to be konked out!!!!

You get the gold medal for dental courage!!!

Take extra special good care of yourself and finish all the antibiotic! (i figure a nice yeast infection is next after all the pre meds before the dental work and now the antibiotics afterwards--goodie!)

xoxo emmie

#16 Guest_Sherrill_*

Guest_Sherrill_*
  • Guests

Posted 06 December 2006 - 07:50 PM

Now, now Emmie!

Definitely no "nice" yeast infection! :P I only have a 5 day course of antibiotics, so with any luck that should avoid any nasties! Here's hoping anyway! No particular pre meds before either, except the local anesthetic. Thank goodness that worked OK! I had an extraction about 3 years back where the local only partially worked, and it HURT!

The dentist has a picture on the ceiling of the surgery, so I concentrate on that to take my mind off what is happening. I don't look too closely at the different instruments as they approach either! They're not particularly inspiring! :unsure:

When the dentist had the crown off my tooth, she had a good look and said that I had a particularly bad fracture of the root. I said that when I do something I usually do it properly, and she thought it was very funny! But I do seem to specialize in that. :o

#17 emmie

emmie

    Senior Silver Member

  • Topic Starter
  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 07 December 2006 - 06:15 PM

Sherrill,

I'm happy to hear that the yeastie beasties won't be a part of this horrow show, but ###### there's even a picture of the whole affair of the procedure on the ceiling and you watch it!!!!! At this point, I'm not askiing to be konked out, I have passed out!

You not only specialize in funny, you specialize in dental heroics as far as I am concerned.

emmie

#18 Guest_Sherrill_*

Guest_Sherrill_*
  • Guests

Posted 07 December 2006 - 07:38 PM

Uh sorry Emmie!

The way I put it misled you. I said "the dentist has a picture on the ceiling of the surgery, so I concentrate on that to take my mind off what is happening".

What I meant was that there's a picture on the ceiling above the chair in the surgery! Its just a picture which gets changed every so often, and serves to take patients' minds off what is going on. I don't think a picture of WHAT is going on would help at all! :unsure: I don't really think I'd want to watch that! :P

#19 emmie

emmie

    Senior Silver Member

  • Topic Starter
  • Members
  • PipPipPipPipPip
  • 321 posts

Posted 08 December 2006 - 07:10 PM

okay, sherrill, I am glad to hear that the picture show on the ceiling is not of the actual procedure. That really seemed midevil (on purpose misspelling) to me!

xoxo emmie

#20 MaryFanPhilly

MaryFanPhilly

    Silver Member

  • Members
  • PipPipPipPip
  • 120 posts
  • Location:Central California

Posted 09 December 2006 - 03:37 AM

Hey Folks,

Oh my, seems like all our teeth are going at the same time. I too am losing a tooth. I have an old, old crown on a front tooth, and woke up the other day to find it loose. As some of you know, I've been working in the dental field for many years and just knew what was coming. Well, my office took a picture, and of course the root is fractured. And of course it has to come out, and I need a bone graft to fill in the space. I'm ever so grateful that I have friends in the dental community to take care of me, and at a discounted rate no less.

My big thing is to replace the missing tooth. My preference would be an implant but I doubt if I'll get clearance from my rheumatologist for that.... Sherrill, consider all your options before going ahead with bridgework.

Sherrill, I am so sorry for what you went through. Spending years in a periodontist's office I've seen such things and much worse. I once saw a poor woman who had some very bad dentistry- he had placed an implant 6 mm INTO her sinus- chronically infected after several years of course, of the bozo telling her everything was just fine. Well my doctor (who literally wrote the book they use in dental school) had to extract the implant, and the poor woman had draining through her nose and mouth for a long while afterwards, since there was now a big hole in her sinus cavity. It was so awful. The worst part is that she had paid the bozo mega bucks, then had to pay our office more mega bucks to get the job done right.

Well, there are many resources, not the least of which is the Academy of General Dentistry, they have dentists on call 24/7 for advice online. I highly recommend contacting them. Also your own local dental society can be helpful.

My own dentists are becoming experts in sclero, sadly through me and my own experiences.

Lots o'luck to us all,

Love,

Mary in Philly
Diffuse sclero; diabetes; hypertension; GERD with Barrett's