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August 28, 2014 3:01 PM   Subscribe

You are not my doctor, I know, I know. I'm trying to decide 1) which doctor to see, if I go see one and 2) to what degree to panic. There's a spot on my left face that's tender to pressure. My teeth feel it when I touch this spot. Should I go see a dentist? Or should I go see a nose doctor?

Here is too much detail:

I had a very taxing day on Saturday and in the evening I started feeling very weak and general malaise. Then I got a pressure headache in the back of my head and around my eyes and brows. All of sunday I felt ill and had the headache that got worse when I change position. But I had no runny nose or anything like that, just stuffiness and generally felt sick.

Then Monday I started having a sore throat, the lining of my nostrils felt like they were burning and were quite sore, and the whole area under my eye/cheekbone to the side of my nose felt sore and tender to the touch. All the symptoms have been very slowly disappearing up to today (though I still have a sore throat and my nose still burns), and today the only sore spot left is right next to the left wing of my nose (it feels like there's something deep underneath). I can also feel this spot if I stick my finger in my left nostril. Or, from the inside of my mouth, it's all the way above my upper left canine , but like all the way up, to the roof/ very top where gum ends and I guess my lip starts.

When I press this sore spot, it hurts, and my nose feel a little stuffy. More disconcerting though is that my front teeth also feel pressure, and sometime my upper left molar gum feels sore.
On their own, and without touching the spot, my teeth don't feel pain or anything unusual. No biting pain, although sometimes shortly after I touch the sore spot my teeth feel a little sensitive.

Incidentally, near the sore spot--though not exactly-- I got what looks like a pimple since Monday and it's still there. Don't know if it's related.

I feel like it's maybe a dental thing, because my teeth feel it. But also maybe a nose thing? I've had quite a bit of dental work done in the past but these days are extremely diligent about dental hygiene, and at my last check up in June everything looked fine. Could this be an abscessed tooth? Could it be my last unerupted wisdom tooth (upper left) acting up? Or could this be a sinus thing?
Any info, advice, thoughts, comments will be helpful. I am not even sure which doctor to see.
posted by atetrachordofthree to Health & Fitness (18 answers total)
 
Revise: So, the sore spot, accessed from inside of my mouth-- it's really more like a general region that's all the way to the very very top of my gum, but above upper left canine and the two incisors. So, like, a three-teeth span. And the gum soreness I feel are all in the very back -- the last 3 molars.
posted by atetrachordofthree at 3:03 PM on August 28


Not a doctor, but this sounds almost exactly like what I experience during bad sinusitis episodes, especially the teeth pain and a pressure-sensitive spot on the roof of my mouth. I'd 1) see your GP, tell them what you said here (you'll likely get a referral to an ENT) and 2) don't panic even a little bit.
posted by Merzbau at 3:05 PM on August 28 [2 favorites]


This is what a sinus infection feels like.

Hit up your internist/GP and have them give you a once-over. You might need antibiotics, it might be a drink fluids and wait it out thing. I doubt it's something serious or dental in nature.

The reason you're feeling it in your teeth is because your maxilla is basically a terrifying* world of pits and hollows where your sinuses and teeth live. If you have sinus pressure you can definitely feel it in your teeth from time to time.

*Don't believe me?
posted by phunniemee at 3:05 PM on August 28 [3 favorites]


Yeah, sounds like an infection. It might go away by itself or it might go really nasty; go to a doctor, they should be able to clear it up with an antibiotic or w/e.
posted by Sebmojo at 3:08 PM on August 28


yeah, this definitely sounds like a sinus infection. I have a cyst in my sinuses, too, and it's tender when I press it.
posted by sandwiches at 3:09 PM on August 28


Yep, sinuses. You're probably on that teeter-totter point between your immune system fighting it off or tipping over into an infection that requires antibiotics.

I get a double-whammy with my teeth when I'm having sinus troubles - not only are my teeth all up in my sinuses so it all hurts, the post-nasal drip makes my gums raw and swollen back near my throat.
posted by Lyn Never at 3:12 PM on August 28


My dentist has confirmed that teeth can be affected with sinus issues.
posted by brujita at 3:46 PM on August 28


If the six before me weren't enough...when I get a sinus infection, my teeth frequently hurt. In fact, last time I was worried bc the pain was so localized at first to just one tooth, and I really didn't have time for an emergency dental experience. I was actually HAPPY when the pai spread to other teeth bc I know how to deal w sinus issues.
posted by atomicstone at 4:05 PM on August 28


Adding one more to the pile. My first sinus infection, I thought I was losing a filling, it hurt so bad in my teeth. I called my dentist, who listened to my description and said "you have a sinus infection. go to your GP."
posted by KathrynT at 4:16 PM on August 28


Oh yeah, I had this last week, when the weather got down to 65 degrees and very damp. I woke up, feeling a sore spot on my forehead, as if I'd banged into a doorway. The next day, it migrated down into my face, behind my nose and cheekbones. The third day, it was the same, but not quite as worse, but I started crying because it was dragging on me, and then it got better. That was also the day the weather changed for the better.

FWIW, I did do a dose of Advil Cold & Sinus (the stuff you have to sign for at the pharmacy) and it did not appear to do much in the way of helping. The raw feeling in the nose is the worst! Mine cleared up on its own, but I was on the verge of calling my GP.
posted by Marie Mon Dieu at 4:20 PM on August 28


If it continues after the sinus issues, see a dentist. I had the sensitive spot near the corner of my nose. After getting a fancy all around 3D xray, it turned out that the root of my tooth was poking through the bone in that spot. It was fixed with a root canal.
posted by SandiBeech at 4:58 PM on August 28


More disconcerting though is that my front teeth also feel pressure

Yeah, sinus pressure can cause sensation in your teeth, and according to my dentist it's not anything (in general) to worry about. But just because I was told not to worry doesn't mean you shouldn't.

Is your face swollen at all? Infections in that area can easily travel to the brain, so if there are any signs of an infection you don't want to put off getting treatment -- if it gets worse over the weekend with facial swelling you'll want the emergency room, and it might make sense to see a doctor tomorrow just to head off that possibility.
posted by yohko at 6:12 PM on August 28


I do not think there is any documented incident of "brain infection" from a sinus infection. Go for long enough with an infection and you can damage your heart, but you will not infect your brain or do any additional damage in a day. It takes years.
posted by Lyn Never at 6:43 PM on August 28


Lyn Never - brain infections actually are possible secondary to sinusitis (I'd say on the timeframe of days to weeks rather than years), it's just very rare. I've never seen a case of it. Relatively more common in people who are immunocompromised.

Most sinusitis cases are caused by viruses, and so the recommendations generally suggest not treating sinusitis with antibiotics, just treating the symptoms with over the counter medications and home remedies until the infection has been going on for at least a week. As the link points out, most sinusitis gets better on its own, even if it is caused by bacteria. But I do notice that people really enjoy mentioning the possibility of infections traveling to the brain from the face when questions get asked here on the green about the issue… it certainly does sound dramatic.
posted by treehorn+bunny at 6:59 PM on August 28


Sorry if "infection" was the wrong term, Lyn Never, I am not a doctor or any sort of medical professional.

I don't think any of us can be certain the OP has a sinus infection, or something else, or that any of us can know how long the OP has had any sort of infection they might possibly have.

My personal experience with this is from traveling with someone who had a toothache on a weekend where it would have been very expensive for them to see a dentist and we simply did not have the money. When we got to a dentist two days later my friend's face was swollen and the dental staff was very concerned and said that if we had waited any longer that my friend could have had the infection spread to their brain (and it's quite possible this was phrased differently, it was some time ago).

From Medline:

Brain abscess
A brain abscess is a collection of pus, immune cells, and other material in the brain, usually from a bacterial or fungal infection.
...
Germs may also travel from a nearby infected area (for example, an ear infection or a tooth abscess)

posted by yohko at 7:03 PM on August 28


Fun fact! A good dentist will often diagnose and treat sinus infections when your referred pain is localized to your teeth. Mine regularly took X-rays and prescribed antibiotics the year I had sinus infections all the damn time. Get thee to your GP and just say you think you have a sinus infection. Feel better, friend!
posted by Hermione Granger at 7:05 PM on August 28


This image showing where the nerves that transmit sensation from your upper teeth travel from shows you why a sinus infection can be felt in your teeth - the nerves to the teeth go right through that area.

And no worries yohko, you were correct that facial infections can cause brain infections. It's just an extremely rare complication. Most sinusitis will get better without any prescription treatment - see my link above for details.
posted by treehorn+bunny at 7:07 PM on August 28


I do want to be completely clear that my comments are in reference to sinusitis generally, and not about the OP's specific situation, given that I'm not his/her doctor, and thus am certainly not giving medical advice - just thought the information might be relevant given the rest of the conversation here. I agree with the comment above stating that although it sounds like sinusitis is one possible reason for the OP's symptoms, only a healthcare professional who can evaluate them is truly positioned to make any diagnosis or give medical advice.

Also: in the case of an abscessed tooth, some general info that may assist is that the abscess develops from an infection of the tooth root - thus, touching the infected tooth is generally extremely painful.

Generally, the best doctor to see when you're not sure which one to see is your primary care doctor. yohko is right on the money in saying that facial swelling is a sign of a much more urgent issue that should be addressed in the emergency department (or at an emergency dental appointment, possibly, if the swelling is not severe and you're sure the problem is coming from a tooth). Other concerning symptoms of facial infections include high fevers/shaking chills, difficulty with swallowing or breathing, or severe headache.
posted by treehorn+bunny at 8:14 PM on August 28


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