It's like a root canal...on your the middle of a blizzard.
February 13, 2015 12:50 PM   Subscribe

At least, that is what I'm afraid of. Due to intense pain, I'm sneaking in to see my dentist tomorrow morning before the gods dump a seventh foot of snow on Boston. At my last visit he decreed that I need a root canal re-treatment on an upper right bicuspid, and I'd do just about anything to fix this, so I'm on board. But I have some concerns...

YANMDentist, and I'm not looking for dental advice.

There's painful swelling on the outside of my gum just above the upper right bicuspid. Sounds like a root canal situation to me. But -- all on the right side -- I also have post nasal drip, a slight earache, and bad sinus pain that seems to run in a direct line from that swelling, up the right side of my nose and into the area above my right eye. Pressing on the right side of my nose by the nostril is extremely painful. Basically the entire right side of my face hurts, with a slight emphasis on the tooth about to be treated. My dentist gave me some antibiotics, an estimate of how much of my rent money will now be funneled into his kids' education funds, and an appointment for tomorrow morning.

I have a vague recollection that during the original root canal, the dentist was worried about going too far up because he didn't want to hit my sinus. This dentist says that dentist probably didn't go up far enough. Now I'm concerned that he'll drill right through into my sinus and ... the world will end? I don't even know what it would mean if that happened.

Under normal circumstances I'd just say, if something goes wrong and my tooth (or my eyeball) falls into my sinus, I'll just go back to the dentist or the eyeball replacer... wherever you go when something like that happens. But I just got three different blizzard warnings in my inbox, and chances are no matter what happens, I won't be going anywhere on Saturday night or Sunday.

If you've had a root canal on an upper tooth - did your dentist ever mention any danger of a sinus puncture to you? Is that a thing that can happen? Is this a rational worry, or am I just catastrophizing? To be safe, should I put off this appointment until the weather improves (i.e., spring)?
posted by kythuen to Health & Fitness (13 answers total)
This sounds to me like you'll be getting antibiotics and not a root canal tomorrow, making this whole worry null and void.
posted by DarlingBri at 12:59 PM on February 13, 2015 [1 favorite]

Yeah. You most likely (IANAD / TINMA) have a major infection that's probably spread quite a bit. You need a load of antibiotics before anyone even goes near that tooth, and when they do it'll be with a microscope that lets them see down into the canal so they can shape it in such a way that the infection drains. Go to an endodontist, but first, please get on meds ASAP.
posted by marsbar77 at 1:04 PM on February 13, 2015

If you do get an upper tooth root canal, and by some *slim* chance there is perforation of your sinus - it seems that this is something not too difficult to rectify.

I'm sure your dentist is skilled and has good credentials. This does not seem like a frequent occurrence. Good luck!
posted by Everydayville at 1:05 PM on February 13, 2015

Sorry to threadsit - but I've seen this dentist once to examine the tooth, and I've already got the antibiotics - I've been on those since Tuesday morning. Not much has changed since then; the dentist put through a refill for me this morning. Tomorrow is definitely the root canal day.

I checked the web page for the dentist's office, and it says he's a DMD / MD / MS - the DMD is from Tufts University 2006. I... don't think he's an endodontist. Is that bad?
posted by kythuen at 1:18 PM on February 13, 2015

To be safe, should I put off this appointment until the weather improves (i.e., spring)?

Please don't put off getting dental treatment (which likely will begin with antibiotics as mentioned). Dental infections can have very serious consequences -- a co-worker's brother died from an untreated dental infection that spread. Also, please if possible see an endodontist rather than a general dentist -- they are specialists in root canals, with the training, techniques, and best tools to do a superb job on even the most delicate and difficult cases. I actually just saw an endodontist for the first time this past Wednesday -- it was a wonderful experience (an adjective I never thought I'd use in reference to a root canal!), far less painful and much more thorough than any of the several root canals I've had done by general dentists.
posted by RRgal at 1:19 PM on February 13, 2015 [2 favorites]

Do not put it off if you have an infection, even if you have antibiotics. It's miserable and you don't need to live with it. If your dentist is confident it can be taken care of, get it done.

I had a root canal on an upper tooth about four years ago. I had a great deal of pain and infection, and I was incredibly happy and relieved when it got fixed. There was no more pain! It was like magic!

In terms of safety, you have no cause to worry. I had mine done by a student at a student clinic, and while I was not his first, I was definitely in his first ten ever. It turned out fine. Other dentists have complimented the work! He did explain to me the risks, but also explained the risk of a poor outcome-- which is very low. During the root canal, they take a series of xrays to compare to the before image-- it's difficult to go too far because it would be immediately obvious. Also, dental work always feels dramatic and intense because it's rattling inside your head, and you're in pain, but it's actually a series of small, precise movements and procedures that are well-researched and time-tested. So please don't worry about it and just get it over with.
posted by blnkfrnk at 1:24 PM on February 13, 2015 [1 favorite]

I have had a root canal on an upper tooth (very back molar on one side) and the dentist didn't mention any concern about my sinuses. At least not to me - this was done at the Tufts Dental Clinic, so there was discussion between the endodontal student and the faculty/supervisor about things, but no concern expressed to me that I recall. The procedure went perfectly fine - the whole tooth ended up needing to come out later, but that was not an unexpected possibility.

Also, in case something weird and unexpected and worrying happens before your dental appt, and since you're in the Boston area, I'll note the existence of the Tufts Dental School Emergency Clinic - the clinic is normally open M-F business day hours, but the page says you can get service off-hours via the medical school phone line.
posted by rmd1023 at 1:39 PM on February 13, 2015 [1 favorite]

Ugh. Absolutely not a dentist, but a vet of sinus infections whose root cause was an infected tooth. That tooth needs to come out, and the infection drained in order for the sinus infection to improve. If the infection has already moved into your sinuses, all the more reason to remove and drain the original source. Once that's gone, the antibiotics will have a better chance of doing their job. My endo explained to me that it's very hard for antibiotics circulating in your bloodstream to reach infected dental roots - which is why they probably haven't helped up to now. As long as that infected tissue is there, nothing is going to get better.

This is going to sound weird, but even though you are literally numbed to your eyeballs, and not feeling any pain, there is nothing like the feeling of pressure release when the dentist or endo finally gets in there and drains the infection. Try not to smell it though. Disgusting.

P.S. Your eyeball will not fall out, and your dentist will probably not puncture your sinus - although, your sinuses may already be perforated as a result of the infection. It's not a big deal.
posted by ereshkigal45 at 2:05 PM on February 13, 2015 [1 favorite]

Your description of your symptoms sound exactly like what my son had when he developed two abscesses because of teeth that developed hidden cavities - right down to the lump on the gum and (excuse my grossness) epic snot. In his case, after a round of the strongest antibiotics I've even had a kid on, the teeth were extracted because they were baby teeth and the permanent teeth would come down soon enough.

We had no idea about the abscesses until one morning when he said his tooth hurt. Got him to the dentist that day, and I'm grateful we did. This was the most scared I've ever been about one of my kids' health.

This is all my way of saying: take the antibiotics, all of them, and keep your appointment with the dentist. Share your concerns, but GET IT TAKEN CARE OF. You want that stuff out of your head ASAP.
posted by Lulu's Pink Converse at 2:08 PM on February 13, 2015

If you've had a root canal on an upper tooth - did your dentist ever mention any danger of a sinus puncture to you? Is that a thing that can happen? Is this a rational worry, or am I just catastrophizing?

Aww I'm sorry. I'm currently neurotically living with a sinus problem that I've been SURE was a tooth thing, and the dentist keeps saying that I just have sinuses that live right on top of my tooth roots and my teeth are okay (I have different symptoms, but I know what you're feeling). I've also, in the past, had a root canal on an upper tooth. And they did not puncture my sinuses. I was worried also but even though it sounds super creepy and scary, it's a thing that medical people can deal with. And getting the root canal is a really good idea and my experience has been different from ereshkigal45 where me and my mom have both had abscesses (mine small, hers less small) that were alleviated with antibiotics prior to getting root canals.

You are in pain and really stressed out and there's a lot of crazy weather going on, but you're handling things and this will be significantly better tomorrow by the time you get home. Hang in there, I know the feeling but you will be okay.
posted by jessamyn at 3:17 PM on February 13, 2015

Do not put off the appointment, get this taken care of now. I've had root canals in upper teeth and also recently had an abcessed tooth extracted because it was too far gone. It came on suddenly while we were on vacation visiting our son, luckily he got me right in to his dentist and who sent me to a great oral surgeon. Relief was immediate and no complications even when we had to fly several days later.

Infections are dangerous, you want that area cleaned out now. Don't wait.
posted by mermayd at 3:50 AM on February 14, 2015

For what it's worth, on topic of root canals: they have this reputation for being, like, the Ultimate Bad-ass Dental Nightmare Of Pain! So natch I was real freaking happy to learn that I needed one - this was about 5 years ago.

I was totally blown away at just how non-painful it was. I don't know but I'm guessing that root canals used to be awful, traumatic experiences. But over time, the medical tech and procedures have gotten better and better.

My point is: don't freak out over the pain aspect. I think root canals are like a juvenile delinquent from the 1950s: he used to carry a switchblade and be all hard and scared people - but now he's this old fat bald guy who's in lousy shape and drinks a lot and tells kids to get off his lawn and talks to his cats about how kick-ass he was back in the good old days.
posted by doctor tough love at 1:26 PM on February 14, 2015

Many thanks, everyone - your answers were really helpful. I went ahead with the root canal with my regular non-endodontist dentist, and I think -- so far -- it went pretty well. My eyeball didn't fall down into my sinuses; my sinus seems to be unperforated.

It was a bit of an odd procedure, because my dentist did the entire thing himself with no dental assistant. I think she had probably called out due to the storm. But he was extremely careful and pro-active with pain shots. The first shot itself didn't hurt very much, and neither did the second one I needed partway through the procedure. The root canal itself didn't hurt at all; I got the second shot when I reported feeling a twinge of pressure, and after that there wasn't much sensation. So you guys called that one right!

I was in pain later yesterday, and I'm still in pain today, but it's a little less, and it feels basically on-target for how I would expect it to feel. Hopefully things will improve tomorrow!
posted by kythuen at 7:16 AM on February 15, 2015 [2 favorites]

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