Expert: Howard Finnk, D.D.S., P.A., CEO - 1/7/2007

Question
Thanks so much for your help.  You asked if I could let you know what I did.  I have gotten my teeth fixed but I'm not sure if I'm out of the woods on infection lurking in my system.  I plan to get in to my doctor next week to find out.  Here's a timeline of what I did.  The whole thing first hit, Sat., Dec. 9 when I started with the jaw and cheek pain.  Mon., Dec. 11, I saw my dentist and found out I had the tooth infection with a questionable second one.  The dentist put me on the antibiotic Cephalaxin (sp?) for the tooth infection.  He referred me to an endodonist who verified that two upper left teeth were infected and needed root canals.  The endodonist checked two of my right teeth that had started hurting badly and didn't see where they needed root canals but said an eye should be kept on them.  On Fri., Dec. 15th, I went back to my dentist and had extensive x-rays (the office has very up to date technology) on all my teeth to find out the status on them and get a plan started to fixing any other problems. On Tues., Dec. 19, I had root canals on the two upper left teeth by the endodonist. On Wed., Dec. 21, I had onlays on the two upper right teeth, and my dentist mentioned one of those right teeth had decay very close to the nerve.  On Wed.,Dec. 20, also I finished the Cephalaxin antibiotic on Thurs.,Dec. 21 a day after I was off the antibiotic, I started feeling week again and by the next morning, Fri.,Dec. 22, my jaw started aching, then my cheeks, and by the evening, the lymph glands in my neck were swelling up really bad and over the next two days my body felt worse.  I suspected I was dealing with some sort of infection and went to urgent care Sun., Dec. 24.  The doctor there, put me on Levaquin for 10 days and said the Cephalaxin would probably not have knocked out a sinus infection.  That slowly but surely took care of most symptoms.  I went back to the dentist to be certain the right tooth he questioned wasn't a contributing factor and he took x-rays and it didn't show infection.  On Fri., Dec. 29, I had two more onlays done on two other right teeth.  Outside of the two root canals on the left with temporary fillings, and the onlays on four upper right teeth, that just leaves some small to medium cavities on a couple other upper left teeth and some bottom teeth that will only need fillings.  I finished the Levaquin antibiotic Jan. 2 of this week but the lymph glands in my neck are still somewhat swollen and my ears burn just very slightly.  I don't feel weak like I did but I'm not sure if I have my complete energy back and I think as of today, the lymph glands may be getting more swollen again and my cheeks still feel achy to the touch.  I was going to call my doctor on Mon. and see if he could help me determine if the infection is gone.  Both my doctor and dentist although they agree the sinus and teeth are related to a degree, they didn't think that a tooth infection could cause a sinus infection.  Since this whole thing hit, I've been getting treated by my doctor for the sinus infection and by my dentist for my teeth to cover both but my doctor and dentist dismiss that the two could be related even though I've relayed the entire timeline to both. I did read about 10 articles on the internet that said a tooth infection could cause a sinus infection as you mentioned.  Any further advice?  I would guess the tooth infection caused the sinus infection as I had no sinus pain whatsover prior to this and the sinus pain and location I do have it in (concentrated all in the cheeks) is not at all like previous sinus pain I've had with allergies.  How do I convince my dentist that this needs to be taken more seriously in relation to my teeth without offending him?  Should I ask that more x-rays be taken to be certain there is no more infection in my teeth?  Should I call the endodonist that did the root canals and ask if he is knowledgable on the sinus and teeth connection?  Is there any research that you could direct me to that explains or proves that a tooth infection can cause a sinus infection?  If so, how would I present it to my dentist in such a way as to not offend him since he's dismissed twice that the sinus infection was caused by the tooth.  Again, with my lymph glands still seeming swollen and possibly getting worse, I'm not sure if I'm completely out of the woods on infection.  If I can't get help from my doctor or dentist, is there some kind of specialist knowledgable on infection I could go to for a second opinion to be sure I'm not sitting with infection still lurking around?  How can I be certain, all infection is out of my system? I have always taken good care of my teeth with home maintenance and regular check-ups and put all that on hold when I had kids.  I found out in March of last year I had 14 cavities and planned to get them fixed this Jan. when finances would be better.  But my teeth didn't hold out that long.  It's been a huge lesson not to put health matter off and I plan to never again put such things off in the future. Sorry for the length.  I am so grateful for the advice and help.

Kim
-------------------------------------------
The text above is a follow-up to ...

-----Question-----
Can a tooth infection cause a sinus infection?  

Last month I woke up two days in a row with unusual aching in my jaw.  The aching then moved from my jaw to my lower cheeks, however, I had no specific tooth pain.  On day three, I received treatment and advise at my doctor's office for sinus inflammation.  Since I knew my teeth had some bad cavities and the jaw pain seemed so unusual, I went to the dentist the following day just to be certain my teeth weren't causing the problem.  I found out I had a tooth infection.  The tooth did not start hurting until about four days after the initial jaw pain started.  My dentist gave me Cephalaxin for the tooth infection.  One week later I had the root canal and finished the antibiotics.  Two days after being off antibiotics, I suddenly felt weak, then my jaw started aching again, then my cheeks started aching, then a day later the lymph glands in my neck swelled up really bad and I felt worse and worse over a few days.  I was then treated at urgent care for a sinus infection.  The doctor said the Cephalaxin I was on for the tooth infection was probably not strong enough to cover a sinus infection.  It was the most peculiar thing that the sinus problem coincided with the tooth infection.  I didn't have any sinus problems or tooth pain prior to any of this hitting.  Is it possible for a tooth infection to cause a sinus infection?  Or is it more likely that I just happened to have a separate tooth infection and a sinus infection going on simultaneously?
-----Answer-----
Dear Kim:  It is possible for a tooth infection to cause a sinus infection.  It is also possible for a sinus infection to cause tooth infection(s).  If you have several teeth that you know are badly decayed, it will be wise to have them fixed or removed immediately, as you are now likely experiencing the effects of combined tooth and sinus infections, now spreading into the lymphatic chain down your neck.  I consider your condition dangerous, as these infections have been known to constrict your throat, making it difficult or impossible to swallow or breathe.  Don't take this lightly.  Get a complete and comprehensive dental exam, and have the infected teeth fixed if you can, or removed if you cannot have them fixed.  If it weren't for antibiotics (go back only 60 years), you would likely be disabled or dead by now.  So hurry.  Let me know what you did and how it turned out.  dd

Answer
Dear Kim:  Although this appears to be infection of some kind, I believe it has gone too long to be of simple dental origin.  In addition, before your infection and pain and gland issues resolved, the fixing of your teeth was begun.  This adds more complication to your condition, as trauma to the teeth can cause added, sometimes vague, pain.  You did not mention whether your gums have been thoroughly evaluated.  I also do not know if there has been consideration paid to your tempormandibular joint by your dentist.  Plus, I do not know if your physician has given due consideration to other conditions which may effect your glands, that are independent of your teeth and sinuses.  I can't guide you from here about handling your complex set of problems.  If your conditions do not resolve within the next few weeks with your current course of therapy, you need to find an excellent diagnostician with experience in head/neck ailments, who might be able to help sort things out.  You might find such a staff at a nearby medical or dental college.  As I don't know where you live, I don't know what's nearby.  Good luck.  dd