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After filling, pain continues to spread sinus, jaw, and neck
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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After filling, pain continues to spread sinus, jaw, and neck

I am 35 years old, and had my wisdom teeth removed when I was 24.  But that's not why I'm posting.

My current problem started roughly 3 or 4 years ago.  My upper right 1st molar had a filling in it...the filling broke, and the dentist I used to have drilled it out and put a very large filling in.

Even since that fateful day, I've had problems on and off.  For the first 6 months or so, the tooth was tender and my maxillary sinus would hurt.  I would have a very low grade fever that would come and go.

Then, I started having this EXCRUTIATING pain in my jaw, in my right maxillary sinus, and down the right front side of throat.  The pain would get very bad for 15 minutes, die out for 15 minutes, come back, die out, come back, die out..etc.  Each time I would have this pain, I would fight it away with Amoxicillin and lots of mouthwash, and it would go away usually for weeks and then it would just come back again like before.

A couple things I noticed...when flossing, a foul rotting smell would come from the back of my mouth.  Also, when my throat was hurting, the lymph nodes of the right side of my neck would be swollen and tender.

The dentist would X-ray me and say there is no abscess.  He would tap on the tooth and it wasn't especially painful (only is occasionally tender when I "chomp" down on it).  In fact, confusingly, the pain which spread to the jaw/sinus/neck would often be very bad and the tooth might barely hurt, if at all.

Eventually, after a while, the condition seemed to have settled down and it went away for well over a year, maybe almost 2 years, with barely any noticeable pain.  Now lately, it is coming back.  IT seems to be worsened or trigger by weight lifting, which I recently picked back up in an effort to lose more weight.

Should I just get the stupid tooth pulled, or what?  Why does the pain spread when before no abscess was seen?  My theory was that food was getting trapped under the filling and between the gum?
540545_tn?1377626518
Any other symptoms such as runny nose, stuffy nose, sinus or nasal drip, etc?  My guess is that it may be a sinus infection which the antibiotics should solve.

You may want to see an ENT (ear nose throat) doctor and see if there's an issue with your sinuses.  When you're exerting while lifting, my guess is that you're moving your head around a bit it can cause some pain that way.  There's fluid buildup in your sinus which hurts when it moves around in your sinus.

This is my guess though based upon your description.
3 Comments
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I am not having any sinus symptoms whatsoever (runny nose etc).  I never had these symptoms before the tooth was re-filled.  And, my tooth tends to hurt when I chomp on it  when the other stuff is bothering me.   Do you really think it's unrelated?
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540545_tn?1377626518
Well, there's a couple of options you can do.

If there is an infection inside the tooth causing the pain, root canal therapy could help.  But since your dentist can't confirm this is needed, going to a root canal specialist (Endodontist) may help to confirm whether or not its necessary.

Another option is to rule out the sinus infection by going to an ENT.  I would suggest seeing the endodontist first since you seem more convinced its a tooth problem and due to the timing issue.  
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