Severe pain in tooth, sinus, jaw, neck

[Citizen T]

Hi,  about a year ago I had a filling in my upper right molar that broke and was re-drilled and replaced with a large filling.  It's the tooth that's 2nd from the back not including the wisdom tooth which i had removed 5 years ago.    

So, a year ago when I had it re-filled it was rather "sore" for a couple months,  and I experienced and on and off low grade fever for many months as well.   But then after a few months I had extremely severe pain form between the tooth and my maxillary sinus on that side,  and then pain back to my jaw, and below my jaw down my neck with swollen lymph nodes.   Plus when I bite down that tooth and only that tooth hurts.

Well, the dentist took new bite wing X-rays and didn't see an abscess or anything and gave me Amoxil which completely elminated the severe pain in 5 days...

Since then it bothered me slightly from time to time in the sinus/tooth area.  But now I have another very severe pain flare up in the sinus, jaw, neck witih swollen lymph nodes again.   And this time, the Amoxil is only working 60% on my symptoms and I've been taking it 7 days now.  

Now I will be finding a new dentist, probably at the University dental school in my city.   But really the question comes,  since those Xrays showed nothing before, what can this really be?    I know that I never had these symptoms before that tooth was worked on,  but at the same time the pain is in more places that just my tooth.   Right now I'm thinking I don't care if it's pulled, but I'm now also worrying Amoxil isn't getting rid of this infection this time.

I was wondering, do you think if I got my tooth pulled all this would go away?  what else could this be, except for my tooth, and what exactly do you think is causing it from what I describe?

Thanks very much

[Jerome Tsang, DDS]

Well, in terms of effect as in pain relief, yes, it should solve the problem.  But by removing the tooth, you can create other problems such as spacing issues, teeth drifting into improper places, food entrapment, gum problems, etc.  Make sure you discuss all the pros and cons about each treatment before undergoing any treatment so you can make an informed decision.  I would say that if a root canal is possible, it may be the best way to go as teeth don't grow back unfortunately so you should try to preserve as many as you can

[imvron]

I had the same tooth on the left side pulled without any problems, but you really don't want to get that tooth pulled if you can avoid it.  I was going to go the route of a dental implant but decided against it.  I currently have flipper that was cut up by my dentist to be like a nesbit.  It's okay, but annoying at times.  Go the root canal route before thinking about getting the tooth pulled.  Believe me, you might be sorry.  I wish I had gone to another dentist for a second opinion before I had my tooth pulled.  

Best wishes.

[Citizen T]

Just 1 more question...  If I can't afford and/or don't want to go through a root canal,  would pulling that 1 tooth have the same healing effect as the root canal?     Is it more difficult or risky to pull the tooth that is directly connected to the sinus?  

[Jerome Tsang, DDS]

You may want to see an endodontist to see what they say.  An endodontist is a root canal specialist and they may see the need for a root canal which is where I'm thinking is the necessary treatment.

[Citizen T]

Hi,  thanks for the response.   I went to the dentist today who did the work before,  he took new X-rays and saw nothing abnormal (like before).   He tapped on my tooth some with his mirror,  and then blamed my sinuses.   He gave me a different anti biotic,  but I went to my ENT also after I left there and he did an endoscope into my sinuses and said they look clear.   He could feel my swollen lymph nodes.    He, too, suggested different anti biotics,    but here is what I can't figure out... why?   Something is obviously causing this, and it's not my sinuses.    I think obviosly the Amoxil calmed down the pain a great deal for me especially in the tooth/sinus area,  but the bone in my gum is still painful and my glands are still swollen,  plus I think it will just come back like it did before.    Do you perhaps have something else you could add?  

Thanks for your time, I really do appreciate it

[Jerome Tsang, DDS]

It sounds by your description that the tooth has a pulpitis in which the dental pulp inside the tooth is inflammed and causing you pain.  With the swollen lymph nodes and other symptoms, you may be getting an abscess which the antibiotics help to resolve but it not a long term solution.  You should go to a dentist (whether or not you decide to go to the same dentist is up to you) and get it checked out.  It may need a root canal or it may  need to be pulled.

[Citizen T]

Not to keep rambling,  but just an update.   I stopped taking the Amoxil yesterday because I don't like the side effects of lightheadedness.   Right now, it doesn't hurt to bite down, but the bone under my gums above the tooth is sore to the touch,  and it feels like I have a lot of soft tissue puffiness in my jaw and inside my mouth right now,  plus my lymph nodes are still swollen and hurting.    I've been using mouthwash vigorously since yesterday,  I think that's what I did differently last time.  I don't know if it's working yet or not,  but it's not all gone away by any stretch and I figure it'll just flare back up anyway.  Do I need to get that tooth pulled?

[Citizen T]

Yet something else I remembered, I have also noticed that when I walk up stairs or first stand up, or exercise the pain sometimes throbs along with my heartbeat in the tooth area.  In face, I think it flared up when I was lifting weights just over a week ago.

[Citizen T]

Oh and yes, one more thing - I wasn't having symptoms at the time, but 3 months ago my ENT put an endoscope into my sinuses and everything looked normal.