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Please help, Pressure Sensation on cheek after Root Canal
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Please help, Pressure Sensation on cheek after Root Canal

Hi, Please help, I'm really scared. I had 2 root canals done last week, #14 & #13. This all started because I visited a dentist and after taking an xray he noticed I had an abscess on #13, which he thought was caused from an infection on #12 which I had a root canal done on 2 yrs. No symptoms from # 13. He performed the root canal and started a crown on #14. That night I was in a lot of pain and it seemed to be originating from #14, so I went to my endodontist and he performed an open and med. Root canal is incomplete on 14. After the novacaine wore off, I began to feel this pressure sensation on my left cheek above # 13 - I think. The feeling is right below my cheek bone, so kind of high up. I've been on Penicillin since Friday and the dull pain/pressure is still there. It's there all day long and never subsides or goes away. In addition I feel pressure in my teeth and gums but I don't know if that is from 13 or 14. The constant pressure feeling in my cheek is scaring me the most. I don't have any visible swelling, however there is swelling on my gums above #14. Third concern is that I was given an injection on the roof of my mouth and now see a red circular spot in that area. Please help. Thank you.
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373693_tn?1324489102
I apologize for the delay in response.  I just returned from a vacation.

What you have described may be an infection involving the maxillary sinus.  This is an air space above the roots of the teeth in the back of your upper jaw (maxillary bone).  You should seek a consultation with a Board Certified Oral and Maxillofacial Surgeon ASAP.

They would be able to obtain the proper radiograph called a Panorex and combined with a clinical exam localize where the infection is coming from.  The bacteria causing your infection may be resistant to Penicillin and you may require a different antibiotic.

I am wondering if the dentist performed any vitality testing on tooth #13  before the root canal was started and if so, what were the results.  Furthermore, if you have an infection on tooth #12, what is being done about it as antibiotics are rarely curative.

Often times, medications alone is inadequate to resolve the infection and you may require an incision and drainage or other surgical procedure.  When you make the appointment to see the surgeon ask if you should be have an empty stomach for 6 hrs before the appointment.  This may allow the surgeon to sedate you during the procedure.

Keep us informed.

Dr. Kirsch

3 Comments
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Hi Doctor, Thank you for your feedback. I visited an ENT today and he did a panorex, he saw nothing in the xray that suggests infection. He's referred me to a neurologist after I mentioned that I fear it may be neuralgia. I've read online about facial pain after root canals and feared that the most. I wish it was an infection. I'm not sure how strong I am to cope and live with a permanent disorder like that. I'm hoping and praying that this goes away. I have an appointment with an Oral Maxillofacial surgeon on Thursday. And depending on what he says I may remove # 14 or see a neurologist. I'm so scared and lost, I don't know why this happened, I was fine one day and then a complete mess the next day. I started feeling pain in my temple area. The pressure sensation persists in my cheek. Now I'm feeling something in my tonsil area, if I was to point at it, it would be a couple inches below my ear along my jawline. I'm on Clindamycin now after finishing the penicillin. I can't live on pills for the rest of life so I've stopped taking the Ativan and Motrin that's been prescribed to me.
I don't think the root canal should have been done on #13. I had no pain there after he tested, but he said he saw something on the xray. Root canal on #14 is complete now and I have mild discomfort in that area. I wish that it was there and then I'd be more than happy to remove the tooth. But the pain is in different areas of my face, places it shouldn't be if it was tooth related.
Thank you again and if you have further guidance, I'd be happy to receive it.
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428321_tn?1298666741
Hello LostFan,
I'm not sure if you've resolved your issue, but it was the correct call in seeing an ENT for a possible maxillary sinusitis. Did the ENT look inside you nose and attempt suctioning the maxillary sinus? In addition, a panorex is not the proper imaging for this kind of infection. If the ENT was concerned about you having a maxillary sinusitis he would have gotten a CT scan. I would seriously consider getting a second opinion from an ENT before seeing a neurologist or extracting any teeth.
Keep us posted.
Dr Tuchman
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A related discussion, biopsy from roof of mouth causing extreme pain in teeth and roof was started.
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Dr. Michael H. Kirsch
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