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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5813
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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I had a dental abscess for over four years from one of my upper

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I had a dental abscess for over four years from one of my upper molars. During which about twice a week my upper jaw would swell considerably. I never saw a dentist for it because it was never painful and I didn't have insurance. Well I eventually got insurance and had the tooth pulled after the third root canal in ten years on the same tooth. Now it seems that I have some lingering affects of the abscess. For about the last year Ive had numbness problems in my upper mouth all the way to my forehead area. Its like I cant really feel the front of my head very well. I Also smell this awful scent when ever I turn my head and breath. Lastly, I've had issues with numbness throughout my body. It's like my touch sensitivity is off somehow, and I also have had swollen glands in my neck. Needless to say I'm worried and feel like crap.
Thanks For Your Help!
Submitted: 3 years ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 3 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

Please provide additional information:
  • was the onset of all the listed symptoms simultaneous? If not, please provide an estimate of the duration of each of the listed symptoms.
  • did you consult with a dentist since the onset of these symptoms? If so, what tests were performed? What diagnosis and/or treatment was provided?
  • did you consult with your primary care medical doctor? If so, what tests were performed, and what diagnosis was offered?
Answers to ALL these questions will allow me to provide a more relevant and accurate response...
Customer: replied 3 years ago.
The jaw numbness and most of the other symptoms started about a year ago. The jaw swelling and pussing started at least three to four years ago. I consulted with my dentist about eight months ago and he pretty much just put me on antibiotics and sent me to get a root canal. The root canal guy said that there was a lot of work to be done and I should just pull the tooth, so I did. I haven't gone back to the dentist since mainly because I don't think hes that great. In the mean time i've gone to the local urgent care place were they just put me on antibiotics and tell me to take musinex. I also went to a ear nose and throat specialist because I thought it could of been a sinus or neck problem. He had a CT scan done and said it was normal. He also did blood work that was normal and a sinus culture that said i had white blood cell growth. He then put me on Bactrin for a month and that was that. The only thing I can think of it being is a neck or bone infection, b/c I also have issues swallowing at times.
Expert:  Mark Bornfeld, DDS replied 3 years ago.
Taken individually, your symptoms are non-specific, and could reflect a wide variety of different issues. However, taken together, they strongly suggest a chronic oral-antral fistula-- an opening between your sinus and your mouth that was created at the time of your upper molar extraction. This is a common complication of upper molar extraction, because the root tips of the upper molars are situated quite close to the floor of the sinus, and extraction can inadvertently remove the thin partition of bone that separates the sinus from the tooth.

An oral-antral fistula could cause a chronic inflammation in the sinus, but can also be difficult to detect on a CT scan; in fact, the opening allows sinus pus or other inflammatory exudate to drain out of the sinus, which can eliminate one of the tell-tale signs that would have tipped off the radiologist that you do indeed have a chronic sinusitis. The finding of "white blood cell growth" in your sinus and the "awful scent" to which you refer is further evidence that you have an active sinus infection. The widespread numbness, while possibly an independent issue, is suggestive of the dysesthesia or malaise that often accompanies any systemic infection.

Even though treatment of a sinus infection is not within the domain of dentistry, in your case the cause is dental, and you must close that oral-antral fistula in order for a resolution to your problem. Your real treatment omission was a failure to return to a dentist. I'm not suggesting you return to the same dentist; after all, he was the one that got you into this situation in the first place. You should schedule an appointment with an oral surgeon, so that the proper inspection of the surgical site can be done.

To find an oral surgeon, you may consult the online directory of the American Association of Oral and Maxillofacial Surgeons.

Good luck!

Edited by Mark Bornfeld DDS on 12/24/2010 at 1:18 PM EST
Customer: replied 3 years ago.

I appreciate your time. One more thing; The question I have is the numbing didn't correspond with the tooth extraction. It started about four or five months before the tooth was pulled. The only symptoms that changed at the same time was the swelling of the jaw dissipated when the numbing started (this was about a year ago), not sure if thats when the infection spread to a different area or not but thats what it feels like. One last symptom I failed to mention is that I have had trouble swallowing sometimes throughout the day. But Thanks so much for your Help!!!

Eric H.

Expert:  replied 3 years ago.
I won't comment on numbness outside the head area, because I am unqualified as a dentist to rule out extra-oral, systemic issues. However, it is not unusual for facial numbness to result from dental infection; in both the upper and lower jaw, cutaneous sensory nerves pass close to the tooth root tips, and pressure from dental infection can cause compression anesthesia. In the case of the lower jaw, numbness may occur in the tongue, as well as the lower lip and skin overlying the chin; in the upper jaw, compression of the infraorbital nerve can cause numbness of the lower eyelid, the side of the nose, the front areas of the cheek, and the upper lip. It is relevant to note that the infraorbital nerve runs through the roof of the maxillary sinus.

Dysphagia, or trouble swallowing, is generally not a dental issue, and should be assessed by an otolaryngologist and/or gastroenterologist. This symptom can reflect an anatomic or functional constriction of the esophagus (e.g., esophageal strictures or webs, achalasia, Schatzki's rings, neoplasia), or motor nerve or muscular issue. Dental infections occasionally cause pain while swallowing, and severe lower jaw infection can compress the pharyngeal space and impair swallowing or breathing, but your narrative suggests something less severe.

Good luck!
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5813
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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