Stubborn sinus infection with a compromised tooth

Before having my implant, my dentist suggested that I might need a sinus lift. My dental surgeon said it would not be necessary(he is quite excellent by the way).

I had the procedure done, it went perfectly--astonishingly professional, quick, and problem-free.

Cut to the crown 3 months later: I had the crown/tooth inserted, everything looked great, but I have had one sinus infection after another ever since. 3 rounds of antibiotics plus cortisone spray this round.

At one point, I even went to my dentist thinking I had a root canal problem, my upper right tooth was that painful (2 behind the implant tooth).
The x-ray did not scream root canal, and the implant looked fine as well--no infection/inflammation present.

My question is: Nothing went wrong with the implant. Only when the crown was inserted. Can I rule out the implant as the cause of my sinus problems since they only began after the crown, not the implant procedure itself??

I am slowly losing my mind. Could this simply be a stubborn sinus infection with a compromised tooth causing pain in the region of the upper right implant? The compromised tooth (big filling) is the one that actually causes pain, 2 behind the implant tooth. Meanwhile, my "sinus infection" continues...whatever the cause.

Thanks for any assistance you can give.

Comments for Stubborn sinus infection with a compromised tooth

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Sinus problem after crowns put on NEW
by: Anonymous

I also am having severe sinus pain after my abutments and crowns were put on. Never any pain when the implants and healing abutments were put on. I kept them on for a year (at a time). This is my third try to put the abutment and crowns back on.....and the sinus pain came right back, big time. I'm ready to get them crowns off again.

sinus infections after implant crown NEW
by: Anonymous

Do you have any gum swelling anywhere in the region? (I do.)
Did your x-rays also show zero infection in the implant site?
I just don't understand how crown insertion can cause sinus infections when the actual implant would be a more logical culprit--yet isn't.
I'm surprised your general dentist actually believed you. Mine simply won't entertain the idea--and I am being sent off to an ENT and/or CAT scan by my GP. Round and round we go.
:(

Sinus problem after crowns put on NEW
by: Anonymous

In my case it's got to be the insertion of the abutment/crown because this is my third try. I have zero pain with the implant and healing cap. I also had a sinus lift.

After my first try at inserting the crown and because it triggered horrible sinus pain I had a CAT scan, went to an ENT, prosthodontist, oral surgeon, periodontist, etc. Also different round of antibiotics and cortisone pills. You name it, I've been there. No one found anything. So I had the abutment/crown taken off. Immediate Zero pain. But like I said I'm on my third try 4/13/12 and now have horrible sinus pain. I guess I have to get them taken off again. How sad. All that time and money and nothing to show for it.

Sounds like your stubborn sinus infection was triggered by the insertion of the crown. Hope we can all find the cause to our problems.

sinus infections after implant crown NEW
by: Anonymous

Thanks for your feedback.

But HOW can I convince ANYONE that this is my problem (and yours;)? Everyone thinks it's just allergies causing a sinus infection. I even thought it was a possible "root canal" tooth in the upper right--3 teeth to the rear of the implant.

Should I go directly to my oral surgeon--who is the best of the best--and skip all the middlemen?? No one seems to be able to help me!!!


Sinus problem after crowns put on NEW
by: Anonymous

Maybe the dentist here on-line will be nice enough and email us a response.

I think if I were you I would go back to your oral surgeon, but I guess you'll have to do the CT scan and ENT to rule it out.

I can't figure out (nor can anyone else) why in the world I am having such sinus pain with the abutment/crown insertion. I only know since I'm on my third try that I do not have sinus problems until the crown is put in. So obviously it is triggering this reaction. I can bite down with no pain. I have no gum pain. Just the horrible deep sinus pain and when I sleep at night no air coming out of that side of my nose. Completed blocked.

Did any of you ever try taking the abutment and crown off and the healing cap back on to see if the problem resolves itself?

I wish someone had an answer for us!


Sinus Infection NEW
by: Sharon B., RDH

Being that you had no pain until the crown was placed on the abutment, I believe we can rule out the implant having anything to do with it. To me it sounds like allergies and a coincidence of sinus infections at the same time as the crown. I would see the Oral Surgeon (specialist) about the sinus infections to get their opinion and if that does not resolve it then see an endodontist for a consultation about the root canal tooth.

You may need to go through a round of steroids with antibiotics to kick it if it's a nasty, persistent sinus infection. The oral surgeon can prescribe the appropriate medication for you.

Sinus Problems NEW
by: Anonymous

To the dentist here.

Could our problems stem from an abutment being screwed on too tight. Does the abutment expand when it's screwed in.

It feels like mine abutments were screwed on so tight that that's what's causing my pain/sinus pressure?

Is that possible? Has anyone else had this problem? I wish I could get some answers before I have the crowns removed for the last time and give up.

Sinus problem after crowns put on NEW
by: Anonymous

Can abutments be screwed on too tight and be causing our sinus problems? I'm having pain/pressure in the sinus area like they were screwed on too tight. My dentist says that's not possible. They can only be screwed on to a certain point.

Is there any expansion or movement in the implant itself when the abutment crown is put on?

thanks.

sinus infections after implant crown NEW
by: Anonymous

Funny you should say that. That was my exact feeling from day one. I felt it was too tight and my problems began immediately after. That said, is it possible that this crown/abutment exacerbated existing sinus issues? I have now cut out dairy, wheat, oats, chocolate, and alcohol in the hopes I can beat this persistent infection cycle from another angle--without removing this implant or going for CAT scans or sinus surgery or worse. I also take Mucinex and Zyrtec and am on antibiotics. So far so good, but it's anybody's guess if I can sustain this once the antibiotics are gone. Yes, I have your exact issue. But you have removed this crown 3 times, yes? And have found immediate relief?? Isn't that a slam dunk?

Sinus problem after crowns put on NEW
by: Anonymous

This is my third try with the abutments and crowns being put on. They were taken off twice. Yes. It should be a slam dunk you would think. The first time was in 2009, second time 2010, third (now)2012. My oral surgeon and his colleagues said I can't leave the implants and healing caps on because there's a high chance of infection. So I kept foolishly thinking everytime would be different and I wouldn't have pain. I have gone for opinions to other specialists and they can't understand why this is happening and offered to "do it another way." Of course I would have to pay them and can't afford it. If I were 100% sure I'd have no pain, of course I would pay someone else, but I know I can't have a guarantee.

Did you ever consider taking the abutment and crown off and the healing cap back on to see if you would still have sinus problems?

I keep telling my dentist and others that I feel the abutments are really screwed on too tight, but they all say "impossible, we can only go so far."

Maybe the dentist on line will chime in.

Stubborn sinus infection after implant NEW
by: Anonymous

I have not been to my specialist yet because my sinus infection/pain misery has only lasted 4 months--not 3 years like yours. But if/when I do, this problem will be solved in 5 minutes flat because he is that good. If you are in the NY area, I can pass his name to you. I was impressed beyond words!!

In the meantime, is it possible, that since this is sinus-related, that your problem is caused--to some extent--by allergies? I know it sounds like a stretch but I'm coming around to the idea that all my sinus infections have been allergy-based, that's why I've cut out all the things I mentioned before, plus added the nasonex, zyrtek, musonex, etc. The pain and misery seem to be so obviously coming from the implant/crown, but I wonder if I've got it backwards. Could our problems be allergy based, with the implant simply being another element on TOP of the underlying problem? A catalyst, if you will? It is odd that my dental x-rays show NOTHING to indicate any problem. Even my intermittent swollen gum in the region could be an allergic reaction. I'm just trying to look at this in a different way because I have spent 4 months in hell and feel helpless. I am feeling "some" relief since starting on this allergy theory. But it's still too early to claim victory;)

sinus infections after implant crown NEW
by: Anonymous

You could be absolutely right about the allergies. I'm just not convinced of that because I've never had allergies and this has been a three-year process for me. You would think the implant/healing cap would cause the same type of pain....but no, it's zero pain.

I live in the LI, NY area. I would really appreciate having your specialists name. Did you have both the implants and crowns done by the same specialist?

I had my oral surgeon do the implants and my dentist do the crowns.

So tired of the pain and this is my last try at keeping the crowns on.

Thank you.

Specialist's name NEW
by: Anonymous

No, my implant was done by the person I'm recommending. My general dentist is the one who put in the crown/abutment. And I can't really say he's sloppy or careless either. He's painstaking. But not in the league of the Doc I'm giving you.

I know the distance is a bit far for you, but all I can tell you is: this doctor put in my implant + bone graft painlessly in what seemed like 20 minutes. Even the visiting surgeon was astonished and called him the "master." I will definitely see him if things go south with this situation. Right now, my sinus infection seems clear, but I still can't really bite down on that affected side of my mouth--there is intermittent gum swelling. Could be allergies, might be something else. I pray it is not that crown. Anyway, here is the info. I would almost prefer going to this guy than getting a haircut. That's how good he is.
http://www.hudsonvalleyimplant.com/
Please let me know what happens. I will be right behind you;)

Sinus problem after crowns put on NEW
by: Anonymous

Thank you for the referral. At this point I have been to many specialists and they don't understand why this is happening and like I said before they are willing to do it their way (but I'd be paying all over again). I just can't believe some people with sinus problems or allergies can have implants, but not the abutment/crowns?? I had a sinus lift.

I have been to other implant/oral surgeons, a prosthodontist (2), a periodontist, an implant specialist, a ct scan, a denta scan, an allergist, an ent, etc.

Only my dentist that did the abutment/crowns knows exactly what she did (and she's good).....and anyone else won't touch me unless they are going to re-do it. X-rays are perfect.

My only chance is by some miracle I get better. And if I don't I'll have them taken off again. Possibly years down the road when I save up some money I'll have someone new do it over.

Hope you're getting better day by day. Let's keep in touch.

sinus infections after implant/crown NEW
by: Anonymous

OK, there is one last ditch effort I am making in the 'natural' arena. It is working so far but I will not bore you until I'm 100% positive-- and back to normal again. I will be in touch;)

Once again, nobody really understands this until they've been through it

Thanks....

Sinus infection NEW
by: Sharon B., RDH

Please be sure to leave your name so that I can respond to the appropriate person.

1. I do not believe that the pain can be from the abutment being screwed in too tight. If you were to screw a metal screw into a casing, you would see that the casing did not expand...it simply fits into it until it does not go any further.

2. I would not put a healing cap back on, but I would leave the abutment.

3. Make sure the occlusion is being checked appropriately and any high areas are adjusted to ensure there is not too much force making its way up into the sinus when you bite down.

4. It is very, very common to have tooth related pain when it is in fact allergies that are the cause. Be sure to see an allergy specialist to discuss these symptoms with them.


Sinus Infection NEW
by: Nancy

Sharon,

Yes. Good idea to put my name since it's getting a little confusing.

It just seems strange that immediately after the abutment and crowns were put on that I had a "zing" in my sinuses and now I'm clogged up and have sinus pressure.

My dentist did thoroughly check the occlusion.

It just seems strange that when the healing caps are on I have no sinus/allergy problem.

Could it be that I'm not an ideal "implant candidate?" I do know a couple of people whose health had been affected tremendously with implants and they had them taken out and they are now fine.

Note to "Anonymous": Please keep in touch and let me know if your natural remedies help. I guess I could possibly have allergies. Right now I'll try anything.

Thanks.

Stubborn sinus infection with a compromised tooth NEW
by: Anonymous

I have not forgotten. Will tell all if this holds!!

Ideal Candidate NEW
by: Sharon B., RDH

Nancy,

Being an "ideal candidate" is based on your bone, oral and systemic health - i.e. is there enough bone structure to support an implant, do you have active periodontal disease, do you have out of control diabetes. I still suspect it is something when you are biting down on the actual implant tooth. Perhaps you should have your dentist try another type of abutment and a shorter crown.

Pain in Sinuses NEW
by: Nancy

I had bone grafting, sinus lift and implants done in one visit. Then it was closed for a year. Then opened up with the healing caps (I believe that was a couple months).

Then to my dentist. I have a custom made (not pre-fab)zirconia abutment and ceramic crown.

When she first put my abutment and crown on it was with temp. cement in case there was a problem. There was a problem. The 2 teeth (individual crowns) were too big looking in my mouth and the color way off (I went right to the lab for them to pick the color but it was still bad). She cut them off and the lab paid for new crowns because it was their fault).

She then put everything back on with temp cement, but I had horrific pain (color and size were good). Trust me I waited it out for as long as I could (a couple months plus).

Her next attempt to get them off because I was in pain failed. She then had to do an endopore(sp). I'm sure you know what that is, but I'll say it for others. She drilled a whole under the crowns and then had to unscrew the abutments to get the crowns off. I was back to the healing caps with no pain.

The second and third try were with the now modified (almost similar to screw retained) crowns and resin filling underneath.

The pain got unbearable the second and now third try. I'm trying to hang in there, but don't think I can.

A prosthodontist suggested thinning out the zirconia abutments. Not sure if that would help. My dentist said it wouldn't.

Sorry this is so long, but it's now try #3. Would different abutments work? I don't know. I would have to pay to have two new ones.

I don't understand having no pain each time the healing caps were put back on.

Thank you.


Sinus pressure NEW
by: Suzy

Hello, I had an upper dental implant placed 5 months ago. The whole time it was healing I would notice that when I touched the healing cap with my tongue that there was a great sense of pressure up into my sinuses. I mentioned it to the dentist who didn't think it was a big deal.
At the 5 month mark I had to prepare for the mould of my mouth for the implant. The dentist screwed in the post (that would be in the center of the crown) and I immediately felt pressure. I was concerned that this is how it would feel when my actual crown was attached. Again I mentioned it but was blown off. 3 weeks later I got the crown and again felt the pressure. So here I am, I just got this crown three days ago and the pressure is driving me nuts. I went yesterday and got a second opinion from another dentist in the same office (mine was in that day) and that dentist said the implant looks great, and the xray is perfect and nothing is wrong. I explained the pressure feeling up into my sinuses, but the dentist doesn't see how that can be when the xray shows that the implant isn't near the sinuses. I'm so upset. The feeling of pressure is driving me mad. I think I need to get this crown taken off..... but then what?

Resolution! NEW
by: Anonymous

After 6 months of sinus infection hell, it took my dental surgeon to figure out the problem--not the implant or abutment--but a right upper-rear cracked tooth!!! He extracted it, then put a sinus membrane to prevent the oral cavity from "communicating" with the sinus cavity.

I am now done with the rounds of antibiotics and misery.

Also, I found quite accidentally that I had allergies which ALSO led to the sinus infections throughout my life. I cut out wheat, dairy, oats, beer, chocolate and felt a difference within a week. I started using gluten free products.

You might entertain any of the above if you cannot get resolution. I was told it was impossible for an abutment to cause sinus infections. In my case it was true--even though I wouldn't have believed it.

Good luck!!

To Nancy NEW
by: Sharon B., RDH

Nancy, a new abutment that is shorter could help. Otherwise I suspect it is a tooth next to the implant.

Implants and Crown Causing Immune Issues NEW
by: Susan

About 10 years ago, I had immune problems to include, systemic yeast (thought I had HIV), muscle aches, shooting pains, allergic reactions to chemicals, alcohol, sugar, etc. I had an immunologist who gave my anti-psychotic prescription because I couldn't sleep?! A primary who gave me anti-depressants and allergist who told me she couldn't help me unless I was obviously allergic?! I don't trust many doctors as they are just people who studied a particular subject a little more than you did. They don't seem to have a whole body approach and really don't know what's wrong with you if you have immune suppressed problems, unless the can test for it, and even then they might not order the right tests.

After much research, it was my Mom who told me that I had an infection and suggested I pull the tooth with the root canal, out. The Dentist made me sign a waiver, and as soon as he injected me, puss came out of the area. Well, after that, all my issues disappeared, including my allergies.


In the last 4 years, I have Sinusitis all the time. I basically lived with Sinex as I couldn't breathe. I also had a baby so I was waiting to "heal" from giving birth. I have digestive issues, bloating, psoriasis, candidiasis, weight gain, water retention to name a couple of ther issues. Well it shouldn't take 4 years to heal from giving birth and now I am on a mission to find out what is wrong with me. Throughout the years, I have confirmed every thing I thought was wrong with me, but it was not the root cause. I am allergic to mold, tea, coffee, chemicals, alcohol, etc. I even confirmed that my sinus breathing issue was connected to my acid level in my stomach. I started nexium and I can breathe a little. I suspect it's because acid level in my body went down and Candida which is in my nose have a hard time surviving in a non acidic environment. This still doesn't tell me what is the root cause.

Today I am thinking it's related to my implants 5 dental implants which was put in at different times throughout the 4 years. Who knows if it's the implants or crown, or what they really use. Contacted, http://www.melisa.org/ for more information.

Unfortunately, there are no Doctors who can help you with this. Just you

We shall see

sinus problem NEW
by: Anonymous

I feel for you and this issue. I have dealt with sinus issues most of my life. I just hada dentist check my 2 upper teeth which have cracked & old filling gone. he showed me the exrayand how close the root was to my sinus . Makes me think twice now about an implant. I venture to say that you may have the srew for ur implant putting pressure possibly to the sinus.

You may want to go see an Ear, Nose , & throat Doctor.
I wish you the best.

Abutments made of Titanium compounds may react NEW
by: Anonymous

Funny that I should come upon this webpage. I have had a dental implant myself not long back, and like others have noted here, I had no problem with the implant or the healing cap. Yet, once the abutment was put on the problems began. It is a lower tooth, so no sinus pain is involved. Instead the gum feels irritated and raw, even so no gum issues otherwise. I had the abutment taken in and out putting back the healing cap each time; yet each time the abutment is reintroduced the problem reoccurs. I went online to read on a possible problem with the metal composition of the abutment and found more than I thought I would. With Abutments made of Stainless Steel, I found it noted online they contain Nickel, Chromium, and Molybdemum; yet also noted is that the nickel in this compound is in a crytaline form, and innert, moreover safe to use even for those that are sensitive to Nickel.
Another article noted that some metals in abutments, if not in an innert form can act like conductors as to generate an electrical charge. Though not familiar myself with that occurance, at least not away that it has occured, even so it may have, it is something I would think should be checked out to make sure that isn't then occuring. Gold alloy, also a compound used for abutments, is moreover precious metal, and not interactive; yet if a custom abutment is made, then hard to say what all is added in, as that is at the makers discresion, not then standard stock issue. The most common used today is Titanium. Titanium that is unlike that of the implant Titanium, that is rarely allergy causing, if combined with other metals, as these articles relate, can be very problematic.

http://www.ncbi.nlm.nih.gov/pubmed/23031726

http://emedicine.medscape.com/article/1076589-followup

Metals that come in direct contact with your gum may be able to interact with your body then if not in a innert chemical form.

Glues to secure the crown to the abutment may also result in alergic reaction in some cases also. In hunting down the culprit as it were tests for Nickel or Titanium allergy may be needed.

Crown causing sinus issues NEW
by: Deb

I had a crown put on two weeks ago. I had NO issues before the crown. After the first day I had a lot of pressure on the tooth and surrounding teeth. One week after the crown I was still having great pressure. I went back, they did some adjustments, but the pressure continued. I went swimming yesterday (two weeks post crown) and as soon as I went under water, my nose started bleeding and my sinus felt sore and pressure filled and the tooth started to throb. There is no way this isn't connected. Any insight would be appreciated.

Sinus and Palate Pain NEW
by: Val B

Had healing abutments placed on dental implants on teeth 11 and 12 two weeks ago. The next day I had pain and throbbing in the area of my hard palate. I took some prednisone and sudafed and it seemed to calm it down a little. That only lasted a day! I have severe pain the ethmoid sinus area (ice-pick headache) and along side of upper nose and the hard palate.

I haven't gone back to the periodontist who placed the implants yet because of the drive. There is nothing remarkable, only a little redness. Went to the doctor today and got a Z pak. Am scheduled to have permanent abutments and crowns in 5 days. I am very apprehensive about going ahead with the procedures if this pain is still present. The dentist says that everything looked good so, of course, he immediately figures it is another tooth problem in the area. The teeth adjacent (9 & 10) are dental implants and show no sign of a problem.

I have appt. w/an ENT in 5 days also.
I've lost a lot of faith in the detection of problems by dentists because I had an implant in tooth 9 that failed because there was a periapical cyst in the area which led to the extraction #10. Four different dentists looked at x-rays and didn't identify the cyst.

After $6,000 to date, I am pretty aggravated that I am again feeling throbbing pain - the most aggravating part is that there is no ready explanation. I'm tired of the dental problems!

help NEW
by: steverik

I am having a dental implant on the next week of this month. I am so scared about this implantation. After reading several problems about the implantation in your blog I am so stressed and scared now. Is there any problem in doing this dental implantation..Medical History Form Template

long but please read NEW
by: Anonymous

Go to specialist at least for the implants. Hello, I have had three implants done .I also had a sinus lift where they added bone for a implant. The dentist put all three implants in crooked and one implant even punctured my sinus. When your implant is put in crooked, the abutement is then crooked and your tooth will be crooked.. One of them needed a custom abutement to straighten the tooth, but still is less than perfect. The implant that is the worst, is far from centered in my tooth space and my tongue would rub against it before crown was put on. In my case dentist tried to conceal this by, making the two molars fatter to keep the outside line even and then he angled my 2 teeth straight downwards which then took away space for my tongue. The teeth looked straight so this was hard to figure out at first. Next , My dentist ground away as much tooth as he could on the inside of one molar but my tongue still rubs against it. My tongue does not touch the roof of my mouth as much on this side of my mouth . I believe more bacteria is being in trapped in my mouth and sinus because of this. I have had 2 bacterial infections after crown was put on my no. 3.

Finding Solutions by Understanding the Causes NEW
by: Anonymous

Here’s what I’ve learned about sinus pain and infections associated with root canals. The ongoing infection is caused by microscopic bacteria that remains in the canal of the tooth and cannot be cleaned out.

The bacteria is the source of the infection which can travel through your bloodstream to the rest of your body and cause a myriad of other problems including diseases and even death.

It may be possible to treat the infection via biofrequencies. This treatment is only available to those who can travel to it and afford it ($1000.)

Since the in place tooth is what allows the infection to remain, another solution is to pull the tooth and replace it with a bridge. (I’ve already spent $3000 on this tooth – believe me, I’m not feeling excited about this option.) But if the alternative is disease, I suppose I will have to warm up to the idea of having wasted the money.

Here’s a link that made sense to me http://www.icnr.com/articles/biological-root-canal.html

During my procedure I tasted bleach and my throat has been mildly sore ever since. When I read about the various toxic "materials" used in traditional root canals, this validated my experience.

Before I take any action, I am also going to research the use of essential oils to resolve this issue. My experience with essential oils has been very positive to date. They work quickly. They soak into your tissues and are absorbed into the blood stream. They seem like the perfect candidate for an easy and cheap resolution.

I’m going to start trying out applications of geranium, rosemary, melaleuca, and possibly clove. I’ll be applying it as close to the infection as I can, which will mean applying it directly to the gums above the root canaled tooth.

Essential oils are usually most effective when applied frequently in small amounts. I’m going to start out applying 2 – 3 times per day. But if, after a couple of days, I don’t feel that this is making a difference, I’ll add more applications. I’d expect to see an improvement within a week.

Good luck. Do your own research. These essential oils (not all) are safe for consumption for humans over 6 years old (more cautiously in children over 6 than adults.) Also exercise more caution for pregnant or nursing women.

Infection after root canal NEW
by: Anonymous

I had pain after the root canal, go to an endodontist, I had two infected teeth that the dentist never saw on an xray! For a year I fought the infection. An infection can travel to the brain and kill you. Move on to another doctor until you get the answers you seek. You know your health better than any one.
Best Luck!

Sinus infection after healed zygomatic implants into checkbone NEW
by: Anonymous

Just wanted to share my experience. I had dental implants for an all-on-four -- two of the implants had to go thru the sinus and into checkbone. Everything went well until they put the final appliance on - then I started with a sinus infection that wouldn't go away. Thought it was coincidence, then thought it was a loose implant. After months of sinus infection, went to the surgeon to see if the implant caused this. He found the abutment was loose which caused bacteria from the mouth to enter into the sinus. He tightened it, gave me two different types of antibiotic (one for each area as they are different) - and "knock on wood" no problems for about 8 months now. My surgeon is awesome!

Crowned tooth extracted and feel 100% better NEW
by: Anonymous

I have been dealing with a crowned tooth pain and sinus infections for years. I also had dull and severe headaches, swelling, and pressure. Last year my dentist indicated that the tooth in question had roots into sinus cavity area causing issues. After several re-occuring infections and a lot of discomfort, my dentist removed the tooth completely. I must say that I'm astonished at my improvement. I feel better than I have in years. No more symptoms associated with sinus and no more pain. My dentist commented that my immune system gets taxed by fighting the bacteria and has caused all my chronic sinus problems. Pull the tooth in question! Best decision I ever made.

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