I'm sick - Can't get a diagnosis *UPDATE*

[mom of 2 boys]

*UPDATE*

 

10/9 - Well, after another trip to my general doctor, she insisted that she thought it was my sinuses and put me on TWO more rounds of antibiotics along with a round of prednisone (oral steroid) to reduce inflammation. The very day after I finished all of this medication I started getting sick again very quickly. My lungs and eyes were already starting to bother me and my fever started rising out of the "low grade" range, so I made the decision to get the tooth pulled as soon as I could get an appointment. I also got right back on an antibiotic to get my symptoms back under control. I managed to get an appointment for two days later. The oral surgeon insisted that he did not believe that the tooth was causing my systemic symptoms and gave me one last chance to back out, but I insisted that he pull it. I asked for nitrous oxide, and they ended up using it to put me under general anesthesia half way though the extraction. I woke up with stitches on the sides of my gums, so I know that it wasn't a simple extraction. AFTER the procedure, the dentist reluctantly admit to me that there is a small chance that I might get better now. I don't know if he truly felt that way the entire time, or if he found something in my mouth while doing the extraction that changed his mind. I was too out of it to really care at the moment, but so appreciative that he was willing to say that when no other doctor did. My general doctor also did some blood work before the extraction. Everything came back normal except my cholesterol, which is slightly high and my IgA level is slightly high. She is testing me for autoimmune diseases because of the IgA, but I read that those levels go up when you have an infection. 

 

So, I'm on day 5 post extraction. My mouth is healing as expected. I did have some mild night sweats for the first few days after the extraction, but they have stopped. My fever is getting better, and my swollen glands do seem to be smaller at times, but then they swell again, so I'm not sure if that means they're improving or not. They do seem to be changing though, so hopefully that's something (my glands have been swollen for 4 months straight.) I am still extremely exhausted, a bit dizzy, and my eyes are still bothering me though. My symptoms do seem to be very slowly improving, but to be honest, I was really hoping to be feeling much better by now. I am not sure how long it would take to get over something like this though, and since I am the one who made the call to remove the tooth, I really don't have a doctor who can advise me on how long it might take to see a significant improvement. I also have this fear in the back of my mind that I will get better, and then just plummet again once I finish up the antibiotic. If the tooth was truly the cause of my troubles (which I still believe it very well could have been), can anyone take a guess at how long they think it might take to start to feel a little normal? My husband thinks it's going to take at least a week and that I need to try to be patient. Hopefully he's right! 

 

Also, as a side note, I am taking a probiotic now, and I managed to get an appointment with a very good ENT, since I still do have sinus polyps to deal with regardless of what happens with the tooth. His receptionist said he was booked for awhile, but that there was a cancellation, so I jumped on that appointment and I'll be in to see him on Tuesday. 

 

And, thank you to everyone who helped me to have the courage to get the tooth extracted. Not only was it extremely helpful to finally have some validation in my thinking when so many doctors and dentists were telling me that the tooth was not the cause of my issues, but you also helped me to actually walk through the door and get it done. 

 

 

_____________________________________________________

 

Hi there, I was wondering if anyone can help me out here. I had a root canal done on June 1st on a back upper molar. The endodontist did a cone beam x-ray before hand and found that I had 3 cracks in the tooth, but said that there was a pretty good chance (almost as good as a non cracked tooth) that once we put a crown on it it wouldn't be an issue. The reason I had to have the root canal was because I had a large filling in it which led to the tooth becoming sensitive to heat and on-going toothaches which were worsening over time. 

 

Anyway, as soon as the Novocain wore off I was feeling intense sinus pressure above the tooth and pain in my eye. This did not improve by the next morning, so I went back to the Endodontist who told me that eye pain after a root canal is unusual. He said that he suspected it was a sinus infection and put me on a z-pack, which he said would also treat any kind of problem that could arise with the tooth. Two days later I developed a fever and swollen glands. This fever has been with me on and off (mostly on) since that day back in early June. It was the weekend, so I called my endodontist, who advised me to see an ENT and told me that if there was a problem with the tooth, I would have pain and swelling, which I have not ever had. 

 

So, I went to an ENT as soon as possible who ended up doing a CT scan and putting a scope up my nose. He found nasal polyps with the scope and the CT scan showed chronic sinus infections. He put me on a stronger antibiotic, which I ended up being allergic to. After that I went on doxycycline, which seemed to clear up the problem - until I went to get the temporary crown placed on the tooth. Again, a couple of days later I ended up with a fever. I called my general dentist who placed the temporary crown. He took an X-ray and told me that the tooth looked fine. He chalked it up to something viral. This fever started increasing and led to another round of antibiotics prescribed by my medical doctors office. That was about a month after the original root canal. 

 

After those antibiotics, I was okay for a little while (a couple of weeks or so), but then my fevers started returning. My glands have been swollen for pretty much this whole time and I recently had a lymph node in my neck start to swell. I went back to my medical doctor who put me back on doxycycline and referred me to an oral surgeon to rule out any kind of tooth issue that the endodontist missed, but they told me over the phone that they cannot help me when I tried to make the appointment. I went ahead and saw a different endodontist for a 2nd opinion and he reassured me that this is absolutely not a dental issue. I have an appointment with my ENT on Monday morning and I did find an oral surgeon who is willing to take a look at it as well, and I have an appointment with them the following Monday. 

 

At this point, my fingers are starting to swell and I'm having vision issues. It's very difficult to focus on anything and I do have occasional eye pain. I even went to the eye doctor and had my glasses prescription updated (had the new glasses for a week and a half). But I'm not seeing a very significant improvement. I have also had sore throats along with my fevers. I noticed that if I irrigate my nasal passages with a saline nasal rinse, that does help with the sore throat, but it seems to intensify my sinus pressure instead of making it better. 

 

Even though I have had chronic sinus infections (according to the CT scan), I have not ever experienced a relentless ongoing fever like this. I did suspect a sinus issue due to chronic congestion that did not respond to allergy medications of any kind, but I did not have fevers or swollen glands until just after the root canal. My ENT is offering to do sinus surgery on the polyps, but I have not read that people have very good results from this. It sounds to me like the recovery is awful, some people end up with worse symptoms (headaches) and many people's polyps return anyway. I'm not sure that this is really the best course of action. It doesn't sound very promising. I am not even sure that these fevers are even being caused by the sinus issue. 

 

I left a message for my doctor on Friday that I would like to have a full blood work up done, my immune levels checked (my son is immune deficient, I don't know if maybe that means that I could be too?), my thyroid checked and Lyme disease testing just to rule it out (I didn't have a rash, but I do have exposure to ticks.) 

 

Anyway, Does anyone have any idea of what I can try to do to help myself? Should I ask my ENT to put me on a prolonged course of antibiotics when I see him on Monday? Does this sound like some horrible relentless sinus infection that was triggered by the root canal that just refuses to ever leave me? Or does it sound like something else? I am willing to have the tooth pulled, but I keep having dentists tell me that it doesn't need to be, so it's kind of hard to decide to have a tooth pulled for "no reason." Please give me some ideas and opinions. I will gladly give more information if that will help. Thank you in advance!

 

 

 

 

Edited October 9, 2016 by mom of 2 boys

[Pam L in Mid Tenn]

I am so sorry you are going through this. Don't have anything to say really... other than ((( hugs to you ))).

[TechWife]

Did the endodontist do a panoramic X-ray when you went back? If not, I'd suggest it. There may be bacteria trapped under the tooth. Has the tooth had a crown placed on it yet? If not, hold off until this issue resolves. I'd imagine the oral surgeon would do a panoramic X-ray as well. 

 

 

[gardenmom5]

I was also going to ask about if they redid x-rays on the tooth to make sure it isn't infected. also, consider fungus or viral.  antibiotics won't do anything for that.

since you've been taking some pretty powerful antibiotics, I would suggest some very good probiotics.

 

eta: for thyroid - have the reverse t3, free t3, free t4 checked.  tsh is worthless - it is a pituitary hormone that tells your thyroid to make one of 5 thyroid hormones.  totals are also worthless.

 

if the bacteria is within the tooth - oral antibiotics may not be able to adequately treat it because blood doesn't circulate there.

 

 

Edited September 10, 2016 by gardenmom5

[AmandaVT]

Oh I'm so sorry! I'm also dealing with a "is it the tooth or the sinus" issue at the moment, although nowhere near as severe as yours. Did the Dr try augmentin? That's what I'm on right now and it's helping a lot. I have a follow up with the endo next week because they're not sure if I "just" had a sinus infection or if it was a sinus infection + needed root canal. Those upper teeth are so hard to figure out. 

 

Do you wear a mouth guard at night? Could you be clenching your teeth, making the pain worse? (I do and need a guard because of it)

 

Is your Dr. or ENT willing to consult on the phone with the endo? I always wish Dr's would talk to each other to narrow down diagnoses. 

 

Hope you feel better soon!

[Splash]

I think you're going to have to have that tooth pulled. The antibiotics would help for a bit but as soon as i'd go off them the problems would start again.  I went through something similar last year and ended up pulling tooth and haven't had a problem since.  I'm now getting an implant in that area.

[mom of 2 boys]

I am so sorry you are going through this. Don't have anything to say really... other than ((( hugs to you ))).

 

Thank you!

[mom of 2 boys]

Did the endodontist do a panoramic X-ray when you went back? If not, I'd suggest it. There may be bacteria trapped under the tooth. Has the tooth had a crown placed on it yet? If not, hold off until this issue resolves. I'd imagine the oral surgeon would do a panoramic X-ray as well. 

 

No, I haven't had a panoramic X-ray done yet, but the oral surgeons receptionist told me when I made the appointment that they would do a panoramic at that appointment. I did have a permanent crown placed on it. The endodontist told me not to wait more than 4 weeks due to the cracks in the tooth. He was afraid that it would break. 

[momto5blessings]

I think you should pull the tooth, I'm sorry!

[momto5blessings]

I think you should pull the tooth, I'm sorry!

[trulycrabby]

Wow, I cannot believe they have kept your tooth so long. I don't usually say things so strongly, but I really think that tooth needs to come out asap.

 

Upper teeth are especially prone to problems and infection due to their proximity to sinuses and brain.

 

Have you lost weight lately, or been having sweats?

[mom of 2 boys]

I was also going to ask about if they redid x-rays on the tooth to make sure it isn't infected. also, consider fungus or viral.  antibiotics won't do anything for that.

since you've been taking some pretty powerful antibiotics, I would suggest some very good probiotics.

 

eta: for thyroid - have the reverse t3, free t3, free t4 checked.  tsh is worthless - it is a pituitary hormone that tells your thyroid to make one of 5 thyroid hormones.  totals are also worthless.

 

if the bacteria is within the tooth - oral antibiotics may not be able to adequately treat it because blood doesn't circulate there.

 

Well, I haven't had a panoramic x-ray yet, but they did take the standard side view type x-rays. I had the 3 different dentists take those and insist that the tooth isn't infected. The last endodontist said that I would have to have significant tooth pain and swelling in the tooth for it to be causing these kind of systemic symptoms. He told me to tell my doctor to rule out the tooth as the source of the fever. I am still not comfortable with that explanation though, and I'm just not sure that I believe it's that simple. 

 

Yes, I was thinking that I would like to start a probiotic, Does it make a difference what kind I buy? I don't really know anything about them. 

 

And I have had someone mention something along those lines to me about the thyroid testing, I just couldn't remember what it was that she said, so thank you! 

[abacus2]

I think you need to pull the tooth or possibly have the root canal re-done. My guess is some undetected crack in the tooth or missed root (teeth can vary in number of roots) is trapping bacteria and causing problems. If you haven't already, visit different root canal specialist doctor for a second opinion.

[mom of 2 boys]

Oh I'm so sorry! I'm also dealing with a "is it the tooth or the sinus" issue at the moment, although nowhere near as severe as yours. Did the Dr try augmentin? That's what I'm on right now and it's helping a lot. I have a follow up with the endo next week because they're not sure if I "just" had a sinus infection or if it was a sinus infection + needed root canal. Those upper teeth are so hard to figure out. 

 

Do you wear a mouth guard at night? Could you be clenching your teeth, making the pain worse? (I do and need a guard because of it)

 

Is your Dr. or ENT willing to consult on the phone with the endo? I always wish Dr's would talk to each other to narrow down diagnoses. 

 

Hope you feel better soon!

 

 

I'm allergic to penicillin, so I cannot take augmentin. I'm not sure if I clench my teeth at night or not, is there a way to tell? I am pretty sure I am clenching them during the day though, so I'm trying to be more mindful of that. I only have mild occasional pain, and every dentist I have seen has told me that in this case, that is to be expected. I guess that is due to the cracks, but also possibly due to the fact that this tooth had 5 canals. I think that the ENT might be willing to consult, but I doubt that any of the dentists would be. Their attitude is that it's not the tooth and that there's nothing more to be said about it. Thank you for your help, I hope that your dental/sinus issues are resolved soon as well! 

Edited September 11, 2016 by mom of 2 boys

[mom of 2 boys]

Wow, I cannot believe they have kept your tooth so long. I don't usually say things so strongly, but I really think that tooth needs to come out asap.

 

Upper teeth are especially prone to problems and infection due to their proximity to sinuses and brain.

 

Have you lost weight lately, or been having sweats?

 

Thanks, that is my gut feeling on this - that it's the tooth. I would feel so much better about having it pulled if I could just have ONE dentist agree with me, or at least agree that there is some remote possibility that it's causing all of this. 

 

I haven't lost any weight. Actually, I think I gained a couple of pounds. Any sweating seems related to the fever (stops when the fever goes down.) 

[mom of 2 boys]

I think you should pull the tooth, I'm sorry!

 

Thank you, it's okay, I agree with you :( 

[mom of 2 boys]

I think you're going to have to have that tooth pulled. The antibiotics would help for a bit but as soon as i'd go off them the problems would start again.  I went through something similar last year and ended up pulling tooth and haven't had a problem since.  I'm now getting an implant in that area.

 

Thanks, I agree. How was having your tooth pulled? I'm very nervous about it, but I cannot imagine that it's any worse than sitting through a root canal. At least it won't take as long! 

[mom of 2 boys]

I think you need to pull the tooth or possibly have the root canal re-done. My guess is some undetected crack in the tooth or missed root (teeth can vary in number of roots) is trapping bacteria and causing problems. If you haven't already, visit different root canal specialist doctor for a second opinion.

 

Thank you, the 2nd opinion insisted that there is nothing wrong with the tooth. He told me that there is no way that the tooth could cause this level of systemic symptoms without a serious degree of pain and inflammation in the tooth. I am just betting that all of this would go away if I had it pulled though, so that is most likely what I am going to do. After this nightmare, I don't really want to consider having it re-done. The tooth wasn't great to begin with (3 cracks, 5 canals), so I think I just want to be done with it. 

[mom of 2 boys]

Thank you so much, everyone. I'm starting to lean to towards just getting the tooth pulled. I'm very nervous about it though! I am seriously afraid of dentists, especially after this experience. Please tell me that having a tooth pulled isn't that bad. I'm not too worried about the recovery, it's more so whatever will happen while I'm sitting in the dentists chair. This root canal took at least an hour and a half though, so at least I can reassure myself that it will be over with a lot faster, right? I'm seriously afraid of literally having a panic attack in the waiting room or in the chair before hand. Is there anything they can do to help me with this massive anxiety? 

 

Also, I'm kind of worried about chewing. Is that going to be an issue? The endodontist who did the root canal told me that I might not be able to get an implant in that location because of the proximity of my sinuses. Then I was reading in a root canal brochure at the 2nd endodontist's office that having teeth pulled can lead to all kinds of problems with your other teeth, so of course that has me worried as well. 

 

Thanks again :/ 

[trulycrabby]

If possible, you might consider having an oral surgeon pull the tooth so she can give you sedation for the procedure. I had huge anxiety before a tooth pull a few years ago, and decided to have the oral surgeon do it; now I am the most relaxed patient in the chair since I know there will be no pain.

[TechWife]

I think that your dentists and endodontist are a bit off. I had recurring sinus infections at one point, no one even brought up that it could be a tooth issue as I had no swelling and no pain in the tooth. All of the infection was draining out through my sinuses so of course there was no swelling or pain in the tooth! I had a root canal due to something that showed on the X-ray. I don't remember exactly why, it's been, well, over 30 years now. It wasn't prompted by the sinus issue though. As soon as the root canal was done, the sinus problem totally disappeared. By that I mean that by sinuses were clear before I even got to my car! All of that to say that I don't think the absence of tooth pain necessarily means there isn't a problem with the tooth. 

[gardenmom5]

 

 

Yes, I was thinking that I would like to start a probiotic, Does it make a difference what kind I buy? I don't really know anything about them. 

 

And I have had someone mention something along those lines to me about the thyroid testing, I just couldn't remember what it was that she said, so thank you! 

I take pro-5 because of the number of different types of flora.  it is enteric coated to get it past your stomach. pickled/fermented foods are also good  - they will kill yeast and help to establish probiotic  colonies.

 

My son's ND has him on mindlinx.  it has to be refrigerated.

[J-rap]

It sounds like you still have an infection going on, and I think it's very possible that it's related to the tooth!

 

My husband had a root canal that eventually had a tiny, tiny infection brewing way down in a root cavity.  He had an excellent endodontist who was able to see the tiniest shadow there, in the very point of the cavity.  But she mentioned that sometimes you can't even see the shadow of an infection.  So I'm wondering if it's something like that.  My husband had to have the root canal re-done.  Having it re-done took care of it

 

But the other reason I think it could be your tooth is because my husband had yet another problem with another root canal!  On this one, before the dentist put the final closure on it, he sprayed into the root canal with a type of bleach/acid spray to kill any bacteria in there.  Some teeth cavities are very close to sinus cavities, and they believe my husband must have had a crack (small opening) between the root cavity and his sinus cavity, because the spray shot into the root cavity and up into his sinuses, all the way around his eye.  It was terrifying.  At first they thought he was having a seizure because of the shock and pain it caused him!  But in any event, that's when I learned that things that go on in your tooth root cavity can sometimes make their way directly into your sinus cavity.

 

So, maybe it's not showing up in your root canal anymore, but it very well could have started there.  It could be that the infection is traveling back and forth between the two places.

 

 

[Harriet Vane]

I think the tooth is the most likely culprit. You have gotten some great advice.

 

On the sinus front--if you have a colonized infection, oral antibiotics often are not as effective. My son suffers with this due to a deviated septum--when he stops growing, they will do surgery, and he won't be so prone to infection lingering in pockets. The most effective treatment for him was to dissolve a topical antibiotic (the kind suspended in petrolatum--prescribed by the doctor) in warm water along with the little packet of sinus wash solution that comes with a NeilMed sinus irrigation bottle. He would shoot half the bottle through one side, then switch sides. After doing this, the doctor prescribed QVar asthma inhaler--we place a baby bottle nipple with the end snipped off over the inhaler and pulse the inhaler directly into the nostrils. The reason for doing that is the tiny particulates in the inhaler delivery system can find their way better into the nooks and crannies of his nose.

[Omma]

If they take out all the pulp when you get a root canal, you wouldn't necessarily have pain there afterwards, would you?  I have had two previously root-canaled teeth pulled.  One had a bubble on the gum (no pain) and one just showed an abscess on x-ray (no pain).  In fact, my dentist told me to just wait on doing anything with the abscessed tooth until I actually felt pain.  Well, six months after that shadow showed up on xray, I had a very bad bout of bronchitis with fever and decided to go ahead and get that tooth pulled.  The oral surgeon was AMAZED that I did not have any pain with this tooth as it was BADLY infected.  In fact, I did have pain AFTERWARDS (compared with no pain for the gumboil tooth) and was worried so I went back in to the oral surgeon as I still had fevers.  He said there was still residual infection, but I was unable to take the antibiotic that he knew would help me.  Anyway, he said that now that the tooth was gone, the infection should go away on its own (which it did).  I just drank lots of Vitamin C by getting that C-Boost juice at the grocery store. 

 

 

[AK_Mom4]

I had a rear molar pulled a couple of months ago. Tooth cracked underneath a crown. Tried a root canal but it only helped for a few months, then inflamed again.

 

Dentist sent me to an oransurgeon because the roots were long and nasty. Oral surgeon took out the tooth and I have been great since then. A little soreness while the socket healed but really a huge improvement.

 

I would not be afraid to have another tooth removed. It was no big deal.

Edited September 11, 2016 by AK_Mom4

[GailV]

Ditto what everyone else said about the tooth.

 

Dh was talking about a woman who reacted to whatever was used for her root canal -- whatever material was put in there gave her really bizarre symptoms as though she had an autoimmune issue.  Once they pulled the tooth the problem was solved.

 

I had a root canal in an upper molar about 20 years ago.  Lately it's been feeling a little odd.  At first I thought it was just a sinus issue, but it persisted.  When I went to the dentist last week they took an x-ray and were amazed at the infection they saw.  They kept poking my mouth, saying, "does that hurt?  How about NOW?"  Eh, I'm a wimp about pain, and have low tolerance to anything painful, but, really, it just feels ... a little odd.

 

So, now I'm on the calendar at the oral surgeon for an extraction.  The office there was surprised I'm not on antibiotics, but, like I said, I'm pretty much asymptomatic so apparently the dentist decided to not bother.

[mom of 2 boys]

*BUMP* Updated in original post.