What appeared to be chronic sinusitis was actually tooth infection

@303wendy Thank you for your excellent post! It is hard to be a patient with a missed diagnosis, and that seems to be what happens when doctors only consider what their specialty is looking for. I suppose a good question to ask a doctor would be if a dental infection could cause the symptoms. In that way, they have to think outside of their specialty for a moment.

I have a similar history. I broke my front teeth as a kid which started a progressive history of dental work. I got my first root canals at 10 years old because a tooth that was traumatized died. Eventually, my front 4 teeth had root canals under crowns and crowns had been replaced for decay happening under them and in some teeth, there was very little left to crown, so I had a 4 unit bridge that was cemented on every tooth root.

Some years later in my late 50's I had been experiencing pain for a few months that I thought was sinus trouble because I have allergies and asthma. When I felt a soft spot in my mouth in the hard palette area, I knew I was in trouble. One of the old root canals had failed pushing an infection into my jawbone. That tooth would have loosened and fallen out if it was not held in place by the 4 unit bridge.

I had an apicoectomy to save the tooth because for years, I had been so concerned about trying to save my teeth and traumatized emotionally by it. The oral surgeon showed me the exposed root of my tooth with a big space around it eaten out by the infection. He cleaned out the infection and repacked the root and placed bone graft into the space.

A few years later, another root canal was failing. I made the decision to remove all 4 front teeth and replace them with zirconium dental implants with a new zirconium bridge. Doing that removed the infection and toxic metals from my body and my health improved immediately including my asthma which had been a lot worse for a long time. That was a very good decision and I was breathing more easily, that is until I broke my ankle.

Getting titanium hardware plates to fix my fracture made my asthma worse again. My body doesn't like metals, and I had years of internal exposure to metals in dental work and crowns since my childhood sensitizing me. 6 months after my ankle surgery, I was getting large patches of hives on my arms and legs and body and had to stay on antihistamines all the time. A year and a half of recovery with my ankle was enough healing to have the surgical plates removed. Since my body is now metal free again, I no longer have chronic hives.

With dental implants, you do need to take care to clean and floss properly because those can fail too from an infection around them. In healing, it does form a seal around them, but not quite as good as the seal around a natural tooth. They also don't want the implant supported teeth banging against the teeth that oppose them when you bite and chew, so they are a bit smaller so as not to make actual contact. Apparently, this can also make them fail, and it is a lot to go through if they have to replace the implants.

Wow, that's an amazing story. Mine are my four front teeth as well. The oral surgery is daunting to me, but I'm ready for it. My doctors are planning on titanium implants, but now I'm wondering if I should talk to them before that happens, as I have a bunch of allergies, including nickel.

What's frustrating to me is that I did asked the Mayo infectious disease doctor and my local ENT about the possibility of infected root canals causing my symptoms, and both said absolutely not, and that pursuing that line of questioning would be a waste of time and money. I'm a firm believer that the medical world needs to remember that all our body parts belong to the "medical" world. It's silly to think that one area of your body is isolated from the rest of it in every way. I'm happy to hear you had a great recovery. And thanks for the tips about meticulous care after the implants are placed.

My implants and teeth are Zirconium which is a ceramic that does not have metal in them. Zirconium is now the material of choice for crowns anyway and the teeth are carved by computer from a block of it. The Zirconium implants are biocompatible. It is worth asking about this. I had issues with pierced earrings and had to give that up because nothing was safe and I reacted to all of it.

Titanium metal is not pure according to my oral surgeon. It is an alloy when made into an implant and you could react to one of the other metals in it or the titanium. I have heard of titanium dental implants causing a bad allergic reaction in a patient from my pharmacist and the patient is his wife. They had to crack the jaw to get them back out after a lot of denials that the metal was a a problem. Even if you are not allergic now, you can develop an allergy later from exposure.

I've also been through spine surgery for a bad cervical disc and because I had so many issues with metals, I asked for that surgery at Mayo to be done without hardware. I had just a donor bone disc placed and I stayed in a neck brace while it healed for 3 months. That was worth it, and I know I can't react to it. When I broke my ankle and developed the hives and discoloration on my skin over the metal plates, I had conformation that my body reacts to titanium surgical plates. I had constant pain there like I was being kicked. That is a tough recovery, and there were no hives when the cast came off, but 6 months later they started with a vengeance.

Here is some information on Zirconium in scientific literature.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4515795/
Trust your gut feelings on what is best for you. I know I made the right choice and I would be worse off now if I had metal in my body from surgeries and the dental implants. Don't let them talk you into something you don't want. It is your body and your choice. Do your research online and have a meaningful discussion with your oral surgeon and dentist. The surgeon probably hasn't experienced personal issues with metals, and since so much of it can be chronic low grade symptoms, they can be overlooked. I didn't realize that my breathing problems for years with asthma that got worse was being affected because of metals in my mouth and I did have one crown that was replaced with titanium under the porcelain. My gum tissue always pulled away from the top metal edge of the crowns. It helps to see biological dentists. I had all my old silver amalgam filings replaced with safer composites. Those old fillings were leaching mercury and caused thyroid problems with Hashimotos. My blood work confirmed that my thyroid condition improved after removing the old fillings, but with the old crowns and root canals in my mouth, it was still affecting my thyroid. Since becoming metal free, I had the thyroid tested again, and it no longer says I have Hashimoto's and is borderline. Unfortunately, all of this damaged my thyroid so I need to take medication for that.

Here are a few things to watch out for. They will make a temporary denture for you that hooks on other teeth that they call a "flipper". Where that hooks on other teeth creates a perfect place to catch bacteria and food debris and it can easily cause decay. That happened to me and I got cavities on both canine teeth at that contact point. If you are at home with privacy, you don't need to wear a temporary denture. I you wear it, be very assertive about brushing your teeth and cleaning this appliance often.

I also developed a very small blister on my gums over the implant after my new bridge was installed. That was a year after the process began. The surgeon had to make an incision and debride near the implant. Sometimes that happens even with everyone being careful about preventing infections.

I asked to go to the dental lab that would make my new teeth for a color match which was a good idea. My dentist actually had picked a very compatible color, but my teeth are creamier near the gums and cooler "gray- white" near the biting edge. Sometimes they can simulate the translucent edge if it's in the zirconium block. I had worked at this dental lab years ago making crowns when it was done by hand.

They may tell you that ceramic is not as strong as titanium, but you are going to be careful anyway and not bite into hard things like apples. You'll adapt. I had been doing that for years with the crowns anyway. You know what you live with in your body. I have had to stand my ground when doctors didn't believe me. When I came to Mayo for spine surgery, 5 local surgeons had turned me down because I had pain all over my body that they didn't understand. I knew it was caused by spinal cord compression and found medical literature about a case like mine. None of that could be proven, and I went through spine surgery without a guarantee that it would cure my pain. I knew it would and I was right. At least at Mayo, I had a surgeon who respected my wishes and did the right thing for me.

FYI, I am an artist, and my oral surgeon was very kind and empathetic, so I did a portrait drawing for him with charcoal pencil on toned paper. He loved it. When I took the drawing to him, he was nervous about holding it and messing it up. He said he knows how to calmly stop a bleeding artery, but holding this made him nervous. I offered to frame it for him since he had toddlers at home who could destroy it. It's been about 6 years now and I've had no issues with the implants. It is a long process that requires patience, and so worth it.