Nasal Cavity Swelling Linked to Tooth Root Issues

Nasal cavity (dental root) abscess

Before the Lunar New Year, I discovered a lump in my left nasal cavity that is usually painless and does not itch.
When pressed, I feel a sensation at the root of my tooth (but it is not painful).
An X-ray examination revealed that my dentist said the root of the tooth is inflamed, leading to the lump.
Further tests showed that the nerve of my upper left incisor has already died, and I was advised to undergo root canal treatment and observe for one or two months.
If the lump does not resolve, then surgical removal would be considered.
(For context, this incisor was filled twenty years ago, fell out two years ago, and was refilled.
Last October, I experienced unusual tooth pain, and the doctor suggested a root canal, but I did not proceed with it and only took painkillers for three days until the pain subsided.
I ignored it until I discovered the lump in my nasal cavity this February.)
My questions are:
1.
Is it possible that the lump is caused by leftover debris from the dental filling?
2.
If the nerve is already dead, why does the tooth sometimes still react to hot and cold stimuli?
3.
If I do not undergo root canal treatment or any other treatment, will the lump resolve on its own?
4.
Are there other methods to eliminate the lump? Is root canal treatment necessary first?
5.
After root canal treatment, will the incisor become weaker and require special care?
6.
I often need to talk and face customers at work; how long should I rest after the surgical removal to return to normal work?
7.
If the lump is not addressed, will it spread to other teeth?
Thank you to all the hardworking doctors for taking the time to help clarify my concerns.

mó, 40~49 year old female. Ask Date: 2012/04/02

Dr. Zhang Xiangyuan reply Dentistry

Dear online user, based on your description, there are some situations where it is difficult to make an appropriate judgment due to the lack of complete information from the text.
It is recommended that you consult a physician for a detailed examination and to establish a suitable treatment plan.
The responses provided are personal opinions and are for reference only.
I apologize for any shortcomings.

(1) After completing root canal treatment, the next steps generally depend on the amount of remaining healthy tooth structure.
You may consider restoration with a filling or a prosthesis to regain function.

(2) I am unsure about the difference between the lump and granulation tissue as described by you.
Based on a literal understanding, if the lump refers to a tumor or abnormal tissue, it may require early examination and treatment.
Generally, the goal of treatment is to remove the source of the problem first, which can alleviate or resolve the symptoms.
Given your concerns, it is still advisable to seek further detailed examination and treatment from a physician to restore your health as soon as possible.
If it is a root canal issue, you may also consult an endodontist for evaluation.
If it is an unexplained lump in the oral cavity, you can seek assessment from an oral surgeon.
Thank you.

Reply Date: 2012/04/02

More Info

Understanding the connection between dental issues, particularly tooth root problems, and nasal cavity swelling is crucial for effective treatment and management. Based on your description, it seems you are experiencing a complex interplay between dental health and potential sinus issues. Let's address your questions one by one.

1. Could the swelling be caused by improperly cleaned dental fillings?
Yes, it is possible. If the dental filling was not adequately cleaned or if there is residual decay beneath the filling, it can lead to infection or inflammation of the tooth root, which may manifest as swelling in the surrounding tissues, including the nasal cavity. This is particularly true if the tooth has a history of decay or trauma, as in your case.

2. Why is there still sensitivity to hot and cold if the nerve is dead?
The phenomenon of sensitivity despite a dead nerve can be attributed to several factors. Sometimes, the surrounding tissues can still react to temperature changes, or there may be residual nerve fibers that are still functional. Additionally, the inflammation in the area can cause heightened sensitivity, even if the main nerve is no longer alive.

3. Will the swelling resolve on its own without treatment?
Unfortunately, it is unlikely that the swelling will resolve on its own, especially if it is due to an underlying infection or inflammation related to the tooth root. Without intervention, such as root canal treatment or surgical removal, the condition may persist or worsen over time.

4. Are there alternative methods to eliminate the swelling? Is root canal treatment necessary?
While there are some conservative measures, such as antibiotics or anti-inflammatory medications, these are typically temporary solutions. Root canal treatment is often necessary to address the underlying issue effectively. In some cases, if the tooth is deemed non-restorable, extraction may be the best option.
5. Will the tooth become weaker after root canal treatment? Does it require special care?
After a root canal, the tooth can become more brittle due to the loss of vital pulp tissue. It is often recommended to place a crown on the tooth to provide structural support and protect it from fracture. Regular dental check-ups and good oral hygiene are essential to maintain the health of the tooth post-treatment.

6. How long should I expect to rest after a surgical procedure?
Recovery time can vary depending on the extent of the procedure. Generally, for a root canal or minor surgical intervention, patients can often return to normal activities within a few days. However, if you undergo more invasive surgery, such as the removal of the swelling or tooth, you may need a week or more to fully recover, especially if your job involves speaking frequently.

7. If the swelling is left untreated, could it spread to other teeth?
Yes, untreated infections can potentially spread to adjacent teeth or even into the sinus cavity, leading to more severe complications. It is crucial to address the issue promptly to prevent further dental and health problems.

In summary, it is essential to follow your dentist's recommendations regarding root canal treatment and any necessary follow-up procedures. Given the complexity of your symptoms and their potential implications, consulting with both a dentist and an ENT specialist may provide a comprehensive approach to your condition. Regular monitoring and timely intervention are key to preventing complications and ensuring your overall health.

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