A large segment of the population does not seek proper dental care because of fear. Today there are several options that make dentistry much more comfortable. For years nitrous oxide has been available, which is an analgesic gas that raises the pain threshold and alleviates anxiety. This is a good solution for many patients and the gas is out of the system within just a few minutes of breathing oxygen afterwards, so a designated driver is not necessary after treatment.

Some individuals are reluctant to even just have their teeth cleaned because of fear. For these individuals we have oral medication that can be taken 45 minutes to an hour before their appointment that will alleviate their anxiety. The medication is strong enough to really do an effective job so these patients will need a designated driver after treatment.

If we are going to be doing significant dentistry on an individual who is not comfortable sitting for an extended amount of time or has an extreme fear, IV sedation is available. This is a safe method of sedating the patient so that they will not have an unpleasant memory of the treatment. They will not be unconscious, as with general anesthesia, so there are not extreme dangers associated with this sedation. Patients can still respond and inform us if something is bothering them so that we can respond accordingly.

If you have an abscess tooth, and its not hurting too bad, it could be draining in to the sinus, causing chronic sinus irritation. When you look at an x-ray of the upper tooth,  the roots are visible up there and the sinus comes down – usually following a pattern of that root. In other words, the roots are holding that up and when you take the tooth out, there is constant gentle pressure there inside the sinus. The bone reacts to pressure and the bone in the maxilla is softer bone. So it does what we call numatizes that area.: the sinus starts enlarging, getting bigger because it is gently pushing that bone and the bone is resorbing (losing substance).

We see a many individuals who, when their teeth are out, have paper thin bone between the ridge and the sinus. If it’s a denture, then that can be tender all the time when they have sinus problems, and the bone goes away so we don’t have a place to put the implants. If the teeth have been removed and left our for a long time, you can still get implants, but you have to go through a grafting procedure to raise the sinus floor and grow new bone to put implants in. The other thing that is particularly prominent when you have a tooth on the side but the middle teeth are missing, is the sinus comes down and now you have a low spot where the fluids are always sitting. This makes the individual more prone to get infections. 

What are some symptoms that may indicate that the sinus problems you are having may be related to your teeth? If you had a tooth taken out and you want to have it replaced you should do it sooner rather than later so that the sinus doesn’t numatize and you don’t require an extra surgery.