Q:
Dear Dr. B,
I had a root canal last Monday. Shortly after I returned home from the dentist, I leaned over and had a sudden gush of watery substance drain from my left nostril. It smelled just like the sodium hypochlorite that the dentist used to flush my roots. The drainage continued several times that evening. The following day, nearly 24 hours later, I was bending over and moving boxes and it happened again, this time yellow. The drainage amounted to about a teaspoon. I had no pain or swelling.
Toward the end of my root canal procedure on Monday, I had sudden moderate pain that traveled from my jaw up to my temple. The temple pain lasted for about an hour.
The root canal was on my left upper jaw, I believe it was #13. Nasal drainage was left side only and temple pain was left side.
When I discussed this with my dentist, he seemed very puzzeled and said that the drainage would not be related to the root canal procedure and it may be just a coincidence or a possible allergic reaction. He said there is no way to drill into the sinus cavity.
Is it possible to drill through the root into the sinus cavity?
- Lori K.
A:
Hi Lori:
I’m sorry you are going through this issue. I hate to disagree with your dentist, but I do believe that the drainage is connected with the root canal procedure you had recently.
The smell and taste of sodium hypochlorite that you describe is unmistakable, and cannot be synthesized by your body. It is from the lavage of sodium hypochlorite that your dentist rightly used to disinfect your root canal before sealing it. It is possible to drill into the sinus, but that is a catastrophic and unlikely event following a root canal and is usually related to surgical extraction of upper molars.
In this case, the roots of tooth thirteen are already very close to the floor of the sinus cavity, and after a tooth infection (abscess), or with age, there may be direct access into the sinus cavity via the root canal (inside canals of the tooth). Small amounts of the proper concentration of sodium hypochlorite should not cause any permanent damage despite being inadvertently injected into the sinus. However, it is possible to develop acute, sudden, severe facial pain and swelling that would require a trip to the emergency room with possible surgery requiring general anaesthesia. This is called acute chemical sinusitis and is a very serious matter.
I would have immediately recommended sinus saline lavage with a Netti pot, a course of antibiotics, anti-inflammatories, decongestants, time for drainage, and careful monitoring of symptoms. Then, at a later date, careful completion of the root canal (without flushing with sodium hypochlorite). The communication between tooth and sinus will eventually heal. In this case, since the dentist did not acknowledge the possibility of this communication, I would recommend that you see a root canal specialist (endodontist) to complete this root canal. You may also want to find a new general dentist.
Good luck!
Mark Burhenne DDS
What are your tricks to recover from a root canal? Join the discussion and leave a comment below!
Mark Burhenne DDS is a family dentist and award-winning blogger who has written numerous articles on oral health and advised 
{ 20 comments… read them below or add one }
I had nearly the exact thing happen when my dentist perforated my sinus while performing a root canal on tooth #13. I called my dentist the following morning after I had liquid shoot out one nostril a couple times when I bent over. She prescribed an antibiotic. After three or four weeks the pain in my sinuses went away, but I continue to have what I would call a narrowing or pressure, especially in the upper part of my nose and under one eye. I have also had face twitching on the injured side, but that has subsided. I still do not have my sense of taste back after almost three months. Are these symptoms all typical of this type injury, and are any of the symptoms expected to be permanent?
These symptoms, although severe, are plausible after a root canal that is over instrumented. As you unfortunately experienced, these sypmtoms can last for quite a while, but they can even be permanent. What I don’t understand is the loss of taste. This does not make sense with an upper root canal. I’d recommend a visit to an ENT specialist (ear nose and throat). You may even have to consult with a neurologist. I’d do this right away. Your symptoms are extreme for the given sistuation. Good luck!
Mark Burhenne DDS
My left upper molar (14 I think) had a root canal 12 years ago and last week became badly infected with a ‘pimple’ appearing on my gum, which the dentist identified as a sinus draining from this inecfted molar.
Yesterday (15 Sept 2010) he was performing a drainage of this root canal to re-do the root canal and when he flushed the septic root canals with “Miltons solution” I felt the liquid travel up my sinus to the back of my nose and then down the back of my throat. The liquid felt quite caustic and I brought it to the attention of my dentist who lifted the dam and squirted what I think was water down my mouth which relieved the irritation. He then finished the treatment and has left temporary dressings in the root canal. I am on antibiotics.
This morning the left side of my cheek is swollen and very sore, I feel quite unwell but don’t think I have a temperature. What really concerns me is that my sinus was clearly accessed during the procedure. My dentist agreed that the liquid must have come up through the sinus.
I am concerned about complications from this and wonder how long my cheek will remain swollen and sore. I am also thinking I would prefer now to see an endodontist to complete the procedure.
I had a similar experience yesterday. Tooth 14 (upper left) had the root canal. When I got home, lots of drainage with discolored (brownish) mucus. Then, if I turned to sleep on my right side, I could feel fluid moving around in my left sinus. This morning the discolored discharge/drainage was gone, but again when tipping far to the right, there was drainage into my nose and it ran out – basically clear, but discolored (like the water when ice melts after you’ve had a cola – a bit brownish). I’m scheduled to go back in this afternoon to have him look at it.
Five weeks ago I had oral surgery. I was told that I had a large infected leason in my gum around a tooth that had a root canal 5 years ago. They did a bone graft and cleaned it out. I am still having puss comming from this surgery spot is this normal?
I had a root canal done left upper tooth on third visit dentist perforated the side of tooth and drilled into the bone. three days later pain was bad then had the tooth extracted.Since then left sinus blocked and have been told I need turbinate surgery. still pain in jaw, temple, behind eye, left side of face feels numb, loss of taste, and smell. has been going on 70 days approx. please help
I have the same issue as the original poster in this thread. I had an abscessed #15 which required a lengthy root canal by my dentist. Two weeks later, #14 also needed a root canal, this was done by an Endodontist. A few hours after the root canal on #14, I had yellow/brown thin watery fluid pour out of my nose (same side as the root canals) when I leaned forward. This continued off and on next several days and I found your site. I printed this article and took it to the Endodontist. She said the idea of the rinsing agent in the sinus cavity is IMPOSSIBLE. I pointed out #15 was abscessed which may have made an opening. She was 100% sure the nasal drainage was not from the root canal. I have no sinus issues and no allergies, and no cold symptoms. I have an appt. next week with an ENT. Can I have the fluid from my nose tested to prove it is related to the root canal? Why in the face of the evidence are dentists reluctant to admit what has happened. If 3 hours after a root canal thin watery fluid pours out of your nose, and you had NO previous symptoms, where do they think this has come from? I just want answers, not to blame anyone.
@ Elsie: I’m sorry you are experiencing this. It’s potentially very dangerous. The fact that she stated that the idea of the rinsing agent in the sinus cavity is “impossible” is frightening.
You need to find another endodontist immediately. She has no business saying this to you. The professionl literature refers to this situation continually. If you like I can send you studies on the subject matter. I apologize on behalf of the profession that this misinformation has been presented to you.
In hindsight, perhaps, it sounds like the wrong tooth was treated. Maybe #14 was the tooth that needed to be treated to begin with. Find a new dentist and endodontist immediately. The life of your teeth will depend on it.
Mark Burhenne DDS
Dear Dr. B. Thank you for your reply and offer of the articles. I would love to see them. I was able to find abstracts about similar cases (although most involved swelling/pain which I did not have) but I could not access the actual articles. The ENT confirmed that the liquid from my nose had to be from the irrigating agent and is forwarding his findings to the endodontist.
Regarding the possibility of the wrong tooth treated I think #15 had major issues that overshadowed the smaller problem with #14.
I still have some sensitivity on #14 when I press it with my finger, but it has only been 2 weeks and I am hoping that is normal. Nothing about what happened to seems to have been “normal.”
Thank you for sending the articles.
Hi Elsie,
Here is the link to one of the articles I was referring to: http://www.quintpub.com/userhome/qi/qi_39_9_Zairi_5.pdf
Best,
Mark Burhenne DDS
i am having reoccuring pain in my jaw, ear, gums, and neck due to sinus drainage. the only solution to stopping it is when i take benadryl with a ibp 800 twice a day. this pain actually paralyzes me from any movement. PLEASE HELP ME!!!!!!!
Hello there! I have had a terrible smell in my nose (imagine a poopy diaper strapped to your nose 24/7) since Feb 2011. I have had every medical test known to man and all is well. I had one tooth that did not respond to cold (but had no pain) and did not show anything on the XRAyY so went to the dentist and and we did a root canal even though they were not convinced anything was wrong, they understood how miserable I was. EUREKA…the minute they got in there, the smell intensified I about died. The tooth (#4) was cracked, with an air “pocket/bubble” or whatever and pulp was neucrotic. My endodontist did the root canal and did a great job. I was sitting there the whole time just thinking how wonderful it was going to be to not have to smell that stench anymore. But afterwards he told me, that it could take “awhile” for my brain to adjust so to be patient. I had the root canal on Friday, 4/29 and am still have some smell and taste issues and am now freaking out. All the food and drink I try tastes “off”. Are my brain neurons working tirelessly to fix this? Are am I dreaming and this tooth was really not the problem? Help, really, my quality of life is practically a ZERO with this stench! Thank you!
Lori
Oh, just to clarify, I have already ruled out all sinus issues, had sinus CT, head CT, Brain MRI, had neuro consult, seen ENT. I am going back to the ENT one more time and also going back to Neuro one more time just in case because I don’t know what else to do. Also asked for a gastro referral to rule that out. Thanks!
Thanks for sharing such valuable information not found anywhere eles. I need some advice about tooth decay and possible extraction. 1 week ago I noticed that a small part of my 1st bi cuspid tooth (upper) had chipped away. I went to see my dentist who took a couple of xrays. She told me that I had calcification of my root canal therefore I needed the tooth removed as root canal was not an option. I don?t have any pain at all therefore this seems a bit extreme. I really don?t want the tooth removed if it is not necessary and would really appreciate some advice.
Hello there! On Friday, I had a root canal performed on #14 by an Endodontist. It lasted about 45min-1hr. The doctor said he wasn’t expecting for the molar to have 4 canals. The 4th canal was difficult to clean out, as he thought it was blocked by calcium deposits. I left office in a very drowsy state, I believe because of the anesthesia (I am very sensitive to medication). Three days later (today Monday) I have facial pain, jaw pain, pain on my palate and gums. But what is worse is that I have lost my sense to taste. Is this temporary, what do I do?
Thank you,
Ada
Hi there, today I had a root canal on my molar #13. During which my Dentist drilled into my sinus cavity. He basically flushed the canal with bleach not knowing he had drilled through which made my face start burning up and my sinus feel very full and smell bleached out. All day today I’ve been blowing my nose and my nose has been dripping a clear brownish fluid. He gave me antibiotics and didn’t finish the procedure told me to come back in 5 days to finish it. I started reading online if this has happened to other people and basically read a bunch of horror stories…about having sinus infections for the rest of your life. Does it happen to everyone…I’m only 18 I don’t want to have sinus infections forever. What can I do to prevent anything bad from happening. Thank You.
Hi,
I am 4 months pregnant and have been in severe pain for a little over a week now. It started out with me having bad pain in my left upper jaw which made my whole left side of my face hurt. I went into dental emergencies since it was a weekend, they did. Othing and told me they couldnt locate the problem to a certain tooth.
A day later i went back. The pain seemed to be coming from my upper molar, #14 . They took xrays and said i have an infection in the root. So they started a root canal right thwn and said that would at least ease the pain.
After they were working on it for almost 3 hrs, i went home. I began to get more andmore swelling i. My left cheek that wqs ha and hurt badly. I went back to the dentist the next day and they told me it is normal and to keep taking tylenol.
Two days later the pain was no better and neither was the swelling. My cheek was bruised by that time.
So i went back to the dentist after talking to my ob/gyn and they said i need antibiotics. So i had the dentist prescribe them.
The next day they also prescribed me tylenol 3 since the pain is not getting any better.
It. Is now my 4th day of taking penicilli. And the pain has yet to get better.
The swelling i. My cheek has went down but there is still a hard and swollen area i. My cheek. And it is kind of whiter looking than the rest of my cheek.
Since today ive had popping sounds in my left nostril/sinus area, and am now having a really bad smell in that side of ym nose.
Is itpossible that there is an infection still in my cheek and it has travelled to my sinus?
I dont know what to doandi am extremely worried that this will affect my baby.
The doctors here are acti g like. It is no big deal.
I have had X-Rays. Bacteria found in gum of upper molar – older root canal. DDS removed filling, cleaned canals, capped. In so doing, DDS entered the sinus cavity. The cleaning agent of course entered the sinus cavity. Nose bled for a few days, from bright murkish blood to light blood color. If I blew my nose, it came out my nose and my mouth. I had the permanent filling accomplished,before the final surgery, to secure the root canal tooth. DDS then performed gum surgery above same tooth and downsized the canals, recapped and sutured gum. Any nose sprays came out of my gum and into my mouth. Salt water washes went into the sinus cavity and out of my nose – Murkish blood. Many antibiotics and salt water rinses, sprays later, the DDS referred me to oral & maxillofacial surgery DDS. Tooth is loose and must be extracted! Once tooth is extracted, this will leave the sinus cavity exposed. Will the hole to my sinus cavity close and leave my sinus cavity free of infection? Does anyone have any holistic meds that will help clotting and healing?
I had a root canal approximately 2.5 years ago upper lt. side not sure which number. Ever sense I have been experiencing periods of stuffiness, in my lt. nostril. As well, I have had clear drainage, sinus pressure, pressure lt. eye but worst of all are the temporal headaches. I have just visited an ENT and next is the neurologist. I feel like the ENT looked at me like I was crazy and that only thing he could say was “interesting”. I am reading all the posts but can someone tell me where to find help? I am considering pulling the tooth as my neck is now beginning to hurt and I am tired of the headaches. Will pulling the tooth fix the problem?
I have had right upper #14 extracted, root canal in #13, left upper #14 extracted in the last 3 months, the root canal in upper right #13 is now a tiny nub of a tooth, the dentist used a composite filling, and this Mother F’er hurts randomly, I have gone back to the dentist several times complaining of pain, he did a bite adjustment, sanding it down here and there, and of course clipped a lower molar and chipped away an old filling (yet another problem). Dentist claims I can not feel anything in #13 since there is no nerve (well I do) and let me leave in pain. Said there is nothing he can do for me, really? how is this acceptable? after reading the posts above I can clearly see how and why people experience the pain and problems they encounter.
I live with constant jaw, tooth, temporal, neck pain, I had a brief hiatus after the last extraction of two weeks of relief, then the temp outside dropped to 30’s and 40’s and now I am feeling sharp, extreme pain daily.