Sinus Drainage & Pain After a Root Canal Procedure

Root Canal Question: 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 puzzled 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?

Answer: 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 anesthesia. 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 and let me know what happens.

Mark Burhenne DDS