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Is It Possible To Detect Chronic Abscess While Suffering Blocked Maxillary Sinus?

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Posted on Thu, 30 Jan 2014
Question: Dental issue I have a tiny hole at top of my gum, above the second last tooth on the right hand side. My dentist said he believes it to be a small fistula. The last three teeth at the back have recently been filled almost the whole teeth with fillings as the decay was bad. But the issue is that on the xray (opg) no abscess can be seen? That said the maxiliary sinuses appear to be blocking the visual of the top of three back teeth (same both sides). Is i possible i have indeed a chronic abscess that cant be seen on the xray becusee the maxiliary sinuses are in the way? My dentist said they show up black on xrays but so do abscesses and this is why we cant see. Xrays show no growths or anything sinister. This tiny pin size hole is tender when i press hard on it and then i get some stuff from it and a taste in my mouth. The hole appears to get smaller and the bump smaller too and then a few hours later is feels a bit bigger. Then when i press on it it becomes smaller etc. but when i look in the mirror and press on it, i dont see anythong coming out of it. Can you help please?
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Answered by Dr. Anshumala Singh (2 hours later)
Brief Answer: chronic draining sinus. Detailed Answer: Hello and welcome. Thanks for sharing your concern. After going through the complete history, it appears definitely there is a chronic draining fistula.This would have developed due to decayed tooth/teeth. It appears when an abscess develops in the space and pierces through the area of least resistance forming a fistulas tract. In such a case it becomes tough to diagnose the concerned tooth as whatever pus is formed drains upon gentle touch.Therefore an abscess cannot be seen in x rays. To be seen in the x ray, there should be definite demarcation with pus filled sac.There is no such accumulation here and sinus tract is very minute to appear radio graphically. In this case the best advise would be, to go for clinical examination based upon symptoms. I would also suggest you to see an Endodontist(specialist dealing with roots and canals) who have advanced tools(fiber optic lenses) to detect such chronic lesions.once detected it can be treated by root canal treatment. An abscess in infective in nature thus it should be treated soon.For further doubts please let me know. Thanks. Take care.
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Anshumala Singh

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Practicing since :2007

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Is It Possible To Detect Chronic Abscess While Suffering Blocked Maxillary Sinus?

Brief Answer: chronic draining sinus. Detailed Answer: Hello and welcome. Thanks for sharing your concern. After going through the complete history, it appears definitely there is a chronic draining fistula.This would have developed due to decayed tooth/teeth. It appears when an abscess develops in the space and pierces through the area of least resistance forming a fistulas tract. In such a case it becomes tough to diagnose the concerned tooth as whatever pus is formed drains upon gentle touch.Therefore an abscess cannot be seen in x rays. To be seen in the x ray, there should be definite demarcation with pus filled sac.There is no such accumulation here and sinus tract is very minute to appear radio graphically. In this case the best advise would be, to go for clinical examination based upon symptoms. I would also suggest you to see an Endodontist(specialist dealing with roots and canals) who have advanced tools(fiber optic lenses) to detect such chronic lesions.once detected it can be treated by root canal treatment. An abscess in infective in nature thus it should be treated soon.For further doubts please let me know. Thanks. Take care.