Fluid leaking from teeth - Intraoral sinus tracts (Dental fistulous)


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Has anyone come across fluid leaking through teeth with bad taste.

We have read about Intraoral sinus tracts (Dental fistulous) starting to wonder if this may be happening.

Would such a thing show up on cbct scan as we have had one but no infection or abcess showing.

It may explain why the toothache is worse sometimes than others as the pressure would build and as the pus releases ease again.

Had a not too bad day then major pain for a couple of days then last night he flossed and noticed more blood than has been and today the fluid leaking is much more again. Been leaking all day explained as equivalent of a cup full.

When mentioned to our dentists about the fluid they dont seem to have come across it.

Also noticed yesterday when taking pain killers getting the taste of what he has had coming back through in the fluid.
Any ideas?
 
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honestdoc

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There are some details that don't make sense. 1) Who are you talking about that is experiencing this? 2) Why did "he" need CBCT scan? 3) Your dentist couldn't figure your problem? 4) Why is "he" taking pain killers? Try to provide an x-ray of the area and a picture. We can't read minds with all these vague details.
 
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Sorry for the lack of clarity just wanted a
a general idea on a sinus tract as I have posted previously in an earlier thread in relation to the history of my husband’s toothpain and problems. He has seen both his NHS dentist and we have paid to also see a private dentist due to the restrictions for doing any detailed treatment currently with the pandemic. (the NHS are limited at present) neither dentist can see any infection or decay on xray or by examination or identify where the pain is coming from) . The CBCT scan was done to see if more detail would help but hasn’t.

He has been taking pain killers for the toothache as advised by Dentist and Doctor.
We do not have a copy of the xray or scan currently.


Thanks
 

honestdoc

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"Sinus tract" may be interpreted in 2 ways. The sinus has a thin membrane over the top teeth. When a top molar tooth gets extracted, there is a risk for perforating the membrane and the sinus and the mouth will have an unfortunate connection. Another interpretation of "Sinus tract" is a fistula where the tooth abscess wants to drain in the path of least resistance. There will be a pimple in the gum with drainage. Usually the x-ray will detect the abscess if enough time has passed. If the abscess is acute and recent, it may not show up on x-rays since the abscess needs time to resorb through the bone. With the extended period of time your husband is suffering, any abscess will be detectable.

What are all the medical conditions and medications your husband is taking? It is impossible for anyone to diagnose on this forum especially without any images, x-rays, tools, and full work up. Your husband's case seem complicated since many doctors aren't able to determine the problem. I suggest you consider seeing an experienced faculty at a dental school or similar private dentist. Since I'm in the US, I'm guessing that the NHS dentists are inexperienced and unmotivated.
 
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Thank you for your reply. The medications are basic ibrupofen and paracetamol as he still has to work and drive so nothing stronger however, due to the length of time he has had the pain and been taking tablets these are starting to affect his stomach and he is getting fatigued easily so he is trying where possible to reduce the painkillers.

The NHS dentists are very restricted in what they can do at present basically anything involving aerosol procedures there is no sign of when they can perform these as yet such as root canals or replacing teeth with implants or dentures etc if they extract any. This is partly why we went private as they have full PPE and are carrying out more indepth procedures but currently they still cannot see where the issue is they have wondered if there may be a crack in the tooth that isn’t showing and it is a capped tooth which is the possible culprit so the testing is not as simple.

we have at long last managed to get an appointment with the hospital this week to see the oral surgery and maxillio facial department so we are hoping something gets resolved.

we just wondered on the fistula as a possibility on the fluid so we can then raise this with them. The leaking has eased again today and the pain subdued slightly again which would make sense if it then takes pressure off until the fluid builds up again.

Thank you again for your help.
 
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Meant to ask with a fistula is the pimple always on the gum and visible or is there a chance the exit point could be between the teeth outside of immediate view?
 
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honestdoc

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Yes, drainage can happen anywhere. If it is between the teeth, the gums will look more red and puffy (healthy gums are light pink and very tight). Fractures are very tough to detect but if it is deep, with the time your husband had been suffering, it should show up on x-rays as stated previously.
 
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Dentist has advised on trying a mouthguard for a couple of weeks now which my husband has done but it hasn’t helped and now his speech is affected. He has stopped using it as it has made things worse. The dentist has just had to rearrange his revisit and he is due to go and see him in a few days.

could the mouth guard have caused this and will it gradually rectify or should we be more concerned?
 

honestdoc

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I don't believe the mouth guard will affect his speech unless he leaves it in during speech. Is it Over-the-Counter drugstore bought or custom made? If it is custom made and he takes it out, I cannot explain his speech difficulty.
 
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