Have you ever heard of the phrase “when you hear hoofbeats, think horses not zebras?” 

Well, what happened was what I thought was “horses” (a simple sinus infection) turned out to be something I never would have guessed, in other words, “zebras” (an oral pocket infection). 

More often than we realize, our oral health manifests in physical symptoms both inside and outside of our mouth, making it very easy for people to dismiss their dental health as a root cause for any of their symptoms.

A few months ago, I felt a slightly uncomfortable pressure in the upper right quadrant of my mouth when biting down. The best way to describe the feeling is a misalignment of my bite applying a greater than normal pressure to the gumline and roots of my teeth. While uncomfortable, there was no pain, so I chalked it up as a funky side effect of a sinus infection—something I have been dealing with all my life. Due to the lack of pain and any signs of physical tooth damage, I didn’t consider the matter urgent and was fully expecting the problem to resolve itself with time.

Over the coming two days, the discomfort persisted when I ate without getting any worse, but on day 3, a new symptom appeared. I noticed an excessive buildup of food debris collecting between the affected teeth when chewing on the right side of my mouth. If I didn’t floss immediately after a meal, my affected teeth begin to ache. They felt slightly loose as if they were moving around enough for an exceptionally large amount of buildup to collect. This happened every time I ate on that side and eventually, I started chewing primarily on the left side to avoid being in pain.

I made it through the week without any major changes to my symptoms. Hoping that by resting those teeth; chewing on the other side, it would allow them to settle back into place. Saturday arrived and I woke up to an unpleasant taste in my mouth that seemed almost chemical in nature. After brushing and rinsing my mouth, the taste went away.  As any patient does, I soon forgot about it as I bustled around doing my weekend chores. Around mid-day I started to feel nauseated. The headache and minor fever that I had been fighting off from the previous week, which I initially associated with a recurring sinus infection, came raging back much more severely than they previously were. I had forgotten to take my morning dose of ibuprofen with the distraction of the strange taste in my mouth, and now I was paying for it. I took the OTC pain medicine at that point and shortly after, the minor fever and headache subsided enough to allow me to continue my day normally.

I am very familiar with sinus infections.  Due to an accident that happened in my mid-teens, I ended up with a severely deviated septum leading to three or more infections per year since, and have long stopped seeking medical attention for the minor ones or taking antibiotics for each infection. I do monitor, though, my fever to ensure it doesn’t get too high. When symptoms persist for more than two weeks, I usually visit my GP to get a prescription, but this current case had not reached that point yet. Had I made it to Monday morning, I would have scheduled a doctor’s appointment since the symptoms were approaching the two-week mark.

When I woke up on Sunday, I immediately knew something was seriously wrong. The foul taste was back with a significant swelling along both sides of my gumline surrounding the last three molars in the upper right quadrant. What I had assumed as a side effect of a sinus infection had morphed into a full-blown dental emergency. The tissue in the area felt hot and the gums were tender and swollen making it painful to close my mouth. Each time I used my tongue to explore, it seemed to force more of the foul taste into my mouth.  I immediately called around for an office open for emergencies on a Sunday. Luckily, I found a local emergency dentist/surgeon who could see me right away and I went in for an exam. 
It turns out I had a massive pocket of infection around an old root canal which had been growing for some time. The sinus infection symptoms I’ve been having were caused by the pocket of infection spilling into my sinuses and prompting my immune system to attack them.

Now that the problem was identified, my previously treated molar was extracted, and the source of my infection was removed. Several bone grafts were placed before the extraction site was sutured and closed. I was given a prescription for antibiotics which cleared up the sinus infection symptoms over the course of a few days. My pain from the extraction was manageable and it faded with the infection. My treatment plan includes a permanent bridge to be placed a few months after the extraction site has completely healed, something that I will make sure to adhere to. Despite everything I went through, I am grateful to have caught it when I did!

Going through this experience, one thing I learned is the connection between dental and medical health. Had I known that my physical symptoms could be signs of dental issues, I would have gone to my dentist much earlier.