This man’s tooth is the cause of his breathing difficulty

This man's tooth is the cause of his breathing difficulty

When you can’t breathe through your nose, life can get pretty challenging — particularly if it goes on for years like in the case of one patient who showed up at Mount Sinai in New York City. The 38-year-old man had been struggling to breathe through his right nostril since an accident as a child, but doctors discovered that the cause of his breathing problems was something else entirely. He had a massive tooth growing out of his right sinus cavity!
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He had visited doctors

For years, doctors and specialists had been unable to diagnose what was causing him to have trouble with his right nostril. An ENT doctor had even offered to remove it entirely to clear up whatever was bothering him. The man refused that option. In retrospect, I should have agreed, he told NYU Langone Health. But at that time, because I wasn’t working and I didn’t have health insurance and such a high deductible, [it] didn’t make sense. Instead, he turned back to online forums for help and discovered several people had experienced similar issues — although no one seemed able to give a solid answer about why it happened.

 

They found an unusual problem

an impacted tooth. Impacted teeth aren’t new, but they are rare. For example, only 1 out of every 2,000 patients visiting a dentist each year suffers from an impacted tooth, according to a study published in The Journal of Oral and Maxillofacial Surgery in 2012. The researchers tracked 37 cases over 23 years. We’re not talking about anything that happens every day, says Dr. Stephen Bozinovski, one of the authors on that study and chief of oral and maxillofacial surgery at Lenox Hill Hospital in New York City. If you think your health concerns might be related to an impacted tooth — also called an unerupted or hidden tooth — ask your dentist if it could be to blame for your symptoms.

 

There was an unusual reason

In a report published in The New England Journal of Medicine, Dr. Amar S. Khanna and colleagues wrote that an examination using an endoscope — a long tube with a camera at one end — revealed that a dental filling was pressing on and obstructing blood vessels leading to the right nostril. I think it’s unusual, said Dr. Richard Langer, professor, and chair of otolaryngology-head and neck surgery at Lenox Hill Hospital in New York City, who wasn’t involved in the case. As far as I’m aware, there has been nothing like that published before. In general, nasal obstructions are usually caused by swelling or inflammation but can be linked to infections or tumors as well.

 

What happened to him?

I can’t believe it. I’d been to dozens of doctors, and none had figured out that my problem was a dislodged wisdom tooth! Now they’ve removed it and I’m on my way to being well again. Wow! I didn’t expect it to be such an easy fix. It just goes to show you that you should never give up trying to get better, no matter how hopeless things seem…it might be something simple like a wisdom tooth that no one noticed. Glad I kept at it! Good thing too, because otherwise, I might not have found out about all of these other health problems I had!

 

How did they treat him?

Rather than removing any teeth, a medical team led by Mount Sinai otolaryngologist and rhinologist/facial plastic surgeon Dr. Amadeo Malangoni-Filoramo used nasal endoscopy to diagnose and treat him. The procedure involves pushing a thin tube with a camera on it through one nostril to examine the sinuses, nasal cavity, and throat. Bypassing an electrical current through a small probe at its tip, they were able to cauterize (or burn) part of his right inferior turbinate — which they realized was preventing him from properly clearing mucus from his right nostril. Now he’s breathing easy!

This man's tooth is the cause of his breathing difficulty

What can we learn from this?

It’s never too late to have your teeth examined by a dentist, even if you think you don’t have a dental problem. Even something as seemingly small as a cavity can lead to more serious problems, like an infection in your sinuses or nasal passage. And not only will you be able to breathe better, but a healthier mouth means less risk for gum disease and bad breath. Talk to your dentist about any concerns you may have. There’s no better time than now to make sure your teeth are healthy and strong for years to come!

 

Why is this important?

How to Treat a Sinus Infection at Home Sinusitis Diagnosis Guide to Your Sinuses Allergic Rhinitis: Causes, Symptoms, and Treatments World Health Organization – Otorhinolaryngology Reference Group.

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