This week, a puzzled face poked around my surgery room door seeking assistance. The situation? “A piece of the patient’s brain is coming out attached to an upper molar as I’m extracting it...” Never one to shy away from such an intriguing event, I immediately sprang up to investigate.
It was, luckily for the patient, not cerebral material. However, it was a beautiful example of how the body goes to great lengths to contain infected matter. It was a huge mature cyst attached to a decayed molar root.
This particular cyst had been around so long (possibly decades) that it had expanded above the upper back tooth roots and broken into the inside of the neighbouring air sinus.
This cyst had a sack as thick as a deflated balloon and was filled with pus. It always amazes me that such a large entity of infection can at times be lurking in a person’s skull without a single flash of pain being felt.
If you touch your cheek bone it feels hard but actually, this bone is hollow; it contains one of the eight air sinuses in our face. This air sinus sits directly above the upper molar teeth and is the size of a ping-pong ball. The body developed air sinuses to lighten the skull and protect us against microbes. They add resonance to our voice while warming and moistening the air that we breath.
Just like husbands, every air sinus is differently shaped. Some are completely smooth, like the inside of an eggshell, and miles away from molar roots, while others have the roots of the molars projecting up inside them like majestic mini stalagmites.
Just like husbands, every air sinus is differently shaped
That’s why if an upper back tooth gets infected, we often suffer from sinusitis symptoms. Most times when dentists extract upper back teeth the area heals up without complication. However, on occasions like the one I’m talking about, there can be a hole from the air sinus into the mouth after a molar is removed.
If this connection is left open the bacteria go into fiesta mode and travel up along the tunnel into the air sinus creating a frogspawn-looking infection.
So, to help prevent this a surgical dentist pulls the gum over the tooth socket to seal the hole – job done.
