14/10/2026
This patient presented with an extra-oral draining sinus (infection draining outside of her mouth onto her skin) which was associated with her upper right first premolar (UR4). Even though extra-oral draining sinuses of related to teeth are rare (with a reported prevalence of approximately less than 1%), I have seen a few of these over the years in referral practice. The infection spreads through the bone and soft tissues to drain onto the skin of the face. Mandibular teeth are usually more frequently implicated than maxillary teeth which makes this case more unusual. Usually the patient has first presented to their doctor or have even been referred to a dermatologist before seeing their dentist. This patient had no idea an infection from her tooth could drain to her face. She presented with a long standing draining sinus (or infected area) on her right cheek with little symptoms from the tooth or soft tissues intraorally. Following root canal treatment over two visits of UR4, a 3-month review showed early signs of healing as well as healing of the extraoral sinus and the skin.
