Hi jrs,

I am going to re post your post and reply in CAPS.

<<My husband had a root canal removed on tooth #2 (upper back right tooth) on February 15. The infection was large, included the cavitation behind where the old wisdom tooth was, and the removal caused a large sinus exposure. This Huggins trained dentist created tissue from my husband's blood and sewed that in, filling the socket with plugs created from his blood.>>

IN ALL PROBABILITY, THE INFECTED ROOT CANALED TOOTH AND BACTERIA FROM THE CAVITATION HAD ALREADY PERFORATED THE SINUS, PRIOR TO THE EXTRACTION. I MENTION THIS BECAUSE THIS TYPE OF INFECTION CAUSES THE JAW BONE TO CRUMBLE LEAVING THE SINUS UNPROTECTED.

THE ROOT CANALED TOOTH HAS BEEN INFECTED SINCE ON OR BEFORE IT WAS ROOT CANALED AND THE CAVITATION MAY HAVE DEVELOPED SHORTLY AFTER THE EXTRACTION, IF IT WAS NOT ALREADY PRESENT PRIOR TO THE WISDOM TOOTH BEING REMOVED. I MENTION THIS BECAUSE IT WILL GIVE YOU AN APPROXIMATE TIME LINE AS TO HOW LONG THE INFECTION HAS BEEN BREWING.

THE BLOOD PROCEDURE YOU MENTIONED IS CALLED PLATELET-RICH PLASMA AND IT IS USED AFTER THE SURGERY TO PROMOTE BONE GROWTH AND HEALING.

*** DID THE DENTIST PLACE BONE GRAFT MATERIAL AT THE TIME OF THE EXTRACTION?

<<He developed an infection, had a 2nd procedure to "clean up" the site so to speak and stitch up the split where the infection came out, received antibiotics. He now has a fistula on his gum plus the sinus perforation has not fully healed so he can feel air passing through.>>

***WAS HE PLACED ON ANTIBIOTICS FOR THE FIRST SURGERY? IF SO, DID HE TAKE THEM?

***THE SPLIT TISSUE WHERE THE INFECTION DRAINED OUT OF .... WAS THIS THE SAME SITE AS THE INITIAL INCISION OR A DIFFERENT AREA? HOW LONG AFTER THE EXTRACTION SURGERY DID THIS HAPPEN?

*** WHEN THE DENTIST PERFORMED THE SECOND DEBRIDEMENT OF THE SURGICAL SITE, DID HE DO ANOTHER PLATELET-RICH PLASMA PROCEDURE OR PUT IN BONE GRAFT MATERIAL?

*** HAD HE DEVELOPED A FISTULA NEAR OR ABOVE TOOTH #2 PRIOR TO THE EXTRACTION? IF SO, IS THIS NEW FISTULA AT THAT SAME LOCATION OR A DIFFERENT AREA?

*** HAS HE BEEN BACK TO THE DENTIST WHO PERFORMED THE 2 SURGERIES TO EVALUATE THE FISTULA? IF NOT, HE NEEDS TO HAVE IT EVALUATED.

<<First question is the ENT said it can take 3-4 months for the sinus to heal and just to wait it out taking Allegra, Flonase and mucinex. He has just been taking allegra which keeps him from having any mucus so the other two have
not seemed necessary.>>

A SEVERE SINUS PERFORATION, ESPECIALLY WITH THE SEVERITY OF THE INFECTION THAT WAS, IS, PRESENT, CAN TAKE MONTHS TO HEAL CLOSED AND IT WILL ONLY CLOSE IF THE INFECTION IS CURED.

I AM NOT A BIG PROPONENT OF DRUGS AND THIS SEEMS LIKE AN OVERKILL TO ME.

....THE ALLEGRA IS AN ANTIHISTAMINE WHICH REDUCES THE EFFECTS OF HISTAMINE WHICH BASICALLY REDUCE MUCUS SECRETIONS AND SINUS SWELLING. HOWEVER, ANTIHISTAMINES CAN DRY OUT THE NASAL MUCUS MEMBRANES AND PROLONG THE INFECTION.

....FLONASE IS A CORTICOSTEROID AND DECONGESTANT WHICH DRIES UP THE MEMBRANE AND REDUCES INFLAMMATION. HE MAY BE ABLE TO USE JUST SALINE SPRAY INSTEAD OF FLONASE.

...THE MUCINEX THINS MUCUS AND IS OFTEN PRESCRIBED FOR UPPER RESPIRATORY ISSUES. I'M NOT SO SURE HE NEEDS THIS.

ALL OF THESE MEDS SEEM A BIT MUCH. BUT JUST USING THE ALLEGRA CAN CAUSE OVER DRYNESS IN THE NASAL MEMBRANES WHICH CAUSE IRRITATION AND FURTHER PROBLEMS. PERHAPS A PURE SALINE SPRAY WOULD PREVENT THAT DRYNESS FROM OCCURRING. HE SHOULD ALSO STAY WELL HYDRATED THROUGHOUT THE DAY WITH FILTERED WATER. IDEALLY, MOST PEOPLE SHOULD CONSUME HALF THEIR BODY WEIGHT IN WATER OUNCES. MEANING SOMEONE WEIGHING 150 LBS = 75 OUNCES OF WATER PER DAY.

<< He is a slow healer so it's no surprise it's not healed yet. Does waiting it out seem right? The ENT said a gum flap procedure is what they do to fix it.>>

I THINK THE DENTIST SHOULD SEE THE FISTULA. HE SHOULD DO A TRACT TEST WITH A GUTTA PERCHA POINT AND A PERIAPICAL XRAY TO SEE WHERE THE TRACT OF INFECTION GOES FROM THE FISTULA.

***WHY DOES YOUR HUSBAND HEAL SLOWLY? DOES HE HAVE MEDICAL PROBLEMS?

YES, A FLAP SURGERY CAN BE DONE. IT ALL DEPENDS ON THE SIZE AND LOCATION OF THE OPENING.

<<Second question is about the fistula. It continues to weep a whitish salty fluid that is stimulated to come out the gum by pressing on the lymph nodes in his neck or face when he feels pressure building up. It now twice has swelled then sort of popped like a blister. The fluid has been cultured and does no show any infection. It seems to fluid has been less over the past few days. Does he just wait this out, hoping it will eventually heal?>>

*** WAS THE CULTURE TAKEN FROM THE FISTULA OR TAKEN AT THE TIME OF THE SURGERY? IS THE LYMPH NODE SORE OR SWOLLEN? WAS THE LYMPH NODE SORE OR SWOLLEN ANYTIME PRIOR?