Yes, I can get a second opinion. Sounds like a good idea.

How long is the time frame where a minor surgical repair can be done if necessary....before the bone or too much tissue grows in?

Hi Bryanna,

I have an appt. for a second opinion for Thursday morning. Does a CT scan show a perf with good reliability?

That's funny about the smoker and similar situation. Since July wasn't my other perf, I thought you either had me confused with someone else, or you were a mind reader. ;-) Carol
It sounds like there is a "communication" between your mouth and your sinuses. Those symptoms do not occur for no reason. If it were me, I would get another opinion, possibly a dental CT scan and not fly anywhere until I knew what was going on. I know this is all very difficult and worrisome. If it is a perforated sinus that is not healing on it's own, then it can progress into an infection that is very difficult to eradicate completely.

Would you be able to get a second opinion??

Bryanna




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There is a time limit and it depends on how large of an opening there is. The real problem with a sinus perf is that the hole doesn't close which can lead to infection beyond the sinus. The bone becomes dry and doesn't fill in and there is no blood supply there for tissue to grow either.

So it is good that you are going for a second opinion this week.

A DENTAL CT scan.... it has to be a dental one... can show a communication pretty well. If you get nowhere with the second oral surgeon, you could see and Ear Nose and Throat specialist because they deal with these things all of the time.

Bryanna

Bryanna,

Would a regular CT scan show a sinus perforation, or does it have to be a special dental CT scan? Thanks. Carol

It sounds like there is a "communication" between your mouth and your sinuses. Those symptoms do not occur for no reason. If it were me, I would get another opinion, possibly a dental CT scan and not fly anywhere until I knew what was going on. I know this is all very difficult and worrisome. If it is a perforated sinus that is not healing on it's own, then it can progress into an infection that is very difficult to eradicate completely.

Would you be able to get a second opinion??

Bryanna




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Hi Carol,

A regular CT may show something. But the angles and detail of a dental CT scan are definitively looking for anatomical abnormalities and they show the oral and sinus cavity much clearer. These are done frequently, so there shouldn't be any question about doing it. I personally would request a dental CT scan only.

Please let me know how things go!

Bryanna

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Hi Bryanna,

I found a place that had a dental CT scan. He was a regular dentist, not an oral surgeon. He said it was best to wait and see if the hole would close on it's own yet. I didn't feel too comfortable about that. He said the surgery could be done after a few months, and that it's easier to do the surgery if you wait because there will be more tissue. He never heard of someone getting a sinus infection from a perf. Geez!

I did find an oral surgeon who has a dental CT scan. Do you think it's best to go to another dentist or an ENT. Would the ENT do a different kind of surgery? It would be less invasive to go in through the mouth for repair, wouldn't it?

Hi Bryanna,

When they repair a perforation, do they just close the hole in the gum, or do they need to cover the sinus with something also?

I'm so frustrated how these doctors are blowing off the symptoms and the fact that the hole didn't close at almost 4 weeks.

It wouldn't make sense to go to the ER, would it? Do you think it's still best to go to another Oral Surgeon or to an ENT?

The dental scan I had done showed the outline of the tooths roots. Where the roots met the sinus, the outline disappeared which he said means the tooth was inside the sinus.

Thanks. Carol

I found a place that had a dental CT scan. He was a regular dentist, not an oral surgeon. He said it was best to wait and see if the hole would close on it's own yet. I didn't feel too comfortable about that. He said the surgery could be done after a few months, and that it's easier to do the surgery if you wait because there will be more tissue. He never heard of someone getting a sinus infection from a perf. Geez!

I did find an oral surgeon who has a dental CT scan. Do you think it's best to go to another dentist or an ENT. Would the ENT do a different kind of surgery? It would be less invasive to go in through the mouth for repair, wouldn't it?[/QUOTE]

Hi Carol,

Oye.... dentists can be such jerks.... sorry, but they really can. This guy that you saw is SO mistaken on the information he gave to you....not only can waiting to treat this be a problem later on, but sinus infections commonly occur from a sinus perf from an extracted tooth.
To elaborate and help answer your questions, here is a link I found that gives a good description of your situation and the question on there was answered by an oral surgeon.

http://en.allexperts.com/q/Dentistry...traction-1.htm

I know you are very frustrated over this and rightfully so!! If it is any consolation, your situation is not uncommon and I often hear of people going to several dentists before they get the right treatment.

Consulting an ENT doctor may still be a good option for you because it can reaffirm that there is a problem and his opinion may actually be helpful in getting your problem corrected by a dentist. ENT drs generally perform surgery along with a dental surgeon once the sinus has become infected. That's the progression of a sinus perf that you are trying to avoid in the first place.

Please keep me informed of what's going on.
Bryanna

Hi Bryanna,

I found an oral surgeon that seems to be willing to help me. When he looked at the extraction site he said that it would be easy to fix. He did an i cat scan and didn't see any noticeable breaks in the sinus floor. So I'm guessing they were too small to be seen. He said the surgery that he would do would be a flap surgery. He said he's even done this type of surgery a year after an extraction. He thought I might be best served not to do the flap right away. He gave me an antibiotic for a week, since he was concerned about the salty drainage and something is leaking somewhere. He thought the hole might close in a week or two. The fact that there is still drainage......does that mean the hole will probably not close. I asked him how big the hole was. He said about 1 cm. I get different answers when dentists look so not sure how accurate their estimate is. I think it's hard for them to see the hole being so far back and kind of dark to see. Since he's talking about the flap surgery it seems he must think the sinus area will heal by itself, and is only concerned with the hole in the gum. What would you do now? Does any of the info he gave me sound not right to you?

He left it that I would come back if I needed. He would probably do the flap surgery if I go back, and asked him to.

Thanks! Carol

Hi Carol,

It is very hard for me to say if the hole will close on it's own as I have not seen you clinically or radiographically. The salty taste indicates a communication between your sinus and your mouth. It could be as tiny as a pinhole but any communication between the two could result in infection.

Yes, oral surgeons have closed sinus perfs a year or more ater the extraction of the tooth. But that is only because the patient was not evaluated earlier than that. So yes, it can be done but it's not ideal to wait that long.

During the flap procedure, he may cover the opening in the sinus with a piece of collagen membrane and then suture the incision closed over that membrane.

You just may need some more time to heal... it's hard to say. I would take the antibiotic and then wait one more week after that is done to see how it is. If you are still getting that salty taste, then revisit the oral surgeon.

Sometimes these things heal on their own if there is no infection. Hopefully that is the case with you!!

Keep me informed .... ok...

Bryanna