Hi Jedijud,

I agree with the ENT doctor in that you need to have this situation taken care of as soon as you can.

With regard to your dental records.... legally the dentist that extracted your tooth has to turn over a copy of your written records and xrays if you make this request in writing. Any other dentist or physician that treats this condition knows the law and knows that the treating dentist has to comply with your written request.

As I stated previously, the original dentist is partially responsible for your current situation because she was neglectful by not informing you of the size and severity of the sinus opening and also she was a bit lax to say the least in performing the oral surgery properly to close the sinus OR refer you immediately to an oral surgeon.

As far as the severity of the infection.... there can be several reasons why it became that way and it is possible that she may be at some fault having to do with her surgical abilities and sterile technique... or there the lack of. You also could have had a severe infection to begin with which proliferated either during or immediately after the removal of the tooth.

At times, dentists make mistakes or perform below acceptable standards and when this has become obvious or it is brought to their attention, they usually will do whatever it takes to make amends with the patient. I would suggest that you request your records in writing and if possible state the day and time you will pick them up. Have the surgery done to remove the infection, pay the surgeon, and then take the bill to the original dentist and request that she at least reimburse you half of it. Or whatever amount you feel she should pay.

Again, I am sorry this has happened to you. It's such a shame that you have had such a bad experience. I hope you are able to get the help you need soon and I hope the original dentist takes responsibility of her actions.

Bryanna

Hello ginnie,

Yes, I am still here trying to help people.... as I see you are too!!

Glad to hear that your dental work went so well... yay!!! So you are wearing a nesbit... great! Did it need any adjustments? I am sure at your check ups your dentist will be monitoring those two last root canaled teeth. Glad you are aware and acknowledge their instability. That will make things easier for you in the future :)

I hope your check up shows more improvement in the gum health and you are on your way to easier dental visits in the future :)

Thanks so much for keeping us updated :)
Take care!

Bryanna

Hi Bryanna
 

Yes I am trying to help on the site too. Lots of people with spinal issues.
I did get #18 removed also. The other dentist wanted gum surgery, root canal and crown. Couldn't see going that way. I didn't choose the root cannal and I am glad I didn't. The besnit is great. Very easy to get use to and I can smile again. Gums doing fine, and I feel good knowing they are doing so much better. I will keep going now for regular cleanings. This dentist took alot of money off what I owe so I could do this work. she gave mercy on my bill. so I will try even harder to pay her off. That is the kind of doc. that deserves the pay! My teeth are stain and cavity free, and I am smiling!:D ginnie

Sorry to reply on this comment but I am kinda new at this and I wanna get a answer for my question.Alright you have heard my story.I am trying quote trying to get my records from the dentist.They are not wanting to cooperate with me they are only giving me x rays no records last week it was we can only give you records no x rays?This has me puzzled they ask twenty questions why do I need them name of next dentist I am seein?Why are they giving me 20 questions bryanna?Why are they so head strong bout not giving me all my records?

About records and the dentist
 

I want to welcome you to Neuro Talk. I am sure Bryanna will answer your question at some point. I want you to know that things happen in dentists offices that should not happen. You are allowed by law to get your records. If they are not giving them to you, that would put up all kinds of red flags in my mind. I live near Tampa Bay, Last night there was a late night news hour about chain dentists doing work that is unecessary. We are not taught to question dental proceedures, and we should. The first dentist I went to, which was in a chain, proposed doing about 3 thousand dollars work on a single tooth. I found out after a different doctor, and through Bryanna that this tooth was not salvageable to begin with. Question all proceedures, and learn all you can. Bryanna did save me all kinds of money. As you know dental care is very expensive. Getting a second dentist, and that opinion was the best thing I ever did for myself. The New dentist was extremely good with explaining things to me, the first dentist did NOT. I really do hope you can get your records with no more trouble, don't accept their excuses. I do with you all the best with your oral care. ginnie

Jedijud,

It is my understanding that you are legally entitled to a copy of your written records. I have provided records for many patients upon their request without any question.

You can call your local dental board, their number will be listed in the phone book or online. They will be able to tell you the legality and perhaps even help you obtain your records.

You don't have to give the dental office ANY reason for wanting your records.... you are just entitled to them. I get the sense that they may be trying to hide the incident or they have not kept very good records and that fact alone could get them into trouble.

Have you had the oral surgery to deal with this infection?

Bryanna

Hey guys well got my records after I went down and demanded them I had to be a prick but I got them.Well when I went in the girl said can I help you I said I want all my records she said why?I said they are mine and I want them she said what part do u want and I will get that part?I kinda lost it and said I wanted my records she said I have to get ahold of my office manager can you come back I said I will wait.No office manager ever came come to find out she was the office manager and what she did was call the dentist that performed my extraction and told her I was there to get my records she then went on to say the dentist said she strongly recommends you come back to our oral surgeon!I said no I am going to a better orAl surgeon.I live in a very small town so I see the girls from the office everyday it went from talking to me to straight snubbing me.I feel something bad has happened and they r covering it up now.I think the infection has maybe subsided bit now I am breaking out in a rash and I can hold a drink of anything in my sinuses.What I mean is I can hold a drink of pop in my sinus cavity for at least an hour.Then I give it a little suction and it pours out like a fountain drink.Go to oral surgeon on Tuesday will keep you posted thanks for the help it means alot.

Hi jedijud
 

The dentist you got the records from was not doing right by you. I do think her mishandling of your case, has caused the problem you have. I am glad you got the records, even if it took you getting angry about it. I have had the problem before with other physicians. I hope your infection can be cleared up now with a new oral specialist. Sorry this happened to you. ginnie

Jedijud,

It sounds like you have a "severe" sinus perforation. DO NOT drink anything other than water. Any other type of drink can cause further irritation and additional bacteria for the infection to thrive on. Try to avoid drinking on that side of your mouth if possible. Also refrain from drinking with a straw because the suction on the straw will re-open the perforated tissue.

I am glad that you were persistent in getting your records. I hate to hear stories like this.... but hopefully your new oral surgeon will be more competent than your previous dentist.

Please check in with us after your surgery to let us know how you're doing.

Bryanna

Hey ginnie and bryana just got back from my 2nd oral surgeon I will be operated on next week.He explained that he was worried about my sinus and that the hole had been opened to long.The sinus is a sterile cavity he went on to explain he must remove tissue from my cheek to repair the hole.All together 950 dollars and I have to be put under

Hi Jedijud
 

I am very glad to know that you found another oral surgeon to fix your sinus cavity. I know you are anxious to get this cleared up, so you can get on with your life. What I learned from my own experiece now, is to question eveything. I also get second opinions on all proceedures. I hope this turns out just fine for you, so that this experience can be behind you. Let me know how you are doing after your surgery. I will be keeping you in my prayers for a quick recovery. ginnie

Hi all, I just wanted to post my own symptoms as I am unsure of what the problem is. I had 4 wisdom teeth extracted two weeks ago today. Initially I thought the surgery went great as bleeding ceased in about 20 hrs and I didn't even have pain after 2 days from the surgery. 1 week ago, I went in for my follow up. Much to my surprise, the follow up was conducted by the front desk receptionist, not the oral surgeon (wtf?). Anyway, she simply asked me 3 questions and looked in my mouth for about 5 seconds, not even examining my top sockets. She said all looked fine. Here are my symptoms. Starting 5 days after extraction, I began getting the salty taste in the area of my top left socket. I have also had intermittent pain anteriorly to my left tmj (I would guess right around the area where that socket is). The pain has become less often as time goes by. I am a "smoker" but not tobacco. I occasionally smoke marijuana and have probably smoked 4-5 mj "blunts" (all mj tonacco) between now and 1 week post surgery. I did not smoke anything in the first week after surgery. I realize this has probably contributed to my situation.

Anyone have an ideas as to what could be my problem? (besides me smoking)
Any response is greatly appreciated!

I would also describe the problematic socket as a little "sore" when compared to my other open sockets. I'm not sure if I said It in the previous post but I have been using lister one mouthwash for a week instead of warm saltwater mix. Also, my spit has had some degree of discoloration for the entire two weeks post surg. Granted this past week has been much more normal colored.

Hi UCF
 

Hello, and I am glad you found Neruo Talk. There will be others to help address your situation. I think I would have had to squack, if the receptionist was the one to check my mouth after this surgery. That is not acceptable, unless she is an assistant and trained that way. If after your healing began, and you started with more pain, after having no pain, then you need to be seen. Infections can and do start up. I would quick smoking anything, until the issues is resolved, to be on the safe side. I don't think what youdid caused the infection or the problem. However it does put contamination into your mouth while you are healing. I am also surprized that mouth wash was allowed. In my release papers, mouth wash was not allowed, only salt water. Did you get discharge instructions? Bryanna will post to you. She knows more in detail if you would be having an issue with infection, or something to do with the jaw after surgery. Take care, and post to Bryanna. She was assistant for 30 years. ginnie

Since I have noticed I have quit and went back to the salt water rinse. My biggest symptom is the salty taste, there is little to no pain at all as of late.
Looking forward to what Bryanna has to say.

Hi UCF...

Well you know I'm going to say refrain from smoking.... anything.... until the sockets are completely closed over which could take several weeks. There are several negative issues with smoking when you've had oral surgery. But let's just say it can prevent the bone from healing properly and can cause the sockets to remain open.... all of which is not a good thing. So.....

Also.... do not rinse with anything other than lightly salted water. Just add a pinch of salt to about 3-5 ounces of water and rinse thoroughly. Do this about 3-4 times a day until the sockets close completely. Oral surgery or not, it is never a good idea to rinse with a mouthwash that contains alcohol because the alcohol and other chemicals decrease the salivary flow pre- disposing the person to tooth decay and periodontal disease. Also, rinsing with these types of mouthwash are very risky for anyone who smokes because when the mouth dries out, the tobacco.... etc.... is very irritating to the oral mucosa and this actually increases the risk of developing oral cancer. So all alcohol and/or chemical laden mouthwashes should be avoided.

The salty taste that you are experiencing..... did your dentist mention anything to you about a sinus perforation? Sometimes when the sinus is perforated, the person will get a salty taste until the perf closes over.

With regard to the receptionist performing your post op.... I can't stop laughing... sorry... but that is truly ridiculous... and illegal!!

Bryanna

Yea i figured that would be best so i have already ceased the smoking. The mouthwash i was using was alcohol free, but still have switched to the salt water wash, doing this after every time i eat now. As far as i remember, he said nothing of the sort to me or my ride home about perforated sinus. As far as the receptionist doing my follow up..when I told my parents (both are medical professionals) they both about fell over themselves. Worst part was, I drove an hour and a half for that follow up that could've been done over the phone.

Thanks for the replies. Ill post any more changes i experience.

Hey Ladies
 

Ok guys it's been a while I got the sinus perferation surgery done.Terrible pain if people say oh it's easy and none painful....They Lie.Ok he cut a fat packet in my jaw and placed it in the hole and covered the hole with gum tissue.Awsum that's great ......wait how does this work I add....well the fat that he placed in the hole has to rott in order for the tissue around it to grasp ahold and refuse the tissue cool huh.No I have a rott smell that is bad people in the room will leave my breath can kill flowers no joke.And as far as my wife kissing me that's not happening needless to say I went last week to get stitches removed and he didn't want to said he wanted it to be healed before cut the stiches lose.Ive had a bad fever and the pain is still there achy and dull the smell. Omg it's horrible zPack and pain meds are what are prescribed for this I hope anyone that has a sinus perforation reads this.It's serious

hi Jedi,

Your sinus perforation was very serious. Unfortunately, the diagnosis and treatment were delayed which probably caused further infection.

How long have you had the fever? Does your oral surgeon know about that?

Bryanna

Yes
 

He does I leted him know.But the male nurse that I saw before my surgeon wasn't having it?He told me it's like having a paper cut??I am like wtf he said my surgery was minor and really wanted to know why I was there???Ok Gaylord Focker surgeon walkedin asked what was going on I told him that Gaylord seems to think it wasn't that bad of surgery?Surgeon replied yes it was and a major dental problem dentist explained that the fat tissue will rott and cause a infection and that the pain was normal for kinda of surgery I had.That's why I go back tommrow it's still infected I doubt stitches will come out I have a slight fever dull cheekbone pain and the smell will turn people stomachs.

Hi Jed
 

This does not sound right or good. Maybe go see a different surgeon. Hope Bryanna will have an idea or two. This sounds like a bad proceedure from what you described. Did you know he was going to do that when he did the surgery? ginnie

Hi Jedi,

The procedure that you had done to close the sinus perforation sounds like it was what is referred to as a Buccal Fat Pad Graft. A piece of fatty tissue is taken through a small incision made way up high on the inside of your cheek. This tissue is then sutured together with your other oral tissue over the perforation. The idea of this fatty tissue rotting is a bit misconstrued but it's purpose is to encourage the formation of blood cells to grow your own fatty tissue to create a thick, complete closure of the perforation. This oral surgery can be a big deal and it is imperative that you follow your oral surgeons post operative instructions.

I'm not so sure it's a good thing that it's infected. What did your dentist say at your last post op appointment?

Bryanna

Hi Bryanna
 

I am having trouble wondering why these dentists do not tell their patients all that is involved with surgery and proceedures. The more I hear about this kind of thing the madder I get. I was not told the true condition of my neck either until I had more problems and got my records. What is going on??????What has become of a doctors responsibility to their patients?. This gent who had the fat pad surgery, obviously was not told much at all! ginnie

Hi ginnie,

Well... I can't answer why you were not told the full extent of your neck problem. I do know that not everyone likes or wants to know all of the details of their diagnosis or the details of the procedure. Sometimes, the procedure is scheduled to go one way and then there is a complication which can alter the treatment mildly or significantly. To explain every detail to a patient who is anxious or in pain, can cause unnecessary worry or even throw that patient into an emotional frenzy. For instance, to describe the procedure of the BFP Graft to Jedi would have been unnecessarily worrisome for him and others reading it ... that's why I didn't explain it on here.

Also, frequently what happens when we do explain a procedure to a patient.... the patients version or interpretation of the actual procedure when describing it to someone else is a bit misconstrued. Perhaps that is due to fear at the onset and they didn't quite hear what they were told..... or perhaps they just imagined what had happened and liked their version better. Who knows??

On the flip side...... other than a life threatening emergency where the patient is incoherent or unconscious ... I believe the patient should be informed prior to the treatment the general pros and cons of having it done, the possible systemic health risks and be offered the information on all other viable options.

~~~~~I believe every person has the right to be informed.... whether they want to be or not ;)~~~~~

Bryanna

age of reason
 

I guess I believe as you do, we have the right to know. I wish that I had been told the truth, and if it was held from me because of my emotions, it still wasn't right to do as it effected my ability to make a decision. I suppose I would rather hear an awful truth, that not be informed of what I am getting into. I didn't need to know exact details Of my 1st spinal fussion, but I should have been told the condition of the vertrebre above and below the surgery I had. That was what was withheld from me. That is the reason I insist these days on honesty with my physicians, and I get discouraged when other folks get the same treatment of not being informed. Not one dentist made note of the risk of RC to me, but they sure charged alot to do them. These dental problems people come to you about can really be serious. I just wonder what their doctors are thinking? Also to be told it does not hurt, and then it really does, do they really think that is a good idea to tell an untruth? Thank you ever so much Bryanna for the good things you do for folks. I for one, appreciate your honesty. ginnie

Ginnie,

I think you should have been told of the condition of your spine without any question. I agree that without that information you cannot make an informed decision and of course now you cannot undue what has already been done.

It is very common practice, always has been, to withhold information from the patient. There are a lot of reasons why this is done and at times it is the best choice made. But we should not withhold it because we "assume" that the patient didn't want to know or because the explanation was too lengthy and didn't want to take the time to go over it.

You mentioned how your dentists never told you the risks of root canal therapy. The dental profession will always be pro root canal therapy because #1 it is a huge money maker and #2 many dentists do not think beyond the patients teeth which means they don't consider the systemic consequences. Both of those reasons are unacceptable to me.... I am not alone in this thinking but I am of the minority that's for sure.

It's never easy to be a patient. But believe me, it's never easy to be the one taking care of the patient.

Have a good weekend ginnie!! Thanks for all that you do here :-))

Bryanna

Hi Bryanna
 

If I had been told the truth about my spine, that I reversed the curve of the whole dang thing, not just C6-7. I would have gone for a second opinion and maybe could have had the whole thing done at once, and not have to go through a second at C3-7 because the rest failed. That is why I am so interested in finding out the truth about stuff these days. I got caught not paying attention, because my pain was so bad I just wanted to get it over with. I paid a price for rushing into it.
Take care Bryanna, and keep helping those folks out like you do. We sure do need each other on this site. If the moderators are listening... THANKYOU and of course you too Bryanna

Ginnie,

I feel terrible that you were in such a predicament. But all too often, it is either pain or fear that causes us to make the immediate decision to completely trust the doctors "taking care" of us. If they could have gotten you out of pain long enough to give you other options and/or for you to get a second opinion, that may have been helpful. But again, sometimes we are in a predicament where we just can't think straight and if there is no one to be our advocate who can knowingly ask the questions for us, we tend to go along with whatever is recommended at the time. Ginnie, you can only do what you can at the time. The "if only's" can get the best of us if we let them.

I agree.... we do need each other on this site. This is a wonderful group of caring people who have experienced some really tough situations and they so warmly extend themselves to others no matter what. I know your presence here is very important to many people. I'm very glad we're a part of this community :)

Bryanna

Hi!
 

So, I have a question. I came across this feed when googling my symptoms. I had my #14 tooth extracted on Monday (5/7/2012). It was a simple extraction, and I don't believe I have dry socket at all, but I do believe to have sinus perforation (sp?). I noticed on Thursday night that when doing the salt water rinse, some came out my nose. Last night, a lot came out of my nose and then when I sniffled, air came through the hole.

There was no talk of the root being near my sinus cavity, and honestly, I studied dental assisting for a year and didn't even know about this! I knew your roots could sometimes go into the sinus cavity, but I guess I either forgot all about this or just didn't know at all.

Anyway, I'm terrified that it's going to get worse. I don't swish harshly or anything. I'm still eating soft foods. I do smoke and have been doing so carefully. I don't know if I can quit, but I could try... When I do smoke, I make sure to cover the extraction site with wet gauze and I don't suck hard. Now, I'm keeping the site covered because I'm even more freaked out by this... It's not too painful, just kind of a jolt sometimes when the water goes through.

I'm just confused and not sure of what to do? Please help me on this one. :confused:

Hi CoastieStacie,

Your description of symptoms does indicate a sinus perforation. This needs to be checked by an oral surgeon asap to determine how large it is which can help determine if it will heal on it's own or you need to have it surgically closed.

Irrelevant of how you cover up the surgical site, smoking does impede the healing process from a tooth extraction because the (carcinogenic) chemicals in the tobacco irritate the wound and the sucking sensation prevents the hole (and/or sinus opening) from closing completely. Smoking can also make the sinus perforation larger for those same reasons. An open sinus into the oral cavity can cause chronic oral and sinus infections which can spread past the sinuses into the brain. This is not something to ignore.

Please see your oral surgeon for evaluation as soon as you can.

Bryanna

I went in to have my back teeth extracted and he put a hole in my sinus cavity and he said he went back in and he put bone and mesh and a membrane in there to hold it.. all was well for a few days. Then it got real sensitive when I spoke and come to find out there were sinuses draining out of a hole that was in my gums. (not the one he fixed ) but anyway I kept complaining about how sensitive it was and he kept saying that it was healing not to worry. On Wednesday Night I was told to rinse with an antibiotic mouth wash. When I did this It started burning the back of my nose. So I got the flash light and looked at it. There was this sinus material hanging from my gums so I pulled it out and there was a hole in my gums. Where the sinuses were leaking was a big hole so I called the Doctor Thursday morning and they said I need to come back in for emerg surg. So I did. Doctor then looked at it and he took my cheek and sewed it up over my gums. Well I’m getting scared because I have been trying to talk a couple times today and it is getting real sensitive again and I just want this fixed…

Hi ackleyj
 

If you can, post directly to Bryanna. Welcome to Neruo Talk. Your dental issue does sound like this needs to be fixed, and that you may need to see some kind of specialist. Bryanna, is the most knowledgeable about dental issues, as she was assistant for 30 years. No dentist usually requires this kind of mouth wash anyway, that would burn healing areas. Ususally only salt water. The whole issue sounds like you need to be looked at again. Post to me, or even private message Bryanna, by clicking on your name, that leads you to where you can post this way, thereby getting directly to her.
I do wish you all the best. Tooth issues aren't fun. Let me know how you do. ginnie

Hi ackleyj,

To help clarify your description....
The roots of your back molar were either in or near the sinus membrane. You could also have had an infection in the tooth that spread through the end of the root, through the sinus membrane into the sinus cavity. When the tooth was extracted, the perforation was made larger in trying to remove the tooth and clean out the area.

Placing a bone graft at the time of this type of surgery depends on the size of the perforation and the infection present in the surgerized area. If the perf is large and/or there is infection, it is common to place a collagen membrane over the sinus opening and obtain primary closure with sutures bringing as much gum tissue together as possible. Then a second surgery is done weeks or so later to place the bone graft. In your case, the dentist decided to do the membrane and bone graft at the same time. Given the symptoms that you have been experiencing, this may or may not have been an ideal decision.

When there is minimal gum tissue, not enough to obtain primary closure (this means the hole is closed to some degree), and the area needs to be closed off, then the dentist will pull a piece of the inside of the cheek near the extraction site over the surgical opening and suture it closed. If you develop additional "holes" in the gum area of the surgery, then this needs to be examined to determine if the original opening is involved or not.

Anytime the cheek tissue is used to close over the hole, the area will be sensitive to speak, eat, chew, swallow, etc. because the tissue is being pulled every time you do this. It is wise to open the mouth minimally, eat a soft nutritious diet, drink lots of water and not open the mouth wide.

Did you have an oral surgeon do this surgery? If not, then I would suggest that you consult with one.

Bryanna






QUOTE=ackleyj;886803]I went in to have my back teeth extracted and he put a hole in my sinus cavity and he said he went back in and he put bone and mesh and a membrane in there to hold it.. all was well for a few days. Then it got real sensitive when I spoke and come to find out there were sinuses draining out of a hole that was in my gums. (not the one he fixed ) but anyway I kept complaining about how sensitive it was and he kept saying that it was healing not to worry. On Wednesday Night I was told to rinse with an antibiotic mouth wash. When I did this It started burning the back of my nose. So I got the flash light and looked at it. There was this sinus material hanging from my gums so I pulled it out and there was a hole in my gums. Where the sinuses were leaking was a big hole so I called the Doctor Thursday morning and they said I need to come back in for emerg surg. So I did. Doctor then looked at it and he took my cheek and sewed it up over my gums. Well I’m getting scared because I have been trying to talk a couple times today and it is getting real sensitive again and I just want this fixed…[/QUOTE]

Hole in Sinus
 

I just went to an oral surgeon who indicated that I had an infected wisdom tooth that must be extracted asap. He also indicated that there is a hole in my sinus that is leaking bacteria. He has recommended that I have the tooth removed and "simultaneous repair of the fistulae between the oral and sinus cavity with a bone graft and tissue flap." The tooth extraction is covered by my dental insurance but my dental insurance does not cover the repair of the hole in the sinus. My medical insurance would cover the repair of the sinus if I went to an ENT doctor.

To make matters a bit more complicated, I am almost 7 months pregnant. The dental surgeon suggested that if I don't get the procedure done asap, the leaking bacteria could potentially harm the baby.

My question is - should I have the oral surgeon do the extraction (covered by insurance) which is scheduled for this Friday and then go to an ENT for sinus repair or is it just better to do it all with the oral surgeon on Friday and bear the $800 expense for the oral surgeon to repair the hole in the sinus?
Is there any danger to me or the baby if I wait to get the sinus repaired?

Any guidance would be appreciated.

Dear Aney
 

Is there anyway you can fight your insurance company? It isn't like this is some small situation. You do need the proceedure. Most of the time doing the whole thing is advised to my understanding. I would eat the cost rather than have this at all dangerous to your baby. I don't know what the risk would be to wait, but Bryanna will. A hole in the sinus does not sound like something I would want to wait on. I wish you all the best, a speedy resolution, and of course a healthy happy baby. ginnie

Aney,

I am in the dental profession..

At seven months pregnant it is best to have one single surgery... do it all with the oral surgeon.

You could ask for a reconsideration of benefits from your medical insurance company after the procedure is done stating you were in an urgent situation and 7 months pregnant. Perhaps your oral surgeon will write a brief letter explaining the situation and what he felt was in your best interest.

Please let us know how you're doing.

Bryanna


I just went to an oral surgeon who indicated that I had an infected wisdom tooth that must be extracted asap. He also indicated that there is a hole in my sinus that is leaking bacteria. He has recommended that I have the tooth removed and "simultaneous repair of the fistulae between the oral and sinus cavity with a bone graft and tissue flap." The tooth extraction is covered by my dental insurance but my dental insurance does not cover the repair of the hole in the sinus. My medical insurance would cover the repair of the sinus if I went to an ENT doctor.

To make matters a bit more complicated, I am almost 7 months pregnant. The dental surgeon suggested that if I don't get the procedure done asap, the leaking bacteria could potentially harm the baby.

My question is - should I have the oral surgeon do the extraction (covered by insurance) which is scheduled for this Friday and then go to an ENT for sinus repair or is it just better to do it all with the oral surgeon on Friday and bear the $800 expense for the oral surgeon to repair the hole in the sinus?
Is there any danger to me or the baby if I wait to get the sinus repaired?

Any guidance would be appreciated.[/QUOTE]

Hi Bryanna.

So, my obgyn was concerned with why the oral surgeon felt the bone graft was necessary and questioned it. She was ok with performing the extraction for the infected tooth but she didn't understand why the expensive bone graft procedure was necessary at this point.

I then talked to one of my friends who is a periodentist and she looked at the xray and couldn't see why he thought the sinus was affected. To her, it looked like he just needed to do the extraction and fill with gel or collatape (sp?) and suture since there was no indication from the xray that the sinus was perforated.

I then went to an ENT doctor to get his opinion regarding whether my sinus was leaking bacteria. He said that based upon his exam and review of the xray, there didn't seem to be any indication of a perforation of the sinus and I am not experiencing any symptoms suggesting any sinus issues. He said my sinus looked completely fine. Also, from looking at the xray, the ENT doc felt that the sinus was sufficiently far enough away from the sinus that it didn't look like it would be affected by the extraction. He was very concerned as to why the oral surgeon was suggesting that the bone graft was necessary at this juncture, especially since the extraction was not even done yet.

Now, I am concerned that the oral surgeon is telling me I need to have a procedure that no other doctor seems to support at this juncture and pay for it in advance out of my own pocket while I am 7 months pregnant.

All other docs seem to think that the oral surgeon is looking to make a quick buck at my expense.

I want the oral surgeon to do the extraction tomorrow but not the bone graft. I called and left his practice a message so that he can explain to me why the bone graft is medically necessary at this juncture.

Aney



[/QUOTE]

Hi Aney
 

Interesting....Glad you are trying to educate yourself. many dentists do proceedures, that are not necessary and don't tell you the truth. I would not go back to that particular specialist. If you have no involvment with the sinues, and two doctors told you that, I would just get the tooth removed if it were me. I am of the opinion, that I personnally have been told alot of stuff from doctors looking to make money. For example with root canals. I wish you all the best, and if you have questions, go to another specialist, and ask Bryanna for sure. ginnie

Aney,

Without seeing an xray I can only go by your description, therefore, I cannot tell you why the oral surgeon recommended a bone graft. In general, the specialist who would be the most knowledgeable and diagnostic with a tooth and sinus communication is an oral surgeon because he is the one who deals with this type of situation every day. Periodontists specialize in the health of the gum and bone level. Some perform this type of extraction, but not usually. Xrays can be very deceiving and like anything else, some dentists are definitely better at reading them than others.

I am the first to admit that some dentists are not ethical. But I don't think an oral surgeon would suggest an unnecessary invasive procedure on a women who is 7 months pregnant. It's just too huge of a risk to his reputation. Perhaps the oral surgeon was preparing you for the "what if's" rather than definitively stating you needed such and such??

I would sit down and go over everything with this oral surgeon prior to having the tooth removed OR seek a second opinion from a different oral surgeon.

Let us know how things go...
All the best to you!

Bryanna





[/QUOTE]

Hole in Sinus
 

So...prior to all of the other doctors getting involved, the oral surgeon wrote my OBGYN a note advising that I had an infected tooth and a hole in my sinus that needed to be filled with a bone graft.

He asked me to pay in advance for a surgical extration (the co-pay) and the bone graft. A total of about $1000.

After all of the other doctors got involved, reviewed the xrays and his letter, and I questioned it, the oral surgeon said that he was just preparing me for the worst case scenario. He said he saw indications in x-ray of a likely sinus communication. No other doctor saw any such indication.

Surprisingly, when I went to the appointment for removal, he only asked me to pay $35 co-pay for a non-surgical extraction. The extraction took 2 minutes, and he said it came out beautifully and there was no sinus communication. That was on Friday. Today is Monday and I feel great and extraction seems to be healing nicely.

I honestly believe, if I had not questioned it, he would have made me pay $1000 in advance and done an unnecessary bone graft.

Very disappointing. He was caught!

Aney

[/QUOTE]