Hi...I had 4 teeth extracted yesterday. One of them, #2, had roots very close to my sinuses, which I'd known ahead of time. Afterward, I was told by the Dr that he'd packed (I could be using the wrong word) it with something extra/different to defend against the chance of infection (or something to that effect, I'm sorry if I'm not remembering it correctly) as well as a prescription for clindamycin. Fast forward to about a half hour ago. I felt and tasted a salty fluid-like....fluid? dripping from the extraction site. I searched and found this site, and what I read led me to think I may have a perforated sinus. I saw some of the symptoms here, but wanted to describe what else I felt before jumping to conclusions, because I didn't read anything about the other things I'm experiencing. The other 3 were all on the left side of my mouth. There's no pain whatsoever on that side. The extraction site of #2 is painless as well. However, there's a strong amount of pressure in my sinuses on that side, which I'd originally chalked up to swelling due on account of how the Motrin works really well for it, and the propoxyphene doesn't. Even that isn't so much painful as annoying. Also, and I'm not really sure how to describe this accurately, but I'll try. When I swallow, and when I tried to smoke, it felt/feels sort of like...like it's pulling or suctioning mucous towards (but important to note NOT OUT, just towards and needless to say I thought I should wait a little longer before trying to smoke again) the extraction. Sort of like (I'm sory for the graphic visual I'm about to cause) like feeling you get when one side of nose is stuffed and you roll over and it drains to the other side. I hope this made enough sense. Oh, and while I have the salty taste, I do NOT have liquids coming back out my nose when I drink. Hope that's enough info to get an opinion. Also, whether it is or isn't a perforated sinus, do I need to be seen ASAP? Can I wait til Mon to call my Dr? Can I just wait til my follow-up appt Fri? Thanks in advance! Sorry for the length, and again, sorry for the bit of grossness I felt it necessary to include.

~Rachel

Just want to add that after I thought about it a little longer, I realized a good description for the fluid-like fluid is tears. That's how it tasted and it was thin like tears, too.

Hi Rai,

Yes, it does sound like you have a sinus perforation. The description of "tears" is right on. Fluid from the sinuses is salty, just like tears. Your description of the sensation that you have when you swallow also indicates a sinus perf.

Stop smoking. The sucking action on the cigarette may have opened up the sinus that was being held closed by the collagen plug and suture. It is wise to call the dentist on monday and tell them what has happened as he may want to see you tomorrow. If you continue to smoke, the sinus membrane will not heal closed and you will end up with post operative complications and infections that are very difficult to remedy.

It's good that you are concerned about this and should not wait to seek attention for it.

Let us know how you're doing...
Bryanna

Thanks soooo much for the advice. I'll call my Dr. first thing in the morning. Luckily I really liked him and the staff....makes something like this a little easier to keep calm about when you trust the ones who will be caring for you, ya know? It's feeling a bit more like a sinus infection does...kinda painful in the cheekbone/sinus area, so I do kinda hope he'll ask to see me tomorrow. I'll keep you posted and thanks again for the advice!

I have the symptoms of a perforated sinus. I have air leaking out into the mouth. I also have the salty discharge leaking from the extraction site. It's been two weeks since the extraction of tooth #16. The salty discharge has just started to be somewhat less than it had been. I see the oral surgeon today. Do you think a surgical repair needs to be done at this point, or could the extraction hole still close on its own? Normally my gum tissue heals really fast, so I'm concerned about the hole still being open. Also, should the sinus be stitched or patched at this point?

Also, I am supposed to fly out of town next Friday. I would not want to go if this could cause a problem with a sinus infection or tearing the perforation further. What do you think about flying?

Thanks so much. Carol

Hi Carol,

It sounds like another sinus perforation but there is no way to tell if it needs surgical intervention or what exact procedure via the internet. Whatever happened to the other sinus perf on the right side back in July?

I think you said in a previous note that you were a smoker. Anytime a smoker has an extraction, the chances of developing a dry socket anyplace in the mouth and/or a sinus perforation of an upper tooth is more likely to occur than in someone who does not smoke. Also, the gum tissue will take longer to heal closed in a smoker... which can lead to a more extensive sinus perforation and infection. The reason for these complications is due to the lack of oxygen and red blood cells in the oral tissue caused by the chemicals in the tobacco.

It is usually recommended to refrain from flying if you have a sinus perforation from an extracted tooth. The pressure can cause the perf to enlarge and become very painful. It is also recommended to not blow your nose and to cough with your mouth open to diminish the pressure on the sinuses until the sinus perforation has closed.

Did you see the oral surgeon today? What did he say?

Bryanna


[/I]QUOTE=Silky;689935]I have the symptoms of a perforated sinus. I have air leaking out into the mouth. I also have the salty discharge leaking from the extraction site. It's been two weeks since the extraction of tooth #16. The salty discharge has just started to be somewhat less than it had been. I see the oral surgeon today. Do you think a surgical repair needs to be done at this point, or could the extraction hole still close on its own? Normally my gum tissue heals really fast, so I'm concerned about the hole still being open. Also, should the sinus be stitched or patched at this point?

Also, I am supposed to fly out of town next Friday. I would not want to go if this could cause a problem with a sinus infection or tearing the perforation further. What do you think about flying?

Thanks so much. Carol[/QUOTE]

Hi Bryanna,

I'm not a smoker. Thought I'd get that out of the way first. ;-) The sinus perf on the right side healed totally. The surgeon had stitched it at the time of the extraction. I had air escaping symptoms for about 5 months, and then that cleared up.

When I saw the oral surgeon today, he did an xray and examined the site, and he said there is no perf. Would an xray be pretty conclusive for that?

I did some researching and found that oroantral fistula also has the symptoms of air escaping and salty discharge. Is that something different than a perf? Usually I heal very quickly in the gums, about a week. It's been two weeks, and he said the hole is a size of a dime in the extraction site. That's not normal for me. I asked him if he could close it, and he preferred not to. Could the opening just be stitched closed after two weeks. I'm afraid that this is open to the sinus and that's where I'm getting that salty taste. Oroantral fistula sounds pretty scary if it turns into a sinus infection. I've never had a sinus infection, and my sinuses have always been very clear.

If this is an oroantral fistula, what would you recommend about flying then?

You're so helpful. I really appreciate your advice! Thanks. Carol

It sounds like another sinus perforation but there is no way to tell if it needs surgical intervention or what exact procedure via the internet. Whatever happened to the other sinus perf on the right side back in July?

I think you said in a previous note that you were a smoker. Anytime a smoker has an extraction, the chances of developing a dry socket anyplace in the mouth and/or a sinus perforation of an upper tooth is more likely to occur than in someone who does not smoke. Also, the gum tissue will take longer to heal closed in a smoker... which can lead to a more extensive sinus perforation and infection. The reason for these complications is due to the lack of oxygen and red blood cells in the oral tissue caused by the chemicals in the tobacco.

It is usually recommended to refrain from flying if you have a sinus perforation from an extracted tooth. The pressure can cause the perf to enlarge and become very painful. It is also recommended to not blow your nose and to cough with your mouth open to diminish the pressure on the sinuses until the sinus perforation has closed.

Did you see the oral surgeon today? What did he say?

Bryanna


[/I]QUOTE=Silky;689935]I have the symptoms of a perforated sinus. I have air leaking out into the mouth. I also have the salty discharge leaking from the extraction site. It's been two weeks since the extraction of tooth #16. The salty discharge has just started to be somewhat less than it had been. I see the oral surgeon today. Do you think a surgical repair needs to be done at this point, or could the extraction hole still close on its own? Normally my gum tissue heals really fast, so I'm concerned about the hole still being open. Also, should the sinus be stitched or patched at this point?

Also, I am supposed to fly out of town next Friday. I would not want to go if this could cause a problem with a sinus infection or tearing the perforation further. What do you think about flying?

Thanks so much. Carol[/QUOTE][/QUOTE]

Hi Bryanna,

I'm again thinking more it would be a perf. I'm having the same symptoms of runny nose, air leaking into mouth, and salty discharge that I had last time. I thought I heard that sometimes the perfs can be hard to find. With all these symptoms, I really feel worried about flying. What do you think? Thanks. Carol





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Hi Carol,

I must have you mixed up with someone else who asked a similar question... although it is odd that I knew you had a sinus perf on the upper right since you are not that person..... ??!!

What did the oral surgeon say was the problem? Did he just dismiss your symptoms?

The fact that your tooth was removed 2+ weeks ago, the gum area is still open and you have symptoms of a perf... I think another trip to a different oral surgeon might be helpful. Something is definitely going on.

Sometimes you can see a sinus perf on a dental xray but not always. Sometimes it only shows up on a dental CT scan.

Bryanna


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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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