Hi, I found this forum tonite, my third sleepless nite after a tooth extraction. What happened was I had a root canal on tooth 15, my upper left molar and it never felt right, which led to an extraction where the surgeon said that tooth never felt right because there was a hole in the sinuses.. he pulled the tooth and put in some packing and sent me home. Later the next day, I could tell I had opened the hole as all I could do was suck air.. we rushed over and the surgeon then stitched my gum flap over my sinus hole. Now, two nites later, I am in horrific pain. My cheeks are so swollen, ( I am on two antibiotics) and I can't sleep or function at all. I keep taking narcotics, which is barely helping honestly. Is this still normal healing time or is this the sign of a bigger problem? I don't know what to do and I'm so scared, please tell me your opinions, thanks so much

Hi snowbomb,

Very sorry to hear that you are hurting so badly.

It sounds like the root canaled tooth was infected and the infection spread to your sinus causing a break in the sinus membrane. And/or when the root canal was done, the dentist perforated the apex (tip of the root) with an instrument which broke the sinus membrane causing a hole or communication directly into the sinuses. Either scenario would cause you to have some form of chronic discomfort in this tooth prior to the extraction. In cases like these, the extraction is a bit more complicated and the surgical site can take a bit longer to heal.

Did the dentist suture a flap of connected cheek tissue over the extraction site? If so, then that can be very uncomfortable for several days and you should try not to open your mouth too wide... chew too much... talk too much... until he removes those sutures.

Was your extraction done by a general dentist or an oral surgeon?

If you are still in severe pain by tomorrow... see an oral surgeon. The pain will usually lessen by the 4-5th day and continue to get better after that so if that is not the case you know it's not normal.

I know this is difficult... don't over due the pain meds, take them carefully and not more frequently than recommended. Drink as much water (avoid using a straw) as you can to help keep yourself hydrated since you probably are not eating very much. If you smoke, stop, because that will make it worse and will slow down the healing process.

Please keep in touch here...... hoping you wake up tomorrow feeling a lot better!

Bryanna

Bryanna,

Thanks for your answers, I appreciate them. Unfortunately, tonight that sinus hole re-opened somehow, as I am feeling the "wind tunnel" in my mouth and even more pain. The doctor who did the gum flap was a periodontist and he did use cheek membrane. I have no idea what they will do next, what happens when you fail to keep the sinus perf closed even with a gum flap and stitches? I am extremely concerned as to what the next step is...
Thanks for listening

Hi snowbomb,

I would recommend that you see an oral surgeon as they have a lot more experience in treating this type of thing.

Treatment to close a sinus perforation depends on the size of the opening as well as the health of the sinus and the jawbone in that area. Infection in either area can cause complications and delay healing.

Some small sinus perforations close on their own but others may not. To avoid further problems, it is important to have this re evaluated and if necessary, receive treatment as soon as possible.

Keep us posted...
Bryanna

Hi Bryanna,
I have seen a lot of your recommendations and I am hoping you can help me!
10 days ago i had both of my top wisdom teeth extracted. I needed to have one done as it was impacted and infected and needed to go (i am 30 yrs old) so i got both done just so the other wouldn't cause any issues later in lfe. After the procedure i was sent home to heal. About 3 days after the procedure i started have horrible pain in my sinus on the side of the previous impacted tooth. I also had fluid running from my nose to my mouth. I called the oral surgeon and the nurse insisted i had perforated sinus.. told me to not sneeze or blow my nose, no more salt rinse, and basically to just take the antibiotics for an additional week. It's now been 10 days since surgery... i dont have much pain, nor has any fluid moved through the whole, but there is a white discharge that looks and smells like infection.. and its continuously running out of the whole and down my throat. I went back to the oral surgeon today, and he basically laughed at me when i told him i thought it was infected. He said that it's mucus and mucus smells that way. I asked about the perforated sinus and it draining into my mouth, and he said he had to put a hole in my mouth to get the tooth out... That if it's not hurting and nothing passing through it that it's fine.

I guess my question is.. is this normal? Does mucus usually continually flow through this hole 10 days after surgery? Does it smell like infection?

I have been on 200 mg of clindamyacin for the past 10 days.. and it's been draining pretty constant since day 5. I am really concerned as I have heard of big issues that can arise if this heals while infected, but i dont want to go back to my oral surgeon again bc he basically told me today that i was over reacting and i have nothing to worry about... i was going to go for a second opinion but i dont have dental insurance so I already owe a lot for this procedure.

Appreciate any help you can give me!

Hi angmarenardon,

By now hopefully you have had some relief. Did you go to a different surgeon for a consultation?

Generally the extraction site should not be oozing foul smelling liquid or mucus 10 days post op. This situation should be evaluated by another surgeon if the one you have seen is not addressing it.

Bryanna