Hi Bryanna, I've read so much in this forums and have learned so much from you. I'm posting here hoping that maybe you can help me too.

Months ago I had gone to my dentist to have a molar removed, this molar and the premolar in front of it has been root canaled. But the dentist says the the molar is no longer in good condition to be able to have a crown fixed on top of it, which was why it was removed. Due to the brittle state of the molar, the dentist wasn't able to get all of the tooth during the extraction, he says that the tooth fragments should push themselves out if a few months time.

Fast forward approximately 2 months to today, I had gone to see him again. Upon inspection he noticed that the gum where the tooth had been extracted hasn't completely healed and he says that a tooth fragment is still inside. He proceeded to open the gums and tried to remove the bone fragments. He was having a hard time trying to remove it, and later on I felt some pain. Like he poked the small icepick-like dental tool at something soft. At first I thought it was just some part of my gums, but when he told me to gargle, I was shocked that some of the water dripped down my left nostril, later on i bent over again and some more water dripped down from my nose. I informed him about this and he told me to lie down and stop gargling, and to let the blood clot.

Before this happened it didn't seem like he was done, but then he told me that he had removed the fragments already, which I didn't see. I asked him why the water dripped out of my nose and he couldn't answer me directly, he also seemed flustered. Knowing a little about the sinus wall, I asked him if it was punctured and he answered me no. His answer wasn't very confident, and he usually was very loud and jolly, but after he saw water drip from my nose his demeanor seemed to change. After letting me rest for awhile he started to suture the gums.

Being worried I asked him if there was anything I should take, and only then did he suggest that I take antibiotics for 3 days. He said my cheeks might swell because of the procedure he did, which was opening the gums again. I didn't believe any of it, which is why I did some research and stumbled onto this forum.

Help me Bryanna what should I do? I have had a previous case of a bad sinusitis, which has been getting better. But now, knowing that I probably have a sinus perforation makes me worry again. I know having a sinus infection is very dangerous especially being so close to the brain. Today I feel like I'm starting to have a fever and have started taking the amoxicillin, I was instructed to take it twice a day for 3 days.

Is it possible for the perforation to close by itself without any surgical intervention? Because I've read from some other sites that a perforation can't close without surgery. What do you suggest I should do, and what steps should I take to prevent it from worsening? I've avoided sucking from straws and gargling with my mouth closed, should I avoid drinking and eating from that side of the mouth as well?

Is it good news that I don't feel any air going down from my sinuses through to my gums, or is it probably just that because the gums have been sutured and because i'm avoiding breathing/blowing heavily with my nose.

I plan on going to see an ENT 2 days from now.

Hi Jimabano,

I always caution patients to see an oral surgeon (not a general dentist) for most extractions... especially if it is a second surgery because the first one was incomplete. Your initial symptoms are that of a sinus perforation. Sometimes the perf will heal on it's own, other times it doesn't.

If you are prone to sinus infections and/or had one recently then it is wise to see the ENT this week. Make sure he knows your complete medical history and the dental history of both the molar and premolar.

You may have some residual problems not only from the incompetently done surgery but from the root canaled premolar. Make sure to tell the ENT that the pre molar is also root canaled and when that treatment was done.

Please let us know what the ENT says...
Bryanna