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Old 10-10-2014, 11:50 PM #11
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frostyjohn,

I think you should stop putting all that pressure on the sinus. The last thing you want is for the infection to accidentally end up elsewhere.

If that stuff is coming out on it's own...... there has to be an opening.

I am unsure about the throat theory.... but hopefully the ENT will be able to diagnose this properly.

This ordeal must be horribly uncomfortable for you. I hope you get to the bottom of this this week!!

Hang in there....
Bryanna




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When i create back pressure, i can see the green fluid come out. It comes out slowly and i have to create a lot of pressure, and some times it doesn't come out at all, but it definetely comes out from that spot. Some days I can even feel it "squirt" out from that area on it's own.

I try not to create back pressure too often out of fear of making it worse.

How much do you buy this surgeon's theory that it comes from the throat and collects in the extraction site? I just don't see how it would "climb" into the spot and collect in the extraction site.
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 10-11-2014, 09:35 AM #12
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Yeah I feel really discouraged right now. I'm trying to accept maybe there really isn't a hole in my gum. I think maybe focusing on fixing the sinus infection and removing the polyp may be a better route for now. Maybe the ent fixes that and the fluid stops coming altogether. I'll let you guys know what the ent says this wednesday.

Thanks for the input so far.
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Old 10-11-2014, 01:51 PM #13
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It's just irritating because i can sit there without applying any pressure and watch the fluid secrete out. It's more of a sponge type effect, as opposed to a faucet, than an actual hole with fluid draining out.
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Old 10-12-2014, 04:13 PM #14
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frostyjohn,

Please try to be positive... you are not imaging what is physically happening! In all of my years in dentistry.... I have seen countless mistakes and misdiagnosis. I cannot stress enough that you just have to keep searching for the answer.

Regarding the polyp... it may be necessary to have it removed. However, it is equally important to find what caused it because it can grow back again if the culprit is not discovered.

A couple of things come to mind....

1) Let the ENT know the ENTIRE history of that extracted tooth. Get your records and xrays of all of that. That history may be helpful in getting the proper diagnosis.

2) If the tooth were the culprit, then it is imperative that if the polyp is surgically removed, then the entire area of that location all the way down to the tooth socket needs to be explored for residual bacteria and debrided if needed.

3) If any visual infectious bacteria or necrotic tissue/bone is not removed during the removal of the polyp, the problem will not be solved.

4) Sometimes oral surgeons and ENT work together surgically on a patient. One does the nose the other does the dentistry. Ask your ENT if he thinks this would be necessary.

If the polyp in unrelated to the infected tooth.... then you still have to determine the cause or it will return. Polyps form for different reasons. Ask the ENT to provide you with them as something may ring a bell to you that you have either forgotten about or thought it had no correlation to the formation of the polyp.

Repeated sinus infections are linked to various things. Ask the ENT to provide you with that information as well.

Many times polyps are formed from a constant irritant. Could be infection related but not all of the time. Sometimes the irritant is in your diet, your environment or your lifestyle. Food that has been grown in chemical laden soil, food that has been sprayed with chemicals, food that you are sensitive or allergic to can all cause sinus problems and eventual polyps to develop. Environmental factors in your home, at work or in your neighborhood again all contributors to sinus problems. Lifestyle factors.. what you sleep in, bathe in, apply to your body, breathe in like smoke or chemical fumes, anything that irritates your immune system can cause sinus problems.

Sometimes we have to take a serious look at all of those things and make changes wherever we possibly can to become well again.

I often recommend the guidance of a nutritionist who can order various testing to help determine what the irritants could be. Conventional medicine falls very short on stuff like this.... unfortunately.

Hang in there... fingers crossed that this ENT doctor is able to give you some answers.

Keep in touch with us..
Bryanna





Quote:
Originally Posted by frostyjohn View Post
Yeah I feel really discouraged right now. I'm trying to accept maybe there really isn't a hole in my gum. I think maybe focusing on fixing the sinus infection and removing the polyp may be a better route for now. Maybe the ent fixes that and the fluid stops coming altogether. I'll let you guys know what the ent says this wednesday.

Thanks for the input so far.
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 10-12-2014, 04:17 PM #15
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frostyjohn.

This could be because the area is becomes saturated with the stuff. This is very unhealthy.

Can you take a picture of the secretions as they come out of the gum tissue and bring it with you to the ENT?

Another thing that comes to my mind.... do not express the area the day of your appointment. Perhaps you could suggest that the ENT express it and take a sample to send to the pathologist. This would tell the species of bacteria, etc. Actually, your oral surgeons should probably have done this. But the ENT can do it too.

Bryanna


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Originally Posted by frostyjohn View Post
It's just irritating because i can sit there without applying any pressure and watch the fluid secrete out. It's more of a sponge type effect, as opposed to a faucet, than an actual hole with fluid draining out.
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 10-15-2014, 07:26 PM #16
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Hi All

Went to the ENT today. I managed to record my gum releasing some fluid and was able to show it to her today. She took a good look at my gums and at my CT and MRI.

She said for sure that the fluid is not coming out of my throat. That would be defying gravity.

According to her, I have two separate problems. There's no denying something is coming out of my gums. I have a sinus infection as well, but it's not related now to the sinuses. It may have been before, but there seems to be no connection between the two. She thinks the infection that is letting out the fluid is in the gum/bone and that it's necessary to fix that infection first.

She admitted that she can't fix it, that it's a matter for the oral surgeons. She believes it can be fixed. She kept my MRI and is asking one of her coworkers who focuses more on ENT surgery for a second opinion. She said she would call me within the next two days and give me her final opinion and my MRI back. I asked if she knew any oral surgeons who could fix it and she said yes.

Hopefully this is a step in the right direction.
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Old 10-16-2014, 10:06 AM #17
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frostyjohn,

YAY!! Finally a doctor who knows what they are doing!! Can you believe what you've had to go through to get a definitive diagnosis???

We knew all along it was dental related.... and I am so glad that you have pursued this! Most likely the culprit of this whole problem is the result of that extracted root canaled tooth which was previously infecting the bone. When the tooth was removed, either the area was not surgically debrided thoroughly or the infection was so high up that it was not clinically visible. However, every dentist that you have seen should have been able to figure this out without difficulty!! Oye :/

Please keep us informed and hopefully this situation will be behind you very soon.
Bryanna





Quote:
Originally Posted by frostyjohn View Post
Hi All

Went to the ENT today. I managed to record my gum releasing some fluid and was able to show it to her today. She took a good look at my gums and at my CT and MRI.

She said for sure that the fluid is not coming out of my throat. That would be defying gravity.

According to her, I have two separate problems. There's no denying something is coming out of my gums. I have a sinus infection as well, but it's not related now to the sinuses. It may have been before, but there seems to be no connection between the two. She thinks the infection that is letting out the fluid is in the gum/bone and that it's necessary to fix that infection first.

She admitted that she can't fix it, that it's a matter for the oral surgeons. She believes it can be fixed. She kept my MRI and is asking one of her coworkers who focuses more on ENT surgery for a second opinion. She said she would call me within the next two days and give me her final opinion and my MRI back. I asked if she knew any oral surgeons who could fix it and she said yes.

Hopefully this is a step in the right direction.
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 12-02-2014, 10:25 AM #18
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So I saw the other ENT for a second opinion, who focuses more on surgery, about 2 weeks ago as recommended by the last lady I saw. This ENT said that I definitely have a problem and am likely heading towards surgery. I asked him what he thought I had and he said he didn't know but that my MRI scan shows possible evidence of an oral-antral fistula. I then asked him if he thought it was my gum or my sinus which needed to be focused on. He wants to do an endoscopy on my left maxillary sinus (the one affected) pretty soon. He said he wants to go in and clean it out and see if that fixes the problem and if it doesn't he will have to get an oral surgeon involved. I guess it also allows him to look inside my sinus with a camera.

Do you guys think proceeding with the endoscopy is a good idea? So far it seems like my best route. I was wondering why they don't proceed to just open up my gum, but I guess there is no obvious fistula so they don't want to go that far just yet. What do you guys think?
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Old 12-02-2014, 12:31 PM #19
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Hi frostyjohn,

Thanks for checking back in with us.

Yes, have the endoscopy done. The reason they are hesitant to open up the gum and explore is because it may only provide a limited view of what now happening. At the onset of this problem that may have been a different story, but now the best surgical approach may be to look at it from the sinus down. I hope that makes sense to you.

Yes, getting an OS involved may be necessary because if there is oral bone involvement, the ENT is not going to touch that. I have known many cases like yours that go on for years without being properly diagnosed because people give up in despair. I tip my hat to you for being so diligent in this. I know it can be all too consuming, but keep forging ahead and the sooner this is taken care of, the better the outcome will be.

Please keep us in the loop!
Bryanna



Quote:
Originally Posted by frostyjohn View Post
So I saw the other ENT for a second opinion, who focuses more on surgery, about 2 weeks ago as recommended by the last lady I saw. This ENT said that I definitely have a problem and am likely heading towards surgery. I asked him what he thought I had and he said he didn't know but that my MRI scan shows possible evidence of an oral-antral fistula. I then asked him if he thought it was my gum or my sinus which needed to be focused on. He wants to do an endoscopy on my left maxillary sinus (the one affected) pretty soon. He said he wants to go in and clean it out and see if that fixes the problem and if it doesn't he will have to get an oral surgeon involved. I guess it also allows him to look inside my sinus with a camera.

Do you guys think proceeding with the endoscopy is a good idea? So far it seems like my best route. I was wondering why they don't proceed to just open up my gum, but I guess there is no obvious fistula so they don't want to go that far just yet. What do you guys think?
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Bryanna

***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 12-02-2014, 09:58 PM #20
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I just don't get how cleaning my sinuses through the endoscopy will fix the sinus? If I do have a fistula, will they be able to see it?

I have an appointment with an oral surgeon the 17th of December. I have not been able to show a recording of the pus coming out to an oral surgeon yet because all the other times I went to one I didn't have one. It was only when I started to get frustrated that they were saying it wasn't coming from my gum that I decided to record it. Hopefully when I take the recording to this oral surgeon it will change their approach to the problem, which has been nonchalant.

In addition to that, I plan to ask him if the endoscopy is good way to proceed with the problem if he comes up with no solutions.
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oral-antral fistula, sinus leakage, sinus perforation, wisdom teeth

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