on-going infection after tooth extraction - help!
 

Hi, I will try to keep this short. I had a tooth extracted in Sept 2010 which resulted in a fisula. It was in Feb 11 that the hospital confirmed it had closed. In this time I had developed an infection in my maxillary sinus. It is now Apr 13 - I have had 2 x caldwell luc involving debridement, 3 x FESS, and lastly in Jan 13, the maxillary wall removed. I have just been diagnosed with atrophic rhinosinusitis and the infection continues. I am in constant pain with frequent neuralgia/migraine. The smell is awful, I have a post nasal drip and big crusts coming from my nose. Oral antibiotics are not working and I feel at a lost end. I am with my 3rd hospital because they consider my case a mistery. Any advice would be appreciated.
Thank you
Hayley from South Wales-UK

Hi Hayley,

Unfortunately your situation is beyond our scope. There is no one here who can effectively discuss the extent and intricacies of your case.

Not knowing how to help you other than to say that you definitely need an experienced surgeon who is extremely well versed in atrophic rhinitis. During a brief google search, I came across a Dr K.O. Paulose who is supposedly a world class ENT surgeon with 38 yrs of experience and he performs surgery in the UK... or so the site says. I am not personally familiar with his work so I cannot vouch for his abilities. Just google Dr K.O. Paulose if you are interested in reading about him.

My heart goes out to you... I pray that you find the care that you need and deserve. Try to think positively even when you feel drained. Also without a doubt it's important to take good care of yourself. Seek the help of a nutritionist if you think your diet can be improved as our body requires good nourishment to heal.

I wish you all the best... and don't give up.... you will get through this!
Check back with us okay and let us know how you're doing.

Bryanna

Hi Bryanna,

Thank you for the tongue scraper suggestion. I have used my tooth brush for the tongue but not the scrapper so I will definitely give that a try. Another question: I have an appointment to have #31 tooth removed in about 3 weeks. It is a root canaled tooth that was done about 18 years ago (and there has been problems with it too). On a different post you had suggested the person to consider an oral surgeon in their situation rather than a dentist. I was planning on having the same holistic dentist that extracted #2 and #3 root canal teeth do #31, but I do want to make a wise and informed choice. He seemed very thorough with the removal of those 2 infected ones (periodontal ligament, site cleaning, etc.) and he also does cavitation surgeries for those with that unfortunate situation. I have had to really argue with several other dentists to even listen to me that I was having so much pain from those other 2 teeth. I feel really fortunate to have found this Dr. to listen to me and successfully remove them. He did take additional X-rays of #31 to confirm that he could do the removal but I am always open to additional information. Do you feel that lower molars require an oral surgeon versus a dentist?
Thank you,
Samantha

Hi samantha
 

I am not in the profession and Bryanna may have another thought. However your dentist sounds just wonderful. He listens to you, takes all you say seriously, and has done a great job with you so far. If it were me, I would stick with him and not go to another or different oral surgeon. Good dentists, who are really doing their best are hard to find. I hope you continue to heal well. Get lots of rest. ginnie:hug:

Hi Samantha,

I often suggest people see an oral surgeon for extractions because they are trained to perform a more thorough surgery than a general dentist. However, if your dentist is familiar with and experienced in doing cavitational surgery, then he is most likely as thorough as an oral surgeon when it comes to extractions. You also have recent experience with his surgery regarding #2 and 3.... and it's been a good one! So if he is confident that he can remove #31 and you are comfortable with his doing it.... then there is no reason to go elsewhere ;)

Very glad you are doing so well!!
Keep in touch here ok........ ;)
Bryanna

Vitamin D and post-op update
 

Hi Bryanna

Yes, I take a broad range of supplements to help with osteoporosis and thyroid issues. I recently became gluten free so I am thinking that maybe I absorbed more Vitamin D because of that. I had reached a maintenance dose and my results had been the same for a few years, so that's the only thing that's changed.

It's now just over 3 weeks since the surgery and the 'long life' stitches don't look like they are going anywhere. I don't have another appointment until May 21st. There's a little discomfort which comes and goes and still a little swelling and numbness. I just wondered how long these stitches were supposed to last - I forgot to ask the surgeon! :confused:

Lynne x

[QUOTE=Bryanna;977477]Lynney,

The idea with supplementing with vitamin d is to take enough of a dose over a period of time so that your blood work shows that you have ample stored in your body. You will utilize that supply and need to supplement again. I just don't want you to think once the serum level comes up that it automatically stays there... because it doesn't. The level of D decreases as you utilize it. Just wondering, were you supplementing with any other vitamins or minerals at the same time as vitamin D to help absorb it?

Bryanna

Hi Lynney,

Generally the absorbable sutures will fall out or dissolve on their own within 2-4 weeks. Sometimes sooner, other times a bit longer.

If you feel that the sutures are delaying the healing, the gum area is red and/or irritated.... then see your dentist sooner than May 21st. Otherwise it is okay for them to still be there and your dentist may or may not remove them on the 21st. Sutures tend to accumulate plaque so it's best to keep rinsing with the warm salt water after every meal to prevent that from happening.

Glad to hear that you are feeling okay!

Bryanna

QUOTE=Lynney;981710]Hi Bryanna

Yes, I take a broad range of supplements to help with osteoporosis and thyroid issues. I recently became gluten free so I am thinking that maybe I absorbed more Vitamin D because of that. I had reached a maintenance dose and my results had been the same for a few years, so that's the only thing that's changed.

It's now just over 3 weeks since the surgery and the 'long life' stitches don't look like they are going anywhere. I don't have another appointment until May 21st. There's a little discomfort which comes and goes and still a little swelling and numbness. I just wondered how long these stitches were supposed to last - I forgot to ask the surgeon! :confused:

Lynne x

worsening
 

Hi Bryanna - thanks for your reply.

Unfortunately I'm now in quite a bit of pain again,and bleeding, so it could be the sutures. Thanks to your advice I am trying to get an appointment with my local dentist today - will let you know how I get on!

Lynne

[QUOTE=Bryanna;981790]Hi Lynney,

Generally the absorbable sutures will fall out or dissolve on their own within 2-4 weeks. Sometimes sooner, other times a bit longer.

If you feel that the sutures are delaying the healing, the gum area is red and/or irritated.... then see your dentist sooner than May 21st. Otherwise it is okay for them to still be there and your dentist may or may not remove them on the 21st. Sutures tend to accumulate plaque so it's best to keep rinsing with the warm salt water after every meal to prevent that from happening.

Glad to hear that you are feeling okay!

Bryanna

QUOTE=Lynney;981710]Hi Bryanna

Another question for Bryanna - Dry Socket?
 

Hi Bryanna,
Well, it has been a month since the root canaled teeth #2, and #3 were extracted and all is pretty well there but 8 days ago I had #31 (also a root canal) extracted. The extraction took a little work (curvey roots) and the tooth itself was coal black in color (no more root canals for me). Tooth extracted, peridontal ligament removed, irrigated, etc. and I was headed home. Three days after the extraction, I felt more pain from the socket to the front of my chin than I had right after the extraction. By Saturday it was super painful, pain meds were not really touching it. It felt like intense nerve pain from my ear lobe to the front of my chin. I was able to get into a dental emergency center on Saturday morning where a dentist irrigated the socket and applied some thick yellow material down into the open socket. He told me it was healing fine, that I had no infection but that I would need to give it another week and take ibuprofen for the pain. He also gave me an irrigating syringe and suggested I irrigate it regularly with a salt water rinse. He asked me why it had not been sutured shut to begin with. Saturday, Sunday, and Monday were pretty tough. Monday night I was able to go nearly 6 hours without having to take ibuprofen so I took that as an improvement. I was able to contact the dentist office who did the extraction this morning after the long weekend and the dental assistant told me that it sounded like I had a partial dry socket. I was surprised to hear this because I do not smoke and my first extractions did not have this kind of pain. She said I could go to a local dentist (my extraction dentist is a 6 hr car ride from me) and request a dry socket dressing or if I felt up to it, I could just continue to irrigate the site and let it heal up on its own. What do you think I should do now and how long does it take for a lower molar's extraction site to close up?
Thank you,
Samantha

Hi Samantha,

Lower teeth are more inclined than upper teeth to get a dry socket because of gravity. Upper surgical sites will tend to bleed more whereas the socket stays moist longer. Lower sites the clot forms and sometimes it's not adequate or it gets disturbed and the bone dries out. Sometimes the more difficult the extraction, the more likely to develop a dry socket basically because the clotting factor gets interrupted with the length and difficulty of surgery.

I am not sure why the emergency dentist told you to irrigate the socket after he packed it. That packing is not meant to be disturbed :/ As a matter of fact, the packing is put in to medicate and protect the bone. Most of the time the packing is changed by the dentist every other day for about a week depending on the severity of the dry socket.

If you are still in pain, it may behoove you to see a local oral surgeon for evaluation. Extraction sites that have had a dry socket take longer to heal for obvious reasons. Could be several weeks before the site closes over.

Do you drink herbal tea? Clove tea is therapeutic for dry sockets. You can drink or even rinse with the tea a few times a day. Just make sure it is warm and not hot.

Please check back ... ok :)
Bryanna