[Suzqwalk0673]

Hi I am so hoping i can find answers or at the very least someone that has some idea of what I am experiencing- and not think im crazy! (lol)
I will try my hardest to keep this question from turning into a book so here it goes:
one week ago i had my upper last (or first-if you start at back) molar extracted by an oral surgeon- i had a very severe infection (abscess) which was draining a greenish horrible tasting thick mucus like substance into my mouth for approx a week prior to that - i had been to the Emergency room and put on Clindamycin 5 days prior to extraction - (after the ER visit i called the oral surgeon's office and they suggested I wait a couple days to get the antibiotic going through my system and let it drain as much as possible) I went to my oral surgeon appointment on Monday and they took xrays and examined my mouth, they told me I had two choices- 1) have them drain it right then but they didn't know how numb they could get me due to the infection or 2) I could come back the next morning (i had eaten b/c i wasnt told not to & late afternoon appt) after fasting 6 to 8 hours be put out and have it drained and the severely decayed tooth removed- I have a huge dental phobia so i obviously chose to go back and be put under-

brief backround - this tooth had been totally broken for about 2 years, I think the tooth may have been pretty much dead as I was having no pain in the tooth at all for at least a year now- only pain was the abscess on the gum line next to the tooth- since last November (approx 7 months ago)i have had this come and go- my gum would become sore, my cheek would swell, I would be very stuffed up and my eye would leak, had a lot of pressure and frequent headaches came with it so I thought it was a sinus issue because there was no tooth pain - I would call my primary doctor and have an antibiotic called in for me for a sinus infection - prior to this most current time this happened 4 times in the past 7 months- a week prior to my er visit is when i last time i called my primary doctor for an antibiotic at which time he told me he wanted me to see an ENT as soon as i was feeling better, however the antibiotic, augmentin, had not helped and that's when/why I ended up in the ER

So I went to my appointment on Tuesday last Tuesday - they put me under and did what needed to be done when I woke up I was a bit out of it and didn't even know I had been put to sleep yet- (but was kinda shocked when my husband told me beginning to end i had only been back there for 25 minutes) I went home and pretty much slept on and off for at least the next 12 hours or so followed their directions didn't smoke or drink from straw etc etc
On Thursday 48 hours after extraction I started to notice a piercing job of pain when I would breathe in to deep or took a sip of something too cold as the day went on they started to notice when I was talking it felt as though my tongue was being suctioned up towards socket-
by Friday morning I noticed upon talking that not only was it a feeling of suction when I spoke but also when I drank but i also started to notice an odd echo type sound when I talked, however when I asked others if I sounded different and they said no- (since no one seemed to understand what I meant by echo sound the best way I could describe it would be if you pinch your nose shut and speak through a empty paper towel tube-to myself that's how I sound to myself) by around noon on Friday (72 hours after extraction)my husband noticed that when I spoke I sounded very naselly- the only pain I was having was still only when air or cold entered the socket I called the oral surgeons office and asked if I could get checked out before they were gone for the weekend they told me that oral surgeon who did it was not in and to wait till Monday- my husband did not want me to wait and called back and insisted I come in to just get checked -so they agreed - when I went in a different oral surgeon Henry over my mouth and he pressed on my gum line with what look like a tongue depressor he pressed so hard I almost jumped out of the chair and then he left the room never said anything to me,the dental assistant in the room squirted something in my mouth to clean area and had me spit it out, she did this a couple times and then she rubbed a tiny piece of something with brown medicine on it over the socket and had me bite down on gauze- she told me to keep the gauze in my mouth and bite down for at least a half an hour, scheduled me to be seen by the original surgeon on Monday morning, and sent me on my way- I drove home and when I took the gauze out I immediately had the same echo and suction feeling so I put the gauze back in ( thinking maybe it needed to stay a little longer) - I noticed that when the gauze was in covering the entire area I could talk fine, drink fine and eat fine (well as fine as you can eat with gauze in your mouth!) so this continued the entire weekend and because of the strange sound I get of my own voice and the suctioning I kept goes in my mouth prettymuch around-the-clock- it seems to be the only way I can talk drink or eat normally- on Monday morning today I went to C the oral surgeon who originally did the extraction I explained to him what i am experiencing he had me open my mouth he put gloves on, pulled my cheek open took a look (with
his bare eye- no light,no tools, no nothing) just a quick peek and he said it looks great- i said "well is all this going on normal? " He said "well you had a severe infection and it was very close to your sinuses, give it 3 to 4 weeks to heal"
I said "ok but no one seems to understand what I am trying to explain - is this normal?" again he didn't give me a direct yes or no answer instead he said "it looks fine" I said "so do I need to come back or anything?" and he said "no" and walked out of the room.
so here I am still feeling exactly the same nothing has changed and I'm wondering if this is something anyone has ever had or heard of?? what this could be or what causes it?? I guess I want to know if its "normal" after such a severe infection? Thanks so much for reading this and I look forward to hearing what you have to say thanks so much!

[Bryanna]

Hi Suzqwalk,

It sounds like the root of the tooth and possibly the infection had perforated the sinus. Depending on the status of the infection, this may heal on its own or it may not. The dentist should have informed you if the sinus was perforated or not. You can call his office and ask them to give you that information. They legally cannot withhold it from you. Ask for a copy of your records, surgical report and xrays to be sent to you. They have to comply with that request as those records belong to you. I suggest this because you may have further complications and this information would come in handy if you end up seeing another surgeon.

Did the surgeon say it was okay to keep the gauze in there covering up the wound? Do you notice any discharge from the surgical site? Do you have any sinus or ear pain?

Do you smoke? If so, it is best to stop because the chemicals in the tobacco can prevent the sinus from closing and can keep the wound from healing closed completely.

If there is no infection brewing in that area and you do nothing to aggravate it, the sinus membrane can take several weeks to close. The gum tissue may even close over before the sinus does. If the symptoms decrease and the site closes, this area should be monitored with an xray every few months to assure proper closure. If the symptoms stay the same at the end of 2 weeks and/or you develop worsening symptoms and/or sinus or ear pain, then do not wait to have it clinical and radio graphically evaluated.

Originally Posted by Suzqwalk0673

Hi I am so hoping i can find answers or at the very least someone that has some idea of what I am experiencing- and not think im crazy! (lol)
I will try my hardest to keep this question from turning into a book so here it goes:
one week ago i had my upper last (or first-if you start at back) molar extracted by an oral surgeon- i had a very severe infection (abscess) which was draining a greenish horrible tasting thick mucus like substance into my mouth for approx a week prior to that - i had been to the Emergency room and put on Clindamycin 5 days prior to extraction - (after the ER visit i called the oral surgeon's office and they suggested I wait a couple days to get the antibiotic going through my system and let it drain as much as possible) I went to my oral surgeon appointment on Monday and they took xrays and examined my mouth, they told me I had two choices- 1) have them drain it right then but they didn't know how numb they could get me due to the infection or 2) I could come back the next morning (i had eaten b/c i wasnt told not to & late afternoon appt) after fasting 6 to 8 hours be put out and have it drained and the severely decayed tooth removed- I have a huge dental phobia so i obviously chose to go back and be put under-

brief backround - this tooth had been totally broken for about 2 years, I think the tooth may have been pretty much dead as I was having no pain in the tooth at all for at least a year now- only pain was the abscess on the gum line next to the tooth- since last November (approx 7 months ago)i have had this come and go- my gum would become sore, my cheek would swell, I would be very stuffed up and my eye would leak, had a lot of pressure and frequent headaches came with it so I thought it was a sinus issue because there was no tooth pain - I would call my primary doctor and have an antibiotic called in for me for a sinus infection - prior to this most current time this happened 4 times in the past 7 months- a week prior to my er visit is when i last time i called my primary doctor for an antibiotic at which time he told me he wanted me to see an ENT as soon as i was feeling better, however the antibiotic, augmentin, had not helped and that's when/why I ended up in the ER

So I went to my appointment on Tuesday last Tuesday - they put me under and did what needed to be done when I woke up I was a bit out of it and didn't even know I had been put to sleep yet- (but was kinda shocked when my husband told me beginning to end i had only been back there for 25 minutes) I went home and pretty much slept on and off for at least the next 12 hours or so followed their directions didn't smoke or drink from straw etc etc
On Thursday 48 hours after extraction I started to notice a piercing job of pain when I would breathe in to deep or took a sip of something too cold as the day went on they started to notice when I was talking it felt as though my tongue was being suctioned up towards socket-
by Friday morning I noticed upon talking that not only was it a feeling of suction when I spoke but also when I drank but i also started to notice an odd echo type sound when I talked, however when I asked others if I sounded different and they said no- (since no one seemed to understand what I meant by echo sound the best way I could describe it would be if you pinch your nose shut and speak through a empty paper towel tube-to myself that's how I sound to myself) by around noon on Friday (72 hours after extraction)my husband noticed that when I spoke I sounded very naselly- the only pain I was having was still only when air or cold entered the socket I called the oral surgeons office and asked if I could get checked out before they were gone for the weekend they told me that oral surgeon who did it was not in and to wait till Monday- my husband did not want me to wait and called back and insisted I come in to just get checked -so they agreed - when I went in a different oral surgeon Henry over my mouth and he pressed on my gum line with what look like a tongue depressor he pressed so hard I almost jumped out of the chair and then he left the room never said anything to me,the dental assistant in the room squirted something in my mouth to clean area and had me spit it out, she did this a couple times and then she rubbed a tiny piece of something with brown medicine on it over the socket and had me bite down on gauze- she told me to keep the gauze in my mouth and bite down for at least a half an hour, scheduled me to be seen by the original surgeon on Monday morning, and sent me on my way- I drove home and when I took the gauze out I immediately had the same echo and suction feeling so I put the gauze back in ( thinking maybe it needed to stay a little longer) - I noticed that when the gauze was in covering the entire area I could talk fine, drink fine and eat fine (well as fine as you can eat with gauze in your mouth!) so this continued the entire weekend and because of the strange sound I get of my own voice and the suctioning I kept goes in my mouth prettymuch around-the-clock- it seems to be the only way I can talk drink or eat normally- on Monday morning today I went to C the oral surgeon who originally did the extraction I explained to him what i am experiencing he had me open my mouth he put gloves on, pulled my cheek open took a look (with
his bare eye- no light,no tools, no nothing) just a quick peek and he said it looks great- i said "well is all this going on normal? " He said "well you had a severe infection and it was very close to your sinuses, give it 3 to 4 weeks to heal"
I said "ok but no one seems to understand what I am trying to explain - is this normal?" again he didn't give me a direct yes or no answer instead he said "it looks fine" I said "so do I need to come back or anything?" and he said "no" and walked out of the room.
so here I am still feeling exactly the same nothing has changed and I'm wondering if this is something anyone has ever had or heard of?? what this could be or what causes it?? I guess I want to know if its "normal" after such a severe infection? Thanks so much for reading this and I look forward to hearing what you have to say thanks so much!

[Suzqwalk0673]

Hi Bryanna- thanks so much for all the information you are a great help! I apologize for the typos! Using my cell for internet access probably isnt the best idea when typing lengthy notes- with that said I'm sure there will be a few more typos this time too! lol
ABOUT USE OF GAUZE-
I did tell the surgeon that I've been putting gauze over it (at that time he was writing in what I assume was my chart) he looked up from chart and said "gauze wont help" i said "oh but it does actually , it stops the suction feeling and the echo sound" i paused a minute but when he said nothing i continued "well the gauze won't HURT-will it?" but now that I'm thinking of it, I guess he didnt answer me because I don't remember him saying anything about it! His short answers and periods of silence gave me the impression he wasn't really listening to me or interested in what I had to say-I kinda got
the feeling he didn't think I should/needed to be there-makes no sense because I didn't request the appointment they had told me I had to come back in on Monday- Honestly if the symptoms had subsided I would have never went back.
DISHCHARGE-
I have only noticed tiny amounts of yellowish discharge on the gauze after i keep a piece in for an hour or so - i mean tiny- like a small dot- had to really look good at the gauze to even see it (ive been changing gauze probably a little less than every 2 hours -when they get extremely soggy)I am still taking clindamycin - I believe I have about 6 days left on it.
SINUS\EAR PAIN
As far as sinus pain/ear pain -No i havent had any
SMOKING
Yes i do smoke - the first day i did not smoke-The next cpl of days i tried to keep smoking to a very minimal amount -always keeping gauze over that side of my mouth and very cautious of inhaling (many years ago I got dry socket from smoking after an extraction-i would never want to feel that pain again) as of now I'm still trying to limit the amount of cigarettes i smoke, still keeping gauze in my mouth while smoking, rinsing my mouth with warm water after each cigarette also, (not sure that it does any good but if theres a way to smoke cautiously - that's what I'm doing &#128533
- I am curious as to your thoughts on the gauze and healing? Any advice or suggestions you have would be greatly appreciated- the last thing I want to do is delay or interrupt the healing process b/c of gauze!
Today is exactly one week since the extraction & if i still have no improvement in a day or two I will call and request my records, x-rays, etc...
Would you suggest I ask them directly - "Do i have a perforated sinus"? Also do you know if I am obligated to give a reason why I am requesting my records? Because regardless of what they say I would definitely feel much better having someone outside of that office just take a look at my mouth at this point. Being on the outskirts of Philadelphia it is only a short 10 minuet ride to the University of Penn Dental and at this point I'm thinking if nothing changes by the weekend that may be just the place i need to go to get answers, and hopefully a little peace of mind.
I appreciate all your help and information so much!!

Originally Posted by Bryanna

Hi Suzqwalk,

It sounds like the root of the tooth and possibly the infection had perforated the sinus. Depending on the status of the infection, this may heal on its own or it may not. The dentist should have informed you if the sinus was perforated or not. You can call his office and ask them to give you that information. They legally cannot withhold it from you. Ask for a copy of your records, surgical report and xrays to be sent to you. They have to comply with that request as those records belong to you. I suggest this because you may have further complications and this information would come in handy if you end up seeing another surgeon.

Did the surgeon say it was okay to keep the gauze in there covering up the wound? Do you notice any discharge from the surgical site? Do you have any sinus or ear pain?

Do you smoke? If so, it is best to stop because the chemicals in the tobacco can prevent the sinus from closing and can keep the wound from healing closed completely.

If there is no infection brewing in that area and you do nothing to aggravate it, the sinus membrane can take several weeks to close. The gum tissue may even close over before the sinus does. If the symptoms decrease and the site closes, this area should be monitored with an xray every few months to assure proper closure. If the symptoms stay the same at the end of 2 weeks and/or you develop worsening symptoms and/or sinus or ear pain, then do not wait to have it clinical and radio graphically evaluated.

[Bryanna]

Hi Suzqwalk,

Thank you for sharing pertinent information and being honest about the smoking. Yes, it sounds like you have a perforated sinus. The smoking irrelevant of placing the gauze or not, is preventing the sinus membrane from closing.

The smoking... it does not matter if you smoke one cigarette or 20 cigarettes a day.... with each drag you reopen the membrane and inhale chemicals up into the sinus. You should also know that the sinus is only 3-4 inches away from your brain. Everyone knows that smoking is bad for your health but did you know that cigarette smoke contains over 4000 chemicals, 43 or more of those are carcinogenic (cause cancer) and 400 additional ones are known toxins? Cigarettes contain nicotine, tar, carbon monoxide, formaldehyde, ammonia, hydrogen cyanide, arsenic and DDT to name just a few. Please consider the health risks of smoking and please take measures to stop.

The gauze.... covering the site with gauze when you smoke is not preventing the smoke or chemicals from entering the socket or the sinus. The gauze actually holds onto all of that and bathes the area in it. So the gauze is not acting preventatively as I think you assume it is. This is not a lecture, this is me offering you honest information that I guess no one else has.

The attitude of your dentist is unacceptable and I am not giving him an excuse for acting like that. But most likely the reason he may have this attitude is because you smoke and he knows he cannot help you if you continue to smoke. He should be educating you about it like I am rather than patronizing you. FYI.... even if you didn't tell him you smoke, he knows by the odor of your breath, the stain on your teeth, palate and tongue and the discoloration of the gum tissue. All of which may not be evident to you but it is clinically.

If you continue to smoke either the sinus will not close or it can take months to close or it might just partially close. Usually in people who smoke the gum tissue doesn't close completely either and all there has to be is a pin hole size opening in the gum tissue and bacteria from the mouth will continually get up into the sinus which can cause chronic sinus infections and worse. If you stop smoking, you will get a healthy mad rush of red blood cells as the oxygen comes back to the oral tissue and the area will start to heal on its own. You may find that your gums bleed when you stop smoking, this is due to the influx of red blood cells. It is imperative to keep your mouth clean with thorough tooth brushing and flossing to keep the plaque to a minimum.

Just for clarification.... Do you have regular dental care? Or do you only see a dentist when you have a problem?