Had oral surgery 7 weeks ago that resulted in decreased oral cavity and some gum scarring on the right side.
Since then, I have a deep horizontal crease above my upper lip when I smile, it looks like another smile above the smile. Laughing is much worst.
Plus, the area between the mouth and nose is a lighter colour than the rest of the face and simply white when it is hot.
The area looks like standing out a bit compared to before. It is not swollen, I think the gum is holding it a bit away.

Did anyone experience this? What is it? Did it go away with time?
If not, is there anything that can be done in the future about it?
Lasering the damaged gum surface might help in the future? Or by then the face will adjust and doing anything will cause a new problem?
Have seen 3 doctors, noone seems to know what is the cause or of it will go away. They were oral surgeons. Who should I see who might not be scared to address the issue?

Elna

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Hi ELna,

So sorry for my delay in replying to you. I have been crazy busy!!

Regarding your other two posts.... it would not have been wise to leave a huge opening when that molar was removed. Something had to be done to attempt to close it over and get what is called primary closure.

ELna, has any of these dentists every discussed the health of the other teeth in the upper right quadrant? Those teeth from what I recall, were at best questionable on the xrays you shared with us. If there is a brewing infection in any of those upper right teeth that could be one of the major reasons for all of these complications. An infection in one or more of those teeth could be preventing the sinus from closing.

The photo you posted of the upper right quadrant does not look normal or look like healthy scar tissue. The tissue from the first pre molar back along the bony ridge (area directly above each of those teeth) is so irritated, inflamed and spongy looking. Also, is the cheek tissue discolored with purple veins and is it bumpy like ridges?

The longevity of the horizontal crease that you have above your upper lip is very usual after oral surgery. I am wondering if there was some nerve involvement when the tooth was removed which may have resulted in that crease. The blanched area between your mouth and nose may indicate a lack of blood supply there. I don't understand why none of these dentists are addressing these issues more thoroughly with you.

The only dentist that knows what took place during the extraction was the dentist who extracted the tooth. His surgical notes should indicate specifically what he did, what he found, etc. If I recall correctly you had another dentist perform a second closure.... is that correct or am I confusing you with someone else??

I really think there could be an underlying issue going on in that quadrant that is not being diagnosed and I also think one or both of the procedures to close the opening and/or to close the extraction site resulted in further problems.

Have you been going back to the same oral surgeons or have you seen someone new? Forgive me, I just don't recall exactly :/

Bryanna



QUOTE=ELna;1159408]

Had oral surgery 7 weeks ago that resulted in decreased oral cavity and some gum scarring on the right side.
Since then, I have a deep horizontal crease above my upper lip when I smile, it looks like another smile above the smile. Laughing is much worst.
Plus, the area between the mouth and nose is a lighter colour than the rest of the face and simply white when it is hot.
The area looks like standing out a bit compared to before. It is not swollen, I think the gum is holding it a bit away.

Did anyone experience this? What is it? Did it go away with time?
If not, is there anything that can be done in the future about it?
Lasering the damaged gum surface might help in the future? Or by then the face will adjust and doing anything will cause a new problem?
Have seen 3 doctors, noone seems to know what is the cause or of it will go away. They were oral surgeons. Who should I see who might not be scared to address the issue?

Elna[/QUOTE]

Dear Bryanna,

Thank you for your reply, always and again!
Noone seems to think there's anything wrong with the other teeth. I had 8 dentists and oral surgeons looking at the X-rays since the extractions and noone mentioned anything about it. 4 of these I asked if they can see other problem areas.
The perforation seems to be closing, both surgeons I saw last week said to wait now maybe... - I'm very hopeful.

The last one, the super - surgeon, said about the gum that I should give it 6 months maybe even a year to heal. He said he hopes it will become 'acceptable'. But i felt the same as with the others - having no idea better act like its nothing. Noone knows, noone cares. And I'm nice and normal, really, I think the whole thing is so damaged noone wants to touch it. After him I really don't know where else could I seek help.

The crease appeared not after the extractions but after the second closing surgery. I think it's related to whatever is going on with the gum and oral cavity.

Yes, it definitely looks like the blood supply is not ok in that area. Is that dangerous in any ways?
So it seems like you've seen this before - does it normally go away? The whiteness, the crease? Who should I turn to if not dentist to look at it? Is there any harm in waiting?

Thank you so much.
So so much!

The photo of the gums was taken three weeks ago, im scared to look at it but took one now, this is how it looks. Maybe it looks a little bit better? But not good, i know. Thank you thank you thank you

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ELna,

I took another look at your panoramic xray that was taken prior to the removal of your upper second molars. I really think the health of the first molar on the upper right is in question. It appears that this tooth may have a periodontal problem and possibly a cyst or granulation tissue around the root. This tooth is also in very close proximity to your sinus, if not directly into your sinus. Sometimes the roots of posterior molars are in contact with the sinus, that is normal to be that way. But if the tooth is unhealthy it could be one reason why your sinus is taking so long to close.

The recent photo of the gum area does look improved from the previous one. But what the heck is that big lump over the premolars? Is that where the surgeon put sutures to hold the cheek tissue in place??

I tend to agree with you that no one wants to touch that gum above the premolars. It may flatten out a bit more, but I don't really know why it is like that. Is that lump mushy, like squishy or hard? Is it sore or painful?

The crease above your lip that occurred after the second attempt to close the site .... do you feel a pull from the right side connecting to that crease? Or does it just feel odd and tight at the site of the crease? I honestly cannot recall having patient with such a deep crease on the exterior of their face like the one that you have from a closure procedure. I have seen abnormalities occur but mainly they occur inside the mouth, not outside. The blanching of the tissue is indicating lack of blood flow. So something is impinging on that area enough to reduce the blood flow. Where the heck is it connected to?? Do you have a picture of your upper lip prior to the oral surgery?

You may need to consult with a plastic surgeon to see if he can figure out why that occurred and if there is anything that can be done to relieve it.

Bryanna










QUOTE=ELna;1159767]Dear Bryanna,

Thank you for your reply, always and again!
Noone seems to think there's anything wrong with the other teeth. I had 8 dentists and oral surgeons looking at the X-rays since the extractions and noone mentioned anything about it. 4 of these I asked if they can see other problem areas.
The perforation seems to be closing, both surgeons I saw last week said to wait now maybe... - I'm very hopeful.

The last one, the super - surgeon, said about the gum that I should give it 6 months maybe even a year to heal. He said he hopes it will become 'acceptable'. But i felt the same as with the others - having no idea better act like its nothing. Noone knows, noone cares. And I'm nice and normal, really, I think the whole thing is so damaged noone wants to touch it. After him I really don't know where else could I seek help.

The crease appeared not after the extractions but after the second closing surgery. I think it's related to whatever is going on with the gum and oral cavity.

Yes, it definitely looks like the blood supply is not ok in that area. Is that dangerous in any ways?
So it seems like you've seen this before - does it normally go away? The whiteness, the crease? Who should I turn to if not dentist to look at it? Is there any harm in waiting?

Thank you so much.
So so much![/QUOTE]

Thank you Bryanna. That is where the 2nd surgeon took the gum from. Wassmund-Rehrman lobe lengthened to the 14th. He wrote it was one of the most difficult closures he ever did (?). It felt like raw meet 2 weeks after surgery when i could finally open my mouth a bit and went straight to A&E feeling that something is growing together in my mouth where it shouldnt. The lump doesnt bother me. But right from behind it, there feels like an extra layer like skin in between the cheek and where the actual gum should be / is. I can move that thin layer with my tongue.
I might cut it free for myself - then someone will have to fix it. Only joking. For now. Sorry, dark humour.

Ok, seriously, I will not find anyone to consider this a problem until there is the familiar and safe sinus issue to focus on so will wait the one month, hope that that one sorts itself out in the end then will start the next round, trying to find a brave and knowledgeable doctor to address the issue. Somewhere.
I went to the one well versed on surgical methods - he barely examined me at all, simply shrugged about the gum issue, wouldn't even look at it, said it might take as much as a year for the gum to settle and just leave it. I felt that he went with the textbook answers without evaluating the individual case. Like it was too minor and insignificant for him. He made me feel bad. I know he deals with major, more serious issues as well but that is exactly why i trusted him to know enough for my problem. Not because i have that kind of money to throw around. Then he wrote he hopes it will become 'acceptable'. And he wrote that the OS actually did a good job. That the left side was closed beautifully. Who cares? He spent more time in the letter talking about the surgeons than about my mouth. I did not even hint that I was blaming anyone he still felt the need to defend fellow doctors. Without knowing my case or mouth since he barely had a look. I was happy he thought it is best to wait with the sinus closure though.
However, the practice refunded the cost I spent there (the extractions and the one closure they charged me for out of the three) and when i wanted to book an appointment earlier to talk to the OS who did the second one, I found out that the guy who did the 2nd surgery no longer works for the practice...

Added two pictures of my smile from before (r.i.p.) as you asked. I'm desperate. If there's anyone out there (UK) willing to have a look and maybe help please come forward. I would go anywhere privately if I knew I was properly looked at at least. A maybe would do it really.
Thank you Bryanna, will update in a month.

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ELna,

Thank you for posting those additional photos. By any chance did you happen to bring them with you at any of your dental appointments? Because without seeing the before photos, anyone who does not know you personally has no idea what you looked like before. As you have found out dentists are in the club together and for them to act as individuals (meaning to step out of the club) they have to have definitive reason to do so.

So are you thinking that the "extra piece" of extended tissue that you can feel behind the lumpy tissue from your cheek to your gum is what is intricately connected to the crease over your upper lip? I suppose it could be but why isn't anyone acknowledging that possibility? I think when you are ready, the best bet would be to consult with a plastic surgeon who will at least be more likely to discuss this issue with you without prejudice... because he's not in the same club.

I am glad that you received financial reimbursement at least that shows a good faith effort on their part.

Bryanna