Hello everyone,
I got all 4 wisdom teeth extraction on Monday morning (5 days ago). I was giving IV sedation and when I woke up, I was told that they had zero issues and the extraction went well.
Day one I took the hydrocodone, day two I switched to advil because my pain wasn't too bad and I felt better, day three I woke up with my whole mouth jaw and face throbbing and I took advil to find no relief. My mouth throbbed the entire day even though I took 400 mg of advil every 4-6 hours. The next day I did a saltwater rinse and I felt this weird suction (that I thought was coming from the bottom left socket). I spit out the water and a few minutes later my mouth filled up with water. I called the drs office and they told me to come in.
A different surgeon was in the office that day and he took a look at my bottom sockets and said that they looked fine but I might have dry socket so just in case, he packed both sockets with the medicated gauze. I told them about the suction and my mouth filling up with water and no one seemed to know what I was talking about.
So today, the next day, I was doing my saltwater rinse again and swooshing around the water and then I felt the suction again and a stream starting coming out my left nostril. I panicked and called the office and they told me it sounds like I have a sinus perforation from the top left tooth being pulled. They can't see me in the office until Monday but they told me not to blow my nose or chew on that side and to sneeze with my mouth open.
I'm kind of irritated considering that I was in the office yesterday and trying to tell the other dr I felt suction but no one looked into it and now I have to wait several days before seeing anyone.

I guess I just want to know if this is something that heals on its own or how serious it is? I'm having major pressure and pain in my left cheek. I can drink fluids fine without any symptoms, the only time it went through my nose was with the rinsing. I'm on antibiotics and I'm taking 400 mg of advil every 4-6 hours which helps with the jaw pain. I'm already prone to anxiety but all of this is causing me a great deal of panic.

Hi junebird,

Yes, your description indicates a sinus opening or perforation. You should see the dentist on monday to evaluate the sinus to determine the size and location of the opening and to remove the packing from the lower extraction sites. That packing is not meant to be in there for more than a couple of days. If you have dry socket, the packing needs to be changed every 2-3 days for about a week or so.

Also, you should be rinsing with warm salt water 3-4 times a day, not just once. Also be sure to brush and floss the rest of your teeth. You do not have to use toothpaste, just plain water on the brush until the sites have closed a bit. You should be eating a nutritious soft food diet and nothing that requires a lot of chewing. It is best to unhealthy foods like sugar, sugar substitutes, soda, fast food and other junk food as all of these things can interfere with healing because they over load the immune system.

Refrain from blowing your nose, drinking through a straw, lowering your head as to touch your feet, and avoid strenuous exercise as that causes the sinus membranes to open up wider than when at rest. Avoid smoking and alcohol as both can prevent healing.

Some sinus perforations repair on their own, others do not. It needs to be evaluated and depending on that evaluation, it will need to be monitored periodically until it heals.

Bryanna



d

Thank you for answering my question. The dressing they gave me with the medication for the dry socket was actually something that dissolves on its own. They told me that the material used to put the medicine in the socket would dissolve and the medicine would stay in the socket which has happened as far as I know. I haven't had any more pain with the dry socket.

As of today I am taking the antibiotics but I have not had any pain medication in over 8 hours and I am not experiencing any pain with the mouth.
However, I do have muscular pain in the jaw. I'm a licensed massage therapist so I've been gently massaging the massater and doing some trigger point work along the tmj which has helped a lot.
Last night I had major pressure and discomfort on the left side of my nose and cheek (where the perforation is) and occasionally I feel a pop or air bubble like when you roll over in bed congestion and it clears up. It's a slight headache type feeling on the left side of my head which eases up a little with massage and heat. I don't have hardly any congestion though and both nostrils are dry and clear. When I drink its fine. I've been doing a saltwater irrigation with the syringe they gave me but haven't done a rinse because the nurse told me to hold off on rinsing , chewing, or even brushing at all on the left side of my mouth.
I've been staying with my parents in the country and its a food desert out here. I normally eat mostly organic and healthy but since being here its been mostly mashed potatoes, noodles, and ice cream.
I've been eating softer solid foods since day 3 - soft cheese, deli meat, noodles, etc. should I go back to just soft and liquid food like smoothies until I can see the doctor?
I notice when I chew I feel a little air in that left nostril but mainly that whole side just aches really bad.
I'm assuming this is to be expected with the perforation. I keep hoping that this will be something that will heal quickly on its own.

junedbird,

It is important that you brush and floss all of your teeth to keep the plaque from accumulating. Just use water on the toothbrush but brush them all.

The dry socket paste is either out or well absorbed in the sockets by now. Good that you are not experiencing any pain in those areas....good sign considering you were prior to this!

Try to eat healthy. Deli meat is not healthy Drink lots of water, eat fruit, veggies, soft cheese, eggs, things like that.

Use the irrigation very very gently and avoid irrigating that upper left area where the perforation is as you could push debris up into the sinus. Rinse that area with warm salt water instead of the irrigation syringe.

Massage therapy.... perfect... gets the blood flowing, breaks up the inflammation and stagnation. Just go gently and do not overdo it. Your jaw has been through some trauma as it had to be propped open very wide to remove those teeth. So you want to be gentle but thorough.

I still recommend that you see the oral surgeon on monday, not the nurse or assistant, the dentist to evaluate the sinus perf.

Bryanna