Where to begin? Lol.

September 15th I went in for my first tooth extraction (first anything dealing with a dentist actually, besides cleanings here and there.) which was all 4 wisdom teeth. The top right tooth broke when being extracted so the dentist had to go back in and remove the pieces. Somehow during the whole process my sinus must have been punctured. Ended up going to the ER the following Sunday (after I called the dentist on his emergency number 3 times and also left a VM) because the pain was so unbearable. Er prescribed me more Hydrocodones and some penicillin because they suspected an infection had developed. Had to get a shot as well of some generic pain medication they give people with migraines.

14 days later after the penicillin was all gone I went back to the dentist (in case you are wondering, he still hadn't returned my phone call) to see what was going on and what needed to be done. The nurse came and saw me and took some x-rays and then went and showed the dentist, she then came back and said everything looks good here is some antibacterial mouthwash. (and no the dentist never saw me lol) I went home and called my mom to let her know what happened and I found out my sister had some pretty strong antibiotics left over from a few months ago so I got them and they seemed to help quite a bit (2 twice a day for 11 days) .

Shortly after they ran out (about a week later) this sinus infection came back and was worse than before. I went and saw my family doctor (plot twist, its the dentists wife) who said her husband broke his phone that weekend, blah, blah. She prescribed me some amoxicillin (white count was at about 14k) that I took for about 2 weeks and it did absolutely nothing to make it go away, it wasn't getting any worse but I wanted something stronger. (Also got my 2nd round of rocephin 1000mg shot)

Called the following Monday but my family doctor wasn't there so I saw someone else. She said my white count was down to about 10k and nothing looked wrong but she could order a CT scan if I thought I needed one. She also prescribed me cefdinir. So a week later I get this CT scan and the doctor says its an abscess and was referring me to an ENT specialist to drain it.

She never sent the CT over as the nurse asked me if I had a CT scan done yet and I told her I did, who had done it, and that was the reason I was there. She told the ENT specialist and he looked at it and came back and got me to go look at it and explained some of it to me. Whole right side of my face besides about a half inch portion is infected including my maxillary sinus, right frontal sinus and is also spreading to the left side. I now have to have surgery on December 18th to have a sinusotomy, balloonplasty? and something else that involves removing a portion of the infected sinus and a portion of bone. Can't remember the other medical terms as my mom has the paper it's all on.


I have had horrid sinus drainage over the past 2 months, seems to be better throughout the day lately as far as drainage goes but that's when the jaw pain and now lately, headaches near the right eye going throughout the right side of my head. My face is a tad swollen on the right side and I feel a popping sensation or bubbling sensation when I laugh, sneeze, lean forward, even driving on the highway at 55mph I start to feel it. My face feels really warm and blowing my nose generally results in foul smelling yellowish/ greenish mucus that tastes absolutely horrendous. These past few months have taken alot out of me and I am constantly just exhausted feeling.

I do smoke cigarettes but did not smoke until after the first 48 hours as recommended by the dentist and even then, I didn't smoke much. If anything the good that has came out of this infection is I don't smoke nearly as much as I did.

Sorry for the long story, figured I would type it all out rather than having to type more out in a comment if a question is asked.

My question is has anyone ever had anything like this done? If so what was the end result? Is the ENT headed in the right direction? My mom says from the sounds of it he is thinking I have chronic sinusitis and that it's complete overkill. Has anything else gotten infected and that's why he is removing a portion of my bone? It has been almost 3 months, 4 rounds of oral antibiotics, 2 rounds of 1000mg injections, just wondering if maybe the bone is infected and that's why he is removing bone and sinus?

25 years old and have never had anything like this happen.
Any help/ advice would be appreciated.

Thanks everyone, again. Sorry for the novel. Lol

Hi Self,

I'm sorry you have endured all this dental trauma and it sounds like a bit of incompetent follow up care.

The major thing about your case that stands out in my mind is the fact that you smoke. It is irrelevant how much or how often you smoke as any smoking will inhibit the healing of a tooth extraction. The chemicals in the tobacco are not only carcinogenic but they contaminate the surgical site and the open jaw bone to the point of major disruption of the formation of good healing cells. This allows infections to spread much easier beyond the original site as it seems to have in your case.

Any time there is a sinus communication with an extracted tooth, the act of smoking can prevent the sinus from closing as the drawing motion of dragging on the cigarette pulls on the sinus membrane preventing it from closing properly. Even if you cover the surgical wound with gauze when you smoke, there is no way to prevent that outcome on the sinus membrane. Also the chemicals in the tobacco limit the amount of oxygen being produced in your red blood cells which will limit the number of RBC being produced by the body resulting in a significantly less than ideal healing ability. Smoking also impacts the immune system and makes it more difficult for that system to work properly. So infection is more likely to spread and linger longer due to the prohibitive complications caused by the smoking.

The one thing you need to do before you have anything else done is stop smoking altogether. If you continue to smoke, anything you have done including sinus surgery may not be successful and the likelihood of post operative complications due to the smoking are severely increased.

Sorry if I came on a bit strong about the smoking.... but it is a huge problem on so many levels and the type and location of your infection can be very detrimental to your health. If you stop smoking, you are likely to notice that your body responds more favorably to the medications as your immune system is not weighed down by the chemicals and carcinogens in the tobacco. You will likely need some surgical intervention due to the extent of the infection but the healing from those procedures will be significantly better if you do not smoke.

Bryanna

Haha yes I completely agree I do need to quit smoking. Horrible and I mean horrible habit! Anyways I do realize it can cause issues with health and healing but I don't believe it's what caused this. It was 2 nearly 3 days before I smoked and it was only a few puffs. Clots were already formed over all 4 sites. The new ENT I saw Monday even said while smoking doesn't help it definitely didn't cause this. I had the balloon sinuplasty done Friday afternoon at 12pm by him to see if it will help rather than having my sinus completely reconstructed by the first ENT I saw. Haven't smoked at all since it happened because of the open wounds somewhere up there. From what I've read it shouldn't still be hurting more than 24 hours later but it hurts as bad as it did before. My 2 back top right teeth are always super sensitive to hot and cold and they always hurt up in the gum area through my jaw bone up to my ear. Been going on for about a month now. I'm assuming that's just the pressure but shouldn't the pressure be going down? They've already opened 3 on my right side and the frontal on my left. They also have me on prendisone steroid pack and clyndamycin plus rinsing with this Wilson's solution stuff. Doesn't feel any better at all. Can breath a tad bit better through my right nostril but still no where near as good as my right. Which I thought was also weird is that the left side was the side that bled the most yet the right side is the more infected and where the infection originated. I don't know, hopefully it starts to get better because I hate it. Lol. Anyways. Thanks for the response. Wasn't expecting anyone to read the book I wrote.

Hi Self,

The smoking is a definite contributing factor to the sinus infections and post op complications. Is it the "cause" of all the problems, no. But without question it is directly involved with the health of your sinus and the healing simply because you were/are a smoker. Previously smoking to the oral surgery already put you at risk for poor surgical post op healing due to the reasons I stated in my first reply to you. Smoking anytime post op the surgery then exacerbated the poor healing ability. I hope I've been able to clarify that for you.

Did you have sinus issues/infections prior to the extraction of the wisdom teeth and were the teeth decayed? Those things would attribute to the severity of the current problems because they would indicate that the infection was long standing in both the sinus and the teeth.

The temperature sensitivity that you have on the upper molars... are those teeth decayed and/or is the gum receded exposing some root surfaces? Do you know if you have gingivitis or periodontal disease? I ask because any infections either in other teeth or in the gums is going to be an additional hindrance in healing. I am trying to "peel the onion" so to speak to help you understand the layers of potential problems contributing to your post operative healing problems.

Bryanna