nyuszisue,

It sounds like you are assuming more than you really know about the sinus perforation. Keep in mind that just because he did not mention it to you in passing does not mean it wasn't there prior to the extraction. An upper molar that is root canaled or infected can easily affect the sinuses. The bacteria can spread from the tooth, perforate through the sinus membrane and travel from there. I believe I had asked you on a few occasions about a possible correlation between your sinus problems and your root canaled tooth but you never really replied to my inquiry. On a pre op xray (before the tooth was removed) and often on the CT scan, an oral surgeon can frequently tell or suspect if the sinus has been perforated by the tooth root or the infection. The reason I bring this up is because more times than not the patient is never told of that finding or they are told very little.

So you don't know if he did a bone graft or not either? Did you pay for a bone graft? Did he tell you to use the saline nasal spray? If so, how often?

Sometimes sores, like canker sores, develop at the surgical site which would cause burning and pain at the site. These sores typically start out uncomfortable and then get progressively worse for 2-3 days. On the 4th day that start to subside, so long as new ones are not breaking out. The actual sores can be seen in the mouth for up to 21 days from the onset. The salted water will can those sores sting for the first few days until they settle down. Are you prone to canker sores in your mouth or oral herpes lesions? People who are prone to them are more likely to develop them within the first day of surgery. If the salted water is really bothersome, then just use plain warm water to rinse with. Also, you said he used dis-solvable stitches. Sometimes people are allergic or sensitive to this type of suture material which would cause inflammation, redness and pain at the site. So that is something to be mindful of also and if you think that is happening then get in to see the surgeon to have them removed.

At this point I would expect you to have some swelling based on the infection and sinus perforation. Applying ice packs the first 24 hours can be helpful. However after the 24 hours ice packs can make it feel worse. So you can try applying warm moist (not dry) heat to the outside of your face several times a day. A moist heat pack, one that you heat up in a microwave, would be ideal. Do not make it too hot, just comfortably warm. The moist heat encourages stagnated blood to flow which reduces pain and swelling.

Keep your head elevated when laying down ... drink water throughout the day ... take your Arnica and whatever pain meds you think you need ..... apply moist heat packs ..... keep the rest of your teeth clean to avoid plaque from building up ... do not over exert yourself and eat nutritiously. Hopefully by Monday you will be feeling a whole lot better.

Hang in there......
Bryanna

Yes, I assume more than I know about this sinus communication. When he was telling me what he was seeing on the scan, he only said there is infection above the root, nothing else.and I asked. I don't know if there was a correlation between this tooth and my sinus problem, because I have to blow my nose only during winter months, sometimes it was bloody.
No, I don't know about bone graft either, I didn't pay for it, at least not upfront. I asked him about using the nasal spray, he said to use it, but not even how often ( I didn't use it yet ).
I'm not prone to canker sores, and this morning the saline rinse wasn't painful and it didn't come trough my nose either.
I was using ice pack the first day even that I didn't have the swelling the first day ( that wasn't wrong I hope ? ).
My husband just remembered that the OS told us ( of course I don't remember any of it ) that the thing I was afraid of is OK, and that "thing" was the sinus communication. Based on that, he didn't see a sinus perforation at the time of the surgery ? but I felt the air coming trough just a few hours later ? is that possible ?

nyuszisue,

I will re post and answer in bold.

<<When he was telling me what he was seeing on the scan, he only said there is infection above the root, nothing else.and I asked. I don't know if there was a correlation between this tooth and my sinus problem, because I have to blow my nose only during winter months, sometimes it was bloody.>>

AN INFECTION ABOVE AN UPPER ROOT CANALED TOOTH THAT HAS BEEN PRESENT FOR A LONG TIME GENERALLY PERFORATES THE SINUS MEMBRANE. KEEP IN MIND THIS TOOTH HAS BEEN INFECTED SINCE (OR BEFORE) IT WAS ROOT CANALED BECAUSE THE RC PROCEDURE DOES NOT FAVORABLY ALTER THE INFECTION STATUS OF A TOOTH.
WHEN THE INFECTION SPREADS FROM THE TOOTH TO ABOVE THE ROOT, IT IS GENERALLY NOT VISIBLE ON AN XRAY UNTIL IT IS LARGE (DENSE) ENOUGH TO BE PICKED UP ON THE FILM. AGAIN INDICATING THAT IT WAS PRESENT FOR A LONG TIME.
ALSO THE ROOTS OF OUR UPPER MOLARS ARE FREQUENTLY IN CLOSE PROXIMITY TO THE SINUS FLOOR MEMBRANE. SO WHEN INFECTION TRAVELS BEYOND THE ROOT OF THE TOOTH, IT IS LIKELY THAT IT HAS MOVED NEAR OR INTO THE SINUS.
JUST A THOUGHT TO THROW OUT THERE...... IF YOU HAVE SINUS CONGESTION MAINLY IN THE WINTER MONTHS, DO YOU NOTICE IT AFTER YOU PUT YOUR HEAT ON IN YOUR CAR OR IN YOUR HOME?

<<I asked him about using the nasal spray, he said to use it, but not even how often ( I didn't use it yet ).>>

IF YOU FEEL YOU HAVE TO USE IT, THEN DO SO. JUST USE IT GENTLY. IF YOU THINK YOU CAN GET BY WITHOUT USING IT, THEN WAIT AT LEAST ANOTHER WEEK OR SO IF POSSIBLE.

<<I'm not prone to canker sores, and this morning the saline rinse wasn't painful and it didn't come trough my nose either.>>

YAY!!!! DO YOU FEEL ANY STUFFINESS IN YOUR SINUS ON THE LEFT SIDE? HAVE YOU BEEN OKAY WITHOUT BLOWING YOUR NOSE?

<<I was using ice pack the first day even that I didn't have the swelling the first day ( that wasn't wrong I hope ? ).>>

ABSOLUTELY FINE.

<<My husband just remembered that the OS told us ( of course I don't remember any of it ) that the thing I was afraid of is OK, and that "thing" was the sinus communication.>>

THIS TELLS ME THE OS WAS HOPEFULLY THINKING ABOUT THE SINUS WHEN HE EXTRACTED YOUR TOOTH, WHICH WOULD HAVE BEEN A GOOD THING.

<< Based on that, he didn't see a sinus perforation at the time of the surgery ? but I felt the air coming trough just a few hours later ? is that possible ?>>

AGAIN DO NOT ASSUME HE DID NOT SEE A SINUS PERFORATION JUST BECAUSE HE DIDN'T SPECIFICALLY MENTION IT TO YOU.

I THINK ONE OF TWO THINGS MOST LIKELY HAPPENED.
ONE) HE DIDN'T SEE THE PERFORATION BECAUSE IT WAS REALLY SMALL OR HE DIDN'T EXPLORE ENOUGH TO SEE IT.
TWO) HE DID SEE A PERFORATION BUT DIDN'T THINK IT WAS WORTH MENTIONING OR DIDN'T EXPLORE IT TOO MUCH.

EITHER WAY, THE AIR PASSING THROUGH WITHIN THE FIRST FEW HOURS POST OP INDICATES THAT THE PERFORATION WAS PRESENT WHEN THE TOOTH WAS EXTRACTED. WHETHER OR NOT IT WAS PERFORATED BY THE TOOTH, THE INFECTION OR THE REMOVAL OF THE TOOTH IS STILL UNKNOWN BECAUSE THE OS HAS NOT EXPLAINED THAT TO YOU.

Bryanna

Usually it's not even a congestion but I have to blow my nose several times in the morning ( never during night ) and no, the heat doesn't affects it, but the cold does. And when I clean my house ( even without using any chemicals ) I have to blow my nose a few times.
I'm OK without blowing my nose and I'm OK without using the spray. I feel some kind of pressure but not stuffiness on the left side above the extraction side, I don't know if that's the extraction site tenderness .
To tell you the truth, my thought is that the OS saw the sinus perforation but he didn't care to explore it to much. I will try to ask him again about the extraction when I go in for a follow up but he can say whatever he likes to, right ?
Thank you Bryanna for your patient and kindness helping me trough this !