Thanks Bryanne, I am getting in a bad way right now, I think I may be getting an infection as I am burning up (I know its hot here right now but am not right now) Havent been sleeping much keep waking up as well.
My dentist is private (a mercury free one) when I went back to him I should have got prescription for anti-biotics incase, I forgot to ask him.
He did say tooth came out cleanly. He did take xray after. A tooth next to it was taken out couple months ago.
I have been looking for an oral surgeon private practice online and need to book in today with someone.
(As regards my mcs I have had sensitivities since I was 18 mildly up until 8 years ago) I brought on the mcs by doing liver flushing several times then became really sensitive to all chemicals. I would love to go into this more with you in detail another time. Finding it hard to even type now.

A couple of places I have in mind to see on oral surgeon. Need to call first thing in the morning see if any can see me today. dont really have the finances but cant be waiting on referal to nhs. let it go on the credit card. this is too important to sit around on. I dread to think how I am gonna be on the anti-biotics.
Is ct xray the best one I think both of the practices have them (not 3d ones) with panoramic show all thats needed. is the ct one instance results?

David,

Okay, glad to know that you have private dental care.

The fact that you had an adjacent tooth removed just a couple of months ago makes me curious if there is an infection brewing and perhaps both areas are involved.

Can't this dentist give you the name of an oral surgeon in private practice? Not as a formal referral but as an offering to a patient seeking further evaluation?

The panoramic xray is a 2 dimensional xray that shows the upper and lower arches in their entirety, the maxillary sinus cavity, anterior nasal passages, etc. But only in 2 dimensions.

The dental CT scan is a 3 dimensional scan which shows a comprehensive view of the dental and sinus anatomy is slices or cuts, meaning more angles.

Antibiotics may or may not be warranted. I think they should only be given if absolutely necessary. It's best to get a proper diagnosis first and then see what the options are from there.

Bryanna

Thank you,

I norrowed down my search for an oral surgeon to go to see today and decided on this young Portugese oral surgeon. They have a 3D CT Scanner. They were able to book me in 2 hours after I made the phone call.

He was so nice and friendly, very understanding, and gave me so much time.

Down to the nitty gritty.....He had a look in mouth and confirmed the fistula. He said no sign of infection. (relief).

CT Scan showed about one quarter sinus inflammation

Fistula is size 6.6mm x 1.9mm

His opinion to me was to give it 2 weeks to see if it heals itself. If it has not by then to go ahead with procedure to close it. He suggested using PRGF. I am reseaching this right now. Other procedure that he could do is the buccal fat flap, but he preferred the PRGF.

If I need to get it closed, something I read on one of your posts, was debridement to clean up area. Is this something they do anyway or should I ask for it?

I asked him if I do not get any improvement next week to arrange procedure to be done when I return in 2 weeks. I can sometimes be such a worryer.

Am I guessing right that its the repairing of sinus membraine that I am hoping to achieve naturally to stop communication, as it cant be the bone or the gum?

David,

Glad you got in to see the oral surgeon and they took a ct scan.
The term fistula and sinus tract can be interchangeable. In that case it means, yes, there is a definitive opening into the sinus from the extraction site. A fistula of 6.6 mm in diameter is a good size opening. Hopefully it will heal on its own. Did he give you at home instructions of what to do and what not to do between now and next week to try an promote healing of the membrane and reduce the inflammation?

The debridement that I refer to on many posts is correlated with the actual extraction. Every time a tooth is extracted, the dentist is suppose to thoroughly debride the bone socket, remove the periodontal ligament and any disease tissue or bone that is visible clinically or radio graphically. If that debridement is not done immediately and thoroughly after the tooth is extracted, then the dead ligament can prevent or prolong complete healing. Not debriding is like leaving debris in a surgical wound.

When a sinus communication is repaired, the surgeon will debride the surgical site, the sinus and the surrounding area. The degree of that debridement depends on how well the site was debrided at the time of the extraction and if there is infection present.

The hope is that the sinus communication will close on its own. The extraction site, the gum tissue, may or may not close before the sinus opening closes. The bone will not fill in at the area of an open sinus. The sinus needs to be closed for the bone to fill in there.

With or without a sinus opening, the jaw bone normally takes up to one year after a tooth is extracted to solidify. The gum tissue closes over long before the bone solidifies.

The actual surgical repair is of the sinus membrane. However, the gum tissue and bone are involved during the repair surgery.

Bryanna

He told me not to rinse like normal just to hold warm salt water on that side and then repeat. I have been doing things really gentle anyway.
He said if salt water does go up in nose not to worry it wont do any harm.

He never said anything about the inflammation, he just said it may have been there before this all happened. I do have a deviated septum and regularly have stuffiness that side due to my allergies anyway.

I was going to do some research on the inflammation because I think that may hinder healing, do you have any suggestions? Maybe he never suggested anything due to my MCS. I have bought some eucalyptus oil and Alba oil and possibly do some steam inhalation, would that be ok or to harsh.
Any good herbal remedies for this inflammation?

David,

Some suggestions of what NOT to do:
- Blow your nose
- Pinch your nose closed as you did previously to check for air communication
- Drink through a straw
- Rinse with anything other than salt water
- No inhalation of oils as the sinus membrane is very delicate and it's best to avoid disturbing the natural attachment that you are trying to achieve.
- No hard core cardio exercise as this increases the heart rate, elevates the sinus pressure, etc.


Some suggestions of things to do:
- Eat anti inflammatory foods and avoid sugar and processed foods. Avoid dairy and very cold temp liquids or foods as they can increase mucus production.
- Drink plenty of filtered water throughout the day to stay hydrated and flush out toxins, all of which reduce systemic inflammation. Ideally, most people do well with drinking in ounces, half their body weight. Ex: weight 100lbs = 50 oz of water per day.
-Warm herbal teas like white, green, tulsi, or thyme all anti inflammatory. Add some raw local honey (if possible) as this is one of the greatest immune boosting foods you can eat.
-Some supplements that support the immune system and lower inflammation, should be of good quality .... vitamin C, quercetin, and turmeric.
- Massage anti inflammatory essential oils, like eucalyptus, in a carrier oil to the outside of your face over the area above your extraction site. Apply a moist heat over that area for better absorption. Essential oils applied topically are very therapeutic. Remember, a drop of these oils is very potent.
-Take homeopathic remedy, Arnica 30 C or 30 X, 3-5 times a day to promote healing.
-Gentle exercise like stretching or yoga to promote lymph drainage and reduce inflammation.

What do you normally do or take for your sinus allergies? How is your diet? Do you eat organically or .....?

Bryanna

Oh great suggestions, I will pop out to health shop tomorrow.

haven't been drinking any black tea, (have 2 sugars, eek) since extraction, only herbal teas, licorice & peppermint and echinachea and cranberry.
Will cut out cheese.
Will stop my milkshakes
No processed (though normally do dabble)
Always try to get organic veg and fruit but not always available
Need to up my water intake, doing about a 1 litre, will increase to 2 as my urine is pretty dark.

Dont take anything for my allergies as I seem to react to many tablets. I tried an American product called Allercertin that gave me some relief but the major headaches that came with it was not worth the swap.

The dentist who did extraction gives me Traumeel (German product) after extraction. I think it has anti-inflammatory properties. I am taking that 3 times a day

I bought some fresh thyme the other day, I will make some tea with it. was worried about that though because somewhere said its quite potent.

All the good health shops are closing down that I usually go to.
The other day I went to a shop near the dentist to get my usual stock up of pure cranberry juice 100% organic, Udo's choice Ultimate oil blend organic omega 3,6,9's. Got Udo's choice super 8 just in case I will need antibiotics.

Dont get me wrong I am no super healthy eater all the time, (I love my occasional macdonalds, pizza, chocolate and crisps). Maybe its time to say goodbye to them and get in a really healthy routine. Have reaped the rewards in the past with eating strictly healthy diet. And I had noticed good improvement in my health in the past with doing regular exercise, (walking doing my leaflets for work and bike riding.) But then its so easy to slip and go into the bad habits again.

Have been thinking of moving as where we have been for the last 4 years is close to sewage plants and water treatment plants so we get constant nasty smells. This side of London is known to be industrially dirty. All this no good for me and my MCS. Would love the country but need to be long way from farms due to the pesticide spraying and the drift it can give. (pesticides are my no.1 enemy).
Only area I think would be a safe zone would be mid Wales in the valleys. at least 3 - 4 miles from any farms.

Will crack on with the instructions ma'am, my stuffiness and cheek pain is worse today, I dont see any improvement so will try to get out of my slightly depressed state and apply some positivity. My close friend says he admires me how I crack on with all my health problems, though it does take it toll.