I had my second upper molar (tooth 2) extracted 6 days ago. The socket looks ok and I am having the stitches removed tomorrow. I have been doing a lot of reading and now fear that my sinus may have been perforated. I have intermittent pain right next to my nose about an inch above my nostril. The spot is almost on the nose itself and adjoining cheek. The cheek was a little swollen until today and maybe this is just soreness. I am 58 years old so maybe I heal slower. I went to a well known oral surgeon with an excellent reputation. He didn't say anything about a perforation and I didn't notice if he irrigated it. I was so scared that I just remember the extraction taking about 2 minutes and the stitches. I didn't ask any questions afterwards because my mouth was packed with gauze. The tooth did have an infection at he tip which he saw when he removed it.

I read that you can tell if there's a perforation by gargling and seeing if the water comes out of your nose or drinking and seeing the same. I am afraid to gargle right now as I have been so careful to do everything right, the salt water, etc. Can this just be soreness? The whole area is still sore so hopefully that's all it is but I am getting scared. Is it usual to have pain in the cheek and nose area for a week after?

Hi sandy,

Yes, it is common to have soreness as you have described for a week or even longer after an infected tooth is extracted.

Here are a few things that are pertinent anytime an extraction is done are......

1)The periodontal ligament which is the tissue that cradles a tooth in the jawbone along with the area of infection should be removed at the same time as the tooth to aid in the healing of the jawbone

2)Since upper molars can be in close proximity to the sinus, the surgical area should be checked thoroughly after the tooth is out and the area is debrided to rule out a sinus exposure. We check this visually as well as having the patient blow through their nose while the nostrils are held closed. While the patient is blowing through their nose, if air bubbles accumulate at the site of the extraction this indicates a sinus exposure. If no bubbles are seen, then the sinus is most likely intact.

3)All extraction sites should be irrigated with saline solution after the tooth is removed and after the surgical site is debrided but prior to any suturing. The irrigation flushes out any debris that could cause infection and/or delay the healing of the site.

It is good that you have followed the post operative instructions and should continue to rinse with warm salt water for at least another two weeks. It would not behoove you to gargle or try to get water to come out your nose. The best thing to do is express your concerns and "specific" discomforts to the oral surgeon tomorrow and let him check the area for anything unusual. He may take another xray to firmly rule out the possibility of a sinus exposure.

I always tell patients to speak freely about their concerns, irrelevant of how insignificant they feel they may be or how busy the doctor may be. More times than not, a patient can prevent further complication by speaking up....... ~'.'~

Please let us know how your visit goes tomorrow!! Wish you the best of news!

Bryanna

Thank you so much for the quick reply, Brianna. I am new here and more nervous than most people about my teeth since I have had a lot of work done. My surgeon didn't do the test you mentioned. I am hesitant to ask him if he irrigated it because I don't want him to feel I'm questioning his expertise. It all went so fast and I had my eyes closed because when I saw the pliers, I freaked! I will ask him though if there was a sinus exposure or perforation. I would think he would have told me...I wlso want to know if there was, did he treat or fix it. Googling has taught me so much here, maybe more than I wanted to know. I think of people years ago, ouur grandparents who had a million teeth removed and didn't think about or worry and they were fine. Anyway, I am having pains on the other side also, ear, chin, TMJ...I am just a nervous wreck but primarily, this pain on the side of my nose concerns me because it wasn't there before. Can they see a perforation on a regular periapical x-ray? They did a Panorex already beforehand and I'd hate to go through all that radiation again. Or would I need a sinus x-ray? Hopefully, this is all in my mind and will be ok but will be glad to post tomorrow and thanks again! Oh, one more question...if they had to repair it, do they have to re-open the same spot? I worried so much about dry socket and scared to go through this again.

Bryanna, the cheek pain is subsiding and the dentist said if it persists, see an ENT dr. I now have a salty taste but made a separate post.

Please help,My husband just had two upper teeth removed today.They did not give him stitches.One of his tooth was harder to remove,I guess she said he had strong roots.Anyways,He's in pretty bad shape.His mouth hurts very very bad,He says there is pain up by his nose and his forehead.You can see something white in the one extraction site.I've been doing research,And I found it could be a piece of tooth or bone.And that he may have that sinus problem but I did the bubble test and I cant see anything.Do you think he's just pretty badly sore from how hard it took to get the tooth out?Anything will help.

Hi Mrseberly,

Pain in varying degrees is expected for the first few days after a tooth extraction. Sometime the more difficult the extraction the more it hurts... but not always.

You should not put anything inside of the surgical hole...absolutely nothing. White looking stuff seen inside of an extraction site on the first or second day after surgery can be a surgical material that was placed inside of the hole. Do not try to remove that. Also, do not do the "bubble test" because this could actually cause a perforation into the sinuses.

If your husband was given pain meds, he should take them. He should not rinse with anything for the first 24 hours. After that time he should start to rinse very gently with warm salt water and continue rinsing with that for several days. NO mouthwash because the chemicals in them can disrupt the healing process and contribute to a dry socket which can be very painful and would require additional dental treatment to help remedy. NO smoking or drinking alcohol until the surgical holes close up. Both of these things can cause pain and prevent the areas from healing closed.

It would be normal for your husband to have some bleeding during this first night, even while sleeping. If the surgical sites are oozing blood tomorrow, he needs to see his dentist. If they are just bleeding a little bit or bleeding on and off throughout tomorrow, that is normal.

I hope this information helps. Please let us know how he's s doing.

Bryanna