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tooth extraction when root is in sinus cavity

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Unread 06-25-2010, 05:40 AM   #61
anotherbrother
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Default The root may come out of my nose!

Hi,
Just sat here bleeding quietly having had an hour long extraction- upper left molar. The dentist explained after that 'there is a problem, one of your roots has gone up into your sinus cavity. If there is a problem you will have to go to hospital, maybe there will be no problem. The root may come back out into your mouth, or maybe if will come out of your nose."
I have been given a pile of antibiotics and an order NOT to sneeze ever again (well, for a day or so).
So far the other posts give me the fear.... I have the fear!
What to do?
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Unread 06-25-2010, 09:07 PM   #62
Bryanna
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Hi anotherbrother....

First of all, please don't panic. Fear will not make the problem go away, it's just going to give you something else to deal with and this problem will be resolved at some point.

The post operative instructions to not blow your nose (for about a week!!) is suppose to be given to all patients who have had upper molar extractions. If you have to sneeze, keep your mouth open to avoid pressure in the sinuses. Also, do not drink through a straw, smoke, drink alcohol or rinse with any mouthwash containing alcohol or essential oils. All of those things will prevent the surgical area from closing over.

If the dentist said "a root has gone up into your sinus" this generally means that part of the root was fractured off during the extraction and he pushed it up into the sinus while trying to retrieve it. Depending on where the root is, it may work it's way down and eventually poke a hole through the gum as if you were teething. This would be the best case scenerio.... then a dentist could remove it without difficulty.

The big issue here is the risk of infection. So it is wise to take the antibiotic and be diligent with your post operative instructions including rinsing with warm salt water starting 24 hours from now. If water runs out of your nose when you drink or rinse, then you need to go back to your dentist as this means that the sinus has not closed over. If now or in the future you develop unusual sinus congestion, pain or a bloody nasal discharge, then you would need to see an oral surgeon to evaluate where the root is and determine if there is any pathology going on.

This situation does occur from time to time.... if you are symptom free once the extraction site has healed closed, then it is best to have the area evaluated 1-2 times a year with an xray at your dental office to see where the root is and if there are any unfavorable changes occuring in that area.

Were you planning on replacing this extracted tooth with an implant?

Bryanna




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Originally Posted by anotherbrother View Post
Hi,
Just sat here bleeding quietly having had an hour long extraction- upper left molar. The dentist explained after that 'there is a problem, one of your roots has gone up into your sinus cavity. If there is a problem you will have to go to hospital, maybe there will be no problem. The root may come back out into your mouth, or maybe if will come out of your nose."
I have been given a pile of antibiotics and an order NOT to sneeze ever again (well, for a day or so).
So far the other posts give me the fear.... I have the fear!
What to do?
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Unread 07-14-2010, 08:19 PM   #63
Jajahopkins
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Default Sinus Popping through

My husband recently had all but 4 of his top teeth pulled (going in for the last 4 friday) and after the first set were pulled he developed a Sinus Infection. Two weeks later he noticed a "boil" coming through the hole where the tooth was pulled. A day after that, it busted into his mouth. We found out it was his sinus that had popped through, his Dentist said blow his nose as much as possible, and now everytime he does, instead of it coming out of his nose, it blows into his mouth. Today He went back to the dentist and now she tells him dont blow his nose. Shes sending him to an Oral Surgeon. How often does that happen?
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Unread 07-15-2010, 09:06 PM   #64
Bryanna
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Hi Jajahopkins,

Please..... without any doubt..... he should not blow his nose no matter what! He has a large opening in his sinus from the surgery and should not be doing anything to cause pressure on his sinuses. Anytime an upper tooth is removed, the person should refrain from blowing their nose for at least 2 weeks after surgery. If he was deliberately blowing his nose after the surgery then he has caused the opening to enlarge.

I don't want to alarm you... but this is a serious condition because the infection can spread past the sinus cavity. It is good thing that he is going to the oral surgeon tomorrow. In the meantime, please ask him to refrain from blowing his nose and if he needs to cough, he should do so with his mouth open to avoid any pressure on the sinuses.

Please, let us know what the oral surgeon says at his visit.

Bryanna


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Originally Posted by Jajahopkins View Post
My husband recently had all but 4 of his top teeth pulled (going in for the last 4 friday) and after the first set were pulled he developed a Sinus Infection. Two weeks later he noticed a "boil" coming through the hole where the tooth was pulled. A day after that, it busted into his mouth. We found out it was his sinus that had popped through, his Dentist said blow his nose as much as possible, and now everytime he does, instead of it coming out of his nose, it blows into his mouth. Today He went back to the dentist and now she tells him dont blow his nose. Shes sending him to an Oral Surgeon. How often does that happen?
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Unread 10-16-2010, 04:12 PM   #65
freeman
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Great thread, found by searching for answers after my dentist pushed a root through into my sinus with a great 'cracking' sound - not that painful but quite upsetting!

Long story short: I got an appointment with the maxillofacial surgeon who performed a caldwell luc procedure on me recently.

My advice to anyone going through this is - don't look at other people's stories and fear the worst because you are likely to see something negative and my experience of the surgery is one of complete admiration for the health service in the UK. The surgeon was fantastic, there's no swelling, bruising or loss of feeling. I might have been lucky as he doesn't normally do this kind of work, he is senior and tends to leave these 'simple procedures' to his registrars.

Caldwell Luc is one hell of a scary-sounding procedure but I would say that the worst thing was waking up with a sore throat after the operation. I'm not joking either, or trying to make anyone reading this feel better by lying about it - it really was far less trouble & pain than I had anticipated.

Normally I don't go searching the Internet for medical answers - I trust my doctor and dentist to know more about me than anyone else. However, this thread was so close to my situation and the replies from Bryanna were (are) so balanced and well-written that I just wanted to chip in and say the above. Thanks for reading, don't have nightmares!
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Unread 10-17-2010, 10:34 AM   #66
Bryanna
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Hi freeman.

Thank you so much for sharing your positive experience with us!!

Most of the time just the thought of having any surgical procedure scares the life out of us. But many times the procedure goes really well and the outcome is good!

Very glad to hear that you are doing well!!

Bryanna


QUOTE=freeman;705500]Great thread, found by searching for answers after my dentist pushed a root through into my sinus with a great 'cracking' sound - not that painful but quite upsetting!

Long story short: I got an appointment with the maxillofacial surgeon who performed a caldwell luc procedure on me recently.

My advice to anyone going through this is - don't look at other people's stories and fear the worst because you are likely to see something negative and my experience of the surgery is one of complete admiration for the health service in the UK. The surgeon was fantastic, there's no swelling, bruising or loss of feeling. I might have been lucky as he doesn't normally do this kind of work, he is senior and tends to leave these 'simple procedures' to his registrars.

Caldwell Luc is one hell of a scary-sounding procedure but I would say that the worst thing was waking up with a sore throat after the operation. I'm not joking either, or trying to make anyone reading this feel better by lying about it - it really was far less trouble & pain than I had anticipated.

Normally I don't go searching the Internet for medical answers - I trust my doctor and dentist to know more about me than anyone else. However, this thread was so close to my situation and the replies from Bryanna were (are) so balanced and well-written that I just wanted to chip in and say the above. Thanks for reading, don't have nightmares![/quote]
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Unread 10-21-2010, 06:10 AM   #67
infinitewonders
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I just had #2 and 15 surgically removed on the 19th. One of the resulted in an open sinus, but there is not very much pain anymore. The oral surgeon cut the gum and sewed it over the sinus opening though.

I would like to ask one thing though. What are the chances the tooth with the open sinus getting an infection? I received antibiotics, but I have started breaking out in a rash from taking them. So I don't want to take them anymore because I don't feel safe with them.

These were my last two teeth to be removed and all of the others healed without any problems at all. I do smoke which is a concern for the open sinus, but I don't want to have to buy more antibiotics if the chances are low for infection as these were the second ones. I seem to be allergic to most antibiotics I have tried except erythromycin, which I am not supposed to take when I have been taking clindamycin.

Thanks for any help and I hope everyone has gotten their dental issues solved. It has been seven years working on getting mine out and I am hoping the final two will go as smoothly as the others and give me better health!

Infinitwonders
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Unread 10-21-2010, 07:52 PM   #68
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Hi infinitewonders,

An open sinus membrane cannot be sutured closed because the sinus tissue is too thin to hold a suture. Unless the sinus perforation is very tiny, just covering the opening by suturing the gum closed usually does not work. So perhaps the dentist sutured a piece of collagen over the sinus opening and then sutured the gum closed??

Sinus perforations are a hole (could be very tiny or very large) from the mouth to the sinus cavity in which the sinus membrane has been broken. Think of the sinus membrane as a wet piece of kleenex...... then put your finger through it. So yes, this condition is very susceptible to becoming infected especially in people who smoke because the chemicals in the tobacco deprive the area of oxygen preventing the hole from closing. Cigarette tobacco is also highly toxic which causes the surgical site and beyond the wound to become sickly, again preventing the wound from healing properly.

If you have developed a rash from the antibiotic, then stop taking it. Call your dentist and have them prescribe something else.

It is wise to be concerned about the risk of infection and also wise that you should be concerned about the safety issues of taking antibiotics. However, aren't you equally concerned about the health risks of smoking?

It sounds like you have had a long journey getting your dental issues taken care of. Don't let this issue go unattended for too long... your dentist should know your reaction to the meds so he can prescribe something else and also inform him that you have been smoking. He may want to re evaluate the surgical area sooner than later.

All the best to you.... please let us know how you're doing!

Bryann






Quote:
Originally Posted by infinitewonders View Post
I just had #2 and 15 surgically removed on the 19th. One of the resulted in an open sinus, but there is not very much pain anymore. The oral surgeon cut the gum and sewed it over the sinus opening though.

I would like to ask one thing though. What are the chances the tooth with the open sinus getting an infection? I received antibiotics, but I have started breaking out in a rash from taking them. So I don't want to take them anymore because I don't feel safe with them.

These were my last two teeth to be removed and all of the others healed without any problems at all. I do smoke which is a concern for the open sinus, but I don't want to have to buy more antibiotics if the chances are low for infection as these were the second ones. I seem to be allergic to most antibiotics I have tried except erythromycin, which I am not supposed to take when I have been taking clindamycin.

Thanks for any help and I hope everyone has gotten their dental issues solved. It has been seven years working on getting mine out and I am hoping the final two will go as smoothly as the others and give me better health!

Infinitwonders

Last edited by Bryanna; 10-22-2010 at 09:03 AM.
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Unread 10-22-2010, 01:07 AM   #69
infinitewonders
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Quote:
Originally Posted by Bryanna View Post
Hi infinitewonders,

An open sinus membrane cannot be sutured closed because the sinus tissue is too thin to hold a suture. Unless the sinus perforation is very tiny, just covering the opening with gum tissue usually does not work. So perhaps the dentist sutured a piece of collagen over the sinus opening and then sutured the gum closed??

Sinus perforations are a hole (could be very tiny or very large) from the mouth to the sinus cavity in which the sinus membrane has been broken. Think of the sinus membrane as a wet piece of kleenex...... then put your finger through it. So yes, this condition is very susceptible to becoming infected especially in people who smoke because the chemicals in the tobacco deprive the area of oxygen preventing the hole from closing. Cigarette tobacco is also highly toxic which causes the surgical site and beyond the wound to become sickly, again preventing the wound from healing properly.

If you have developed a rash from the antibiotic, then stop taking it. Call your dentist and have them prescribe something else.

It is wise to be concerned about the risk of infection and also wise that you should be concerned about the safety issues of taking antibiotics. However, aren't you equally concerned about the health risks of smoking?

It sounds like you have had a long journey getting your dental issues taken care of. Don't let this issue go unattended for too long... your dentist should know your reaction to the meds so he can prescribe something else and also inform him that you have been smoking. He may want to re evaluate the surgical area sooner than later.

All the best to you.... please let us know how you're doing!

Bryann
Thanks. All I know he told me he cut the gum and sewed it over it, so he may have left out something. If I can I will get erythromiycin since I know I am not allergic to it.

I am concerned over the risks from smoking of course. I hate everything about smoking from the taste to simply doing it. Been hoping to quit, but so far all I got was cut down to about half a pack a day.

I have a follow up Tuesday and have been using salt/water mixture to rinse with. So far it seems fine except the sinus headache that comes and goes. I only had to take two halves of a pain pill one each day as well. I think it hurt more getting them out since it wasn't entirely numb, but I didn't like the lidocaine so much so I didn't say anything.

Hopefully it won't take to long for the sinus to heal though lol
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Unread 10-23-2010, 08:16 AM   #70
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Quote:
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Thanks. All I know he told me he cut the gum and sewed it over it, so he may have left out something. If I can I will get erythromiycin since I know I am not allergic to it.

I am concerned over the risks from smoking of course. I hate everything about smoking from the taste to simply doing it. Been hoping to quit, but so far all I got was cut down to about half a pack a day.

I have a follow up Tuesday and have been using salt/water mixture to rinse with. So far it seems fine except the sinus headache that comes and goes. I only had to take two halves of a pain pill one each day as well. I think it hurt more getting them out since it wasn't entirely numb, but I didn't like the lidocaine so much so I didn't say anything.

Hopefully it won't take to long for the sinus to heal though lol
Well the oral surgeon office said it should be fine now even though I couldn't take those antibiotics. They said he will see when I go back in Tuesday, so I guess I am going without antibiotics anyway until then lol
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