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Sinus Communication...Wasn't Even Warned About It!

B

BingBang

Junior member
Joined
Jun 6, 2024
Messages
12
Location
FL
I had upper left number 2 molar extracted two weeks ago. I put this off for so long because I am just such a mess with these things...had to take a Xanax before going in. All the OS said was that I had "long roots", never mentioned the possibility of a sinus communication or any symptoms to watch for or precautions to take. I had a prolonged terrible taste in my mouth and felt some off and on numbness/pressure in my cheek and up to my eye. Went in on day 6 for him to take a look and he said it was healing up fine. Asked about the pressure in my cheek/eye and asked if it could be my sinus and he said NO. Just sent me home. This was continuing so I called again, reluctantly prescribed amoxicillin for 7 days, still not mentioning sinus comm. Now I started noticing water would come into my nostril when rinsing or drinking so I went in again. This time he said that he looked at the x-ray and my roots (3 of them) went into my sinus! Now I'm on augmentin for 10 days and really no other instructions or cautions. Said it should fully close over in another 2 weeks or so. Is this true?? I don't know what to think because I can't believe that this wasn't told to me right up front!

Also about 4 days ago, I suddenly got the sensation that something was caught in my throat, right below the extraction site. I did ask about this and he blew this off as well. Could this be from the sinus drainage from my communication, just irritating my throat? Or could a bone spicule have possibly come out and either lodged in my throat or scratched it badly? Four days later and it still feels like something is in there. Please help...thanks!
 
Amazing that in the litigation conscious US he didn't mention that before treatment.

He's quite correct that it will (95%) spontaneously heal in a few weeks, otherwise it's a very simple little op. to fix it.

Very unlikely that the feeling in your throat is due to a bone spicule, I've honestly never heard of such a thing. Usually they're so small that you'd swallow it without noticing. I suspect it's a coincidence.
 
Thank you so much for your reply! I am also surprised and very disappointed that it took so many visits and phone calls to get any kind of answer. And I was never even given the proper care instructions (like don't blow your nose, don't sneeze with your mouth closed, etc.). I had to find these things out myself on the internet. And thanks for letting me know that the operation, if needed, isn't too bad. Although I have had more than enough of dealing with mouth related issues already.

Also thanks for weighing in on my throat issue. It's just so weird that it's right below the socket area and came on so suddenly. Could it be irritation from the sinus draining? That's my only other thought.
 
And I was never even given the proper care instructions (like don't blow your nose, don't sneeze with your mouth closed, etc.). I had to find these things out myself on the internet. And thanks for letting me know that the operation, if needed, isn't too bad. Although I have had more than enough of dealing with mouth related issues already.
Again, very odd. Maybe he likes being sued :)
The operation is quite simple, hopefully you'll not need to find out!

Could it be irritation from the sinus draining?
It could be, but there's nothing really in your sinus that would be irritating I think.
 
Thank you SO much for your thoughts on everything! After dealing with this OS that clearly doesn't care it gives me some answers and reassurance. I really don't want to go back there again (and he didn't advise me to follow up) so I am going to call an ENT on Monday to have everything evaluated, especially the scratchy, irritated patch in my throat. Thanks again for all your help!
 
My pleasure, keep me posted on what the throat thing turns out to be... oh, you didn't have a general anaesthetic for the treatment did you? That'd do it.
 
I will definitely keep you posted. I'll be calling for an appointment tomorrow, hopefully they can get me in soon. And no, I didn't have general anesthesia. Just novocaine and a sedative. Thanks for that thought though.
 
Well I called the ENT office yesterday. The doctor is booked through the end of August and the nurse practitioner until July 3! I have an appointment for 7/3 with the practitioner and asked to be put on a cancellation list. I also called my regular dental office today to see if he might be able to take a look at everything and that's not until next week.

In the meantime, the socket still continued to drain a foul tasting liquid and when I touch the area with my tongue it still has that "raw" type feel and taste to it; similar to when the blood clot was there but supposedly that is gone.

It's been 3 weeks ago today that the tooth was extracted. Just how worried should I be about these symptoms? I can tell you that it sure is annoying and after 3 weeks of this I am so done with it. I am on Augmentin for another 4 days and the irritation along the back of my throat on that side continues. I really don't want to go back to this oral surgeon again because frankly I just don't trust him any longer. Do you have any other suggestions for me??

Sorry to bother you again with this...I'm sure you are very busy. But any additional ideas would be much appreciated. Thank you!
 
Sorry to bother you again with this...I'm sure you are very busy. But any additional ideas would be much appreciated. Thank you!
No bother, I'm not that busy, I'm retired :)

I'm sorry, but other than waiting for a professional to take a look there's not much else you can do.
 
I know, and it's frustrating. And now I don't have another alternative. I called my OS's office this morning to see if they would extend my antibiotics and they said no to that and also told me to now follow up with an ENT. So they have now washed their hands of me. Even though I didn't want to go back there, I'm not really happy that they have now just basically dismissed me and my concerns.

Anyway, just crossing fingers for a cancellation so I can get into the ENT before 7/3. Thanks again!
 
TBH I wouldn't have prescribed antibiotics in the first place, so no big loss there. I'd maybe give your regular dentist another shout and see if they could squeeze you in for a quick look?
 
Glad to hear that you are retired now and I hope that you are enjoying your time off! My uncle was a dentist and he could never hang up the drill, so to speak. He really loved his work.

Anyway, I think the augmentin was to avoid getting an infection in my sinus. But I will still be at risk of that. I've run a low grade fever a few times since the extraction (99F - 99.5F) but nothing ever seemed to come of it. Today I started feeling a bit warm and began to sweat a bit. I took my temp and it was 99.6F. Been hanging around between 98.9F and 99.5F since then. This is what worries me about waiting so long to get this taken care of. I was reading a dental chat board today where OS's were discussing their treatments and more than one said to never let this go for weeks. I am already over 3 weeks past extraction date.

I called my regular dentist's office again and today is his day off, and tomorrow (Friday) he is booked. I do have an appointment for early Monday morning at least. But not sure how I will get into an ENT any sooner. Don't OS's usually do the surgery to close the communication? I was kind of surprised that I was being referred out to an ENT.
 
Don't OS's usually do the surgery to close the communication?
Yes. It's a simple flap surgery, even I can do one in 10 minutes flat. I had a read on the US oral surgeon's guidance pages, they advocate surgery after 14 days if no spontaneous healing, or immediately if the defect is larger than 2mm, hence perhaps the different answers you're seeing online?
 
Thanks again so much for your input! It is really helping me right now since no one else has been giving me any answers here. I am really surprised that this OS didn't do - or offer to do - this surgery to take care of everything. He never even told me exactly how large the opening is. All he said is that it was "big" as the tooth had 3 roots. Not exactly comforting.

At least I was able to move my ENT appointment up to next Tuesday (6/18). I decided to be proactive yesterday and call them again and lo and behold I am going to see the actual doctor now and in just a few days. Very happy and relieved about that!
 
Good, let me know how you get on please, I'm really wondering what's going on with your throat.
 
Hello, well I went to the ENT doctor yesterday. He was a really nice man who was very thorough and who patiently answered all of my questions. That alone went a long way toward making me feel better because other than that I feel like I was dismissed and just brushed off by my OS. He looked at my throat and scoped my nose on both sides.

He didn't see anything alarming as far as excess phlegm or any kind of pus in my sinus cavities. But he wasn't able to see if there was any opening with the scope. For that I need to have a CT scan of my head for which he gave me a referral. This makes me extra mad because I don't know why they didn't do this in the OS office as they have this capability right there. Now weeks ahve gone by and I must pay to have this scan done. He said they will have me put markers where I feel the sensation in my throat and also right where the extraction is.

He couldn't say for sure what was happening in my throat. He did say it's possible that a tooth fragment may have scratched my throat. It's also possible that I have irritation from the drainage. If something is still in my throat it should show up on the CT scan. I don't think that there is anything still there but it is definitely still scratchy and irritated right below the extraction site.

If the scan shows up anything new or unusual I will let you know. Thanks again for being there and for your concern.
 
But he wasn't able to see if there was any opening with the scope.
Could it not be that the area has spontaneously started to heal over? They usually do remember...

Thanks for the update, please keep me posted if you finally get to the bottom of it.

A final thought, can you get hold of some Difflam Rinse (should be available from a pharmacy) and gargle with that, it may well help your throat. Tastes OK too :)
 
I'm still hopeful that perhaps it is closing on its own. One suggestion he had was to drink something with a vivid color and then gently blow into a tissue to see if the discharge is colored. I need to purchase something to try that with but it sounds like a good idea.

And thanks for the suggestion of Difflam rinse. I never heard of that before. Of course it's not available in the US (guess that's why I never heard of it)! I looked everywhere. All that comes up are EU, Britain and Australia online pharmacies. It said not available in US. I even looked at Canadian pharmacies and they ahve something called Pharixia rinse which appears to be the same thing or similar. But it's $52.99 plus $10 shipping! I've been using manuka honey recently and that seems to at least give me some temporary relief.
 
You could try gently sucking on a straw, if you can get liquid up the straw then it would suggest the OAF is closed.

Sorry about the Difflam, I didn't know it wasn't available in the US, odd since it's an American company that makes it!
 
No worries about the Difflam and thanks so much for all your suggestions. This has been a miserable last month for me and I am anxious for relief and feeling back to normal.

It is funny how so often things aren't available here that you can buy in Europe and Great Britain. One other thing I had to purchase from England was Gaviscon Advance antacid with added alginate to act as a shield for acid reflux. I believe Gaviscon is also a US company and you can buy their other formulations here but not the alginate. My theory is that big pharma wants to keep pushing the PPIs in the US. Not sure about the Difflam.

But I was able to Difflam lozenges on Amazon that seem to have the same active ingredients as the rinse. So I ordered that for $12. Go figure...
 
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