Extraction & Sinus Perforation

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Jennie - 23 May 2006 00:54 GMT

Hello, I looked for help on this topic before I wrote. I hope I am not
bothering you with my question.
I just got back from my local dentist and I have had the worst luck.
I went in to have a tooth extracted. It was in very bad shape and I
was told that pulling it would pretty much be the only option. The
tooth is my last tooth on my right side top. The dentist took an xray
and then pulled the tooth. Never said a word to me that there might be
a problem. I thought everything was okay until I felt him stiching up
my tooth socket. (I was thinking...I don't remember ever having
stiches before when I had a tooth pulled) Well anyway, after he was
finished stiching me up he proceeded to tell me that he saw on the xray
that my tooth was into my sinus cavity and that when he pulled it it
perforated my sinus cavity. Shouldn't he have told me that BEFORE he
pulled it? I am now at home in major pain and my socket is bleeding
badly. I am worried that I am going to get an infection. I was not
given any antibotics. Should I have been? I don't see him again until
next week when I get my stiches out. Thanks for your help!!

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Mark & Steven Bornfeld - 23 May 2006 01:02 GMT

> Hello, I looked for help on this topic before I wrote. I hope I am not
> bothering you with my question.
[quoted text clipped - 13 lines]
> given any antibotics. Should I have been? I don't see him again until
> next week when I get my stiches out. Thanks for your help!!

    You can't always tell beforehand which teeth will cause a communication
with the sinus when extracted, but you should get a good guess which
might from the x-ray. Yes, if he suspected the sinus could be entered
telling you would have been the right thing to do, but honestly I doubt
very much that this knowledge (other than in the legal sense) is very
useful, as if the tooth really had to come out, it had to come out.
    Stitching over the extraction socket is the right thing to do, and he
was honest enough to tell you what happened--the occurrence itself was
almost certainly not his fault.
    I personally would have put you on antibiotics. Dave King, OMFS
Extraordinaire--you out there? What is the current thinking on this?

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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Dave King - 23 May 2006 19:46 GMT

>> Hello, I looked for help on this topic before I wrote. I hope I am not
>> bothering you with my question.
[quoted text clipped - 27 lines]
>
>Steve

I would have tried to get primary closure depending on the size as
well as antibiotics. The vast majority heal uneventfully.

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Mark & Steven Bornfeld - 23 May 2006 19:55 GMT

>>>Hello, I looked for help on this topic before I wrote. I hope I am not
>>>bothering you with my question.
[quoted text clipped - 30 lines]
> I would have tried to get primary closure depending on the size as
> well as antibiotics. The vast majority heal uneventfully.

Thanks, Dave!

Best,
Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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Jennie - 23 May 2006 22:34 GMT

Thank you so much!!

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Joel344 - 25 May 2006 02:07 GMT

I imagine that increased pressure could "blow through" a
weakened Schneiderian membrane ........ telling folks not
to blow their nose if the oral antral fistula is a possibility.

What say you Dave?

(Dave is widely experienced as OMFS).

Joe

--
Joel34

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Dave King - 25 May 2006 15:10 GMT

>I imagine that increased pressure could "blow through" a
>weakened Schneiderian membrane ........ telling folks not
>to blow their nose if the oral antral fistula is a possibility.
>
>What say you Dave?

I say what you just said.

>(Dave is widely experienced as OMFS).

Oh, everything is relative.....

>Joel

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