Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/2/2009

Question
My husband (27 yrs. old) had severely decayed teeth and had all of his top teeth extracted at an oral surgeon about 2 years ago.  2 months after the surgery he had a dirt bike accident where his face hit the dirt quite hard, causing his denture to cut up into his gum, just below his nose.  He had stitches on a cut on his upper lip that went almost into his nostril.  Three months or so later his nose became very stuffy and his cheek/bridge of his nose swelled up.  He was diagnosed as having a sinus infection, given steroids and antibiotics.  It cleared only to return again 3 times.  At that point he saw a ENT specialist who said his septum was deviated and made an in office adjustment with a type of fork, for lack of the proper term.  Also he gave more antibiotics and steroids.  It cleared up for almost one year with no recurrence.  
Mid summer of this year the infection returned , he saw a different local doctor, and was again treated for sinus infection, he was given two z-packs.  The infection returned again and saw a third doctor, as the other was unavailable, who gave him a different type of antibiotic.  That helped for a while but he now has the same symptoms: sensitivity to his face just below his nostril, bleeding nose, congestion, bleeding into the mouth which pools in his denture slightly, low fever, headache.  He has been taking mucinex as directed and also using the nasal spray form of mucinex.  
Could there be an opening into the sinus from the tooth extraction?? What would explain the year of no occurrences of infection, if there is an opening? How would this condition be fixed?  Could there have been any mistakes made during the surgery which could be causing the infections?  We are waiting to hear back from the oral surgeon who did the original extractions, but now we have medicaid and they do not accept that insurance.  Any information you may have is greatly appreciated, thank you, Beth.

Answer
Beth -  Without examining you I cannot be sure what the cause of your husbands recurring problem, but it could be the extractions, with unhealed openings into the sinuses or the trauma may have causes a blockage of the normal drainage site from the sinus into the nasal canal.  Either situation can be treated, but the main problem is finding a doctor who is knowledgeable enough to diagnose the problem.  

I don't know where you live, but if it is near a large city, see if there is a oral and maxillofacial surgical residency program at a local large hospital.  If you are unable to find such a residency, get back to me, tell me where you live and I'll try to help.