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Dentistry/hole in sinus and bone fragments tooth#3

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Dear Mr. Teig,

on 10-16-12 I had a core build up on tooth #3. It didn't get better. Went back to dentist 10-29-12 had root canal done. had allot of pain and severe headaches,ear pain and itching afterwards. Went to ENT he thought TMJ. I went back to dentist and he put me on antibiotic but, didn't help. After several visits and more antibiotics he told me he had broke tip of file off in my mouth. he didn't disclose that to me when it happened. he did 2nd root canal on 12-27-12 looking for missed canal but, things got even worse. went to ER From pain and then back to dentist. He started doing core build ups on 2,3,5 and extracted #3 on 1-31-13. He said root of tooth cracked from base to tip. His assistant made temp bridge and put on. Four days later ended up back in ER for dry socket more antibiotics but, didn't get better lot of mucus coming from temp bridge. Went back to dentist and he continued to grind surrounding teeth. everytime he did this it got worse.on April 11th went for what i thought was impression for permanent bridge but he grinded on those surrounding teeth again and then made impression for perm bridge. When numbness went away the pain was unbearable. Having mucus coming from temp bridge again. Went to ENT and he did CT SCAN and found hole in fistula and bone fragments. on may 8th had oral surgery by board cert. surgeon. thought i was doing better but, into 4th wk started having burning in nose and all symptoms still and equilibrium problems. went back to oral surgeon and he said I have fix your problems go to ENT. Pain was beyond me so went back to ER they did another CT SCAN and it is my understanding i have nerve damage and more problems with sinus, swelling etc. I'm on steroid right now to get inflammation down which might help nerve pain.I now have new dentist who says he cant put permanent bridge on until I'm out of pain for a least 2 wks. I kept going to the dentist that did the work because he gave me a $600 credit but,since i wont go back to him guess i wont get the credit. Where did things go wrong?

Answer
Donna - What you are suffering from is not uncommon with an opening into the sinus from the mouth that was there for a while.  Closing that hole is fine, but since saliva from the mouth, which is filled with bacteria, had gained entrance into your sinus, you now have either just sinus inflammation or chronic sinus infection. To prevent such occurrences, many surgeons at the time of closure of the fistula, do an oral and nasal antrostomy to clean the sinus.  I am assuming that is not what you had.  

My suggestion is for your ENT doctor to attempt to clean out your sinus and place you on antibiotics.  This usually will work, as long as the opening from the mouth to the sinus is closed.  So contact the ENT or speak with the surgeon to have your sinus cleaned.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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