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Oral Surgery/Tooth extraction with sinus peforation


I had all my back teeth pulled two years ago. I came back to same place to get the last top eight teeth and two bottom teeth pulled, dentures and a partial to be put in immediately following extractions. While getting the last of my top teeth pulled the dentist started to cuss loudly and telling hygienist assisting that he has bubbles. He continued to cuss and both started to work a little frantically when I tried to ask he told me to wait he would explain in a minute. After he finished he put in my denture then called my husband into the room. He told both of us that one of the teeth he pulled was in my sinus cavity and when he pulled it some of the bone came out with the tooth. Not sure what that means. He told me he put in a bone graft which he made sure I knew was 500 dollars that he wasn't going to charge me for. And he represcribed Amoxicillian which I was already on before the procedure and some pain medicine.I went back in Friday morning because he wanted to do a qui
ck check and see how things are healing I was not very swollen and pain was minimal with pain medicine and a 3 on 1-10 scale. I had this done on Thursday morning. Friday night my entire face hurt taking my pain meds pain was a 8 and was very swollen which is understandable with all the work but I also spiked a fever of 102.1 I called the after hrs line when he called me back he told me to double up on amoxicillian and pain pills and go to an clinic we have in town open on the weekends. I went and the doctor gave me clindamycin and told me to keep taking amoxicillian as well and to see dentist on monday since he wasn't dental expert. It didn't change I went into the dentist on monday and he took me off amoxicillian and added flagyl and refilled pain medicine. My swelling has gone down but if I am not taking Ibprophen my fever goes up and on fever reducers it never gets below 99.0 I have gone back to him once and he acting frustrated put me on cephalexin. It has now been 2 week
s total since surgery and the side of the perforation is still very tender and fevers wont go away. He is acting very put out with my questions and refuses to give pain medication even though I still hurt. I get the feeling that since he is not an oral surgeon he is in over his head but I may be wrong. I am exhausted the antibiotics are messing me up digestively and I cant sleep because the pressure and pain on that side is pretty bad. Should I be seeking a second opinion? I am getting treated like an annoyance and they act like I am making up my pain. I would like to know what to do I am a self pay so going to someone else after I have paid this one up front to do this work is going to be hard to swing. I just need a little guidance cause I am scared. Also I do have a lots of yellow green drainage in the back of my throat I keep coughing up."

Jessica, Thank you for your question. It sounds like you have had a terrible experience. I think it is important to let them know that you have lost confidence in them and you would like to see someone else. Secondly, I hope that they got your permission to put in a bone graft to the area. Thirdly, I hope they discussed the possibility of this complication. If they did not do either of these, this is a legal issue and I would seek legal advice. Additionally, It is important for you to get the care you need. If there is a dental school in the area, you should call them because they can see you for probably a reduced rate. I hope that helps.  

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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