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Oral Surgery/drainage from sinus after extraction

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QUESTION: I had #3 molar extracted due to failure of old (30 yr.)root canal.Prior to extraction, it seemed that there was drainage via sinus.I informed oral surgeon of this, and he extracted tooth May 1. Aside from expected pain from procedure, all went well for a week until the wound closed.  I then had slight swelling on palate next to site and bitter tasting discharge from back of throat. The oral surgeon re-examined the site and tried to express any discharge from area (none noted), and said it might be a sinus infection.  He prescribed antibiotic which reduced sinus swelling, but after 2 days the same type of discharge returned and the sinus on that side of the face is congested & occasionally painful. What is my next step--return to oral surgeon & request x-ray or make appointment with ENT? I would like to be infection free (at least as far as this is concerned).
Thank you.  st

ANSWER: Susan -  If the oral surgeon cannot find the cause of any problem in the area, seeing an ENT doctor to determine the cause of the infection and to fight the infection appropriately is probably the correct way to proceed.  

I wish you well and hope a simple cause the surgeon can find, but again, if not, see an ENT doctor.  Please get back to me and let me know how you are doing.  

---------- FOLLOW-UP ----------

QUESTION: "Thank you" for your response and advice.  I  completed a 20 day course of the generic equivalent of amoxicillin and the swelling, off-taste & ear pain are gone.  The oral surgeon told me I was not a good candidate for an implant, as my sinus was too near the roof of my mouth.  Are there any other options.  My #1 & 2 molars had been extracted decades ago.  Thanks again1

Answer
Susan - Even if your sinus cavity is close to the roof of your mouth, a surgical procedure, called a sinus lift, can be used to lift the sinus membrane and a bone graft placed to increase the amount of bone to hold an implant.  So it might be a good idea to find a different board certified oral and maxillofacial surgeon to evaluate you for a sinus lift.

So get that second opinion and let me know how it goes.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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