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Oral Surgery/Bone graft, sinus lift and implant

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Question
It's been 3.5 weeks. I had bone graft and sinus lift on tooth14 after discovering bone loss in root cana led tooth 15 years ago. During surgery dentist was going to try to set post-drilled and tore sinus membrane. He packed area with cadaver bone and covered. During same surgery he investigated another lower molar root canal had sensitivity. He did and X-ray and decided the root must have been cracked and we could place an implant here. He drilled and placed a screw. Afterwards an X-Ray showed screw was too long and close to nerv so he removed and placed a smaller screw. After a few days while rinsing, liquid came from nose.  Im still in serious pain every day. The lower implant area and upper 14 socket don't seem to be healing right. Gums are red and fluffy looking and I'm running a low grade fever. Lower jaw is sore from ear to center of front teeth. He told me to scrub the areas harder to make the gums heal. What should I do? 48 year old with no serious issues prior to this. Usually heal well.

Answer
Michele, Thank you for your question. After a procedure like this, you can expect some pain and discomfit for a few days. If you are still feeling pain after 3 and 1/2 weeks, there is definitely something wrong. Brushing the gums harder will not clear an infection. It sounds like you might have an infection. If your current dentist is not able to manage your issues and pain after 3 and 1/2 weeks, I would suggest to see an Oral and Maxillofacial Surgeon right away. DO NOT place any heat on any of the areas that are sore.  

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

Expertise

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 www.eosdds.com

Experience

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

Organizations
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.

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

Education/Credentials
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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