Oral Surgery/Help please


QUESTION: Ok,  I had a top molar extracted and a bone graft done.  The Dr. told me that my roots were into my sinus (all 3 of them)  He also said that he shaved some off (not sure what he shaved), but he said he did so he could add extra bone underneath sinus.
Day after graft, woke up with an empty hole going from gum into sinus.  I was scheduled for surgery on Monday, so had the hole all weekend.  Monday, he put 2 membranes on the sinus hole, then added bone graft, two more membranes on the bottom of graft, then did a gum flap surgery to close hole.  Day 2 after surgery when swelling went down, several bone pieces started coming out, and came out all day long.  The next day, I have the same sucking/vacuum feeling through my game and face as before, and salt water when doing my rise came out my nose.  The Dr. says there are no other surgical procedures left, and it is worrying me about this hole through my head.  Please advise me on what to do... He says I must wait and see if holes close themselves.  I would at least think he could have glued around the gum flap to stop the air and fluid from getting into the hole?
Thank you for your response.

ANSWER: Amy -  The doctor who performed the extraction, created a hole into your sinus and attempted to close the opening, is obviously incompetent. With the type of hole you describe, the closure may not be simple, but if the doctor was prepared to close the opening into the sinus and at the same time seal the area so no fluids from your mouth or air from your nose penetrate the opening healing should have occurred.  You don't say, but the doctor should have prescribed an antibiotic and possibly a decongestant to dry the sinus.

You now need to see a knowledgeable board certified oral and maxillofacial surgeon.  You don't mention what area of Pennsylvania you live, but if you wish, you can send me the specific area or city you live and I will try to find a board certified oral and maxillofacial surgeon near you.  

I hate hearing of situations like you have.  I will try to help you.

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

QUESTION: Thank you for responding to my question.  I am in WV, and the Dr that I am speaking of is a certified max surgeon. I have been on an antibiotic for a week, that ran out last night, and am on Nexafed.  I am just worried about the hole between sinus and mouth, and the fact that most of the second bobe graft is gone.  He has told me there is nothing surgically left to do, and we have to see if the two holes close themselves.  This surgery was done last Monday the 8th and as of yesterday, salt water still makes its way out my nose from my mouth.  
Thank you again

Amy -  I am sorry to hear what is continuing to happen.  I am a little disappointed that your surgeon has done improper surgery and said there is nothing surgically left to.  A repair is possible in every situation and the doctor giving up is wrong.  

My suggestion is that you should have yourself examined by Dr. Bryan Weaver.  He is the Chairman of West Virginia University's residency in oral and maxillofacial surgery.  You should contact him at the University.  You can call (304) 293-2841 and ask to be examined by Dr Weaver and not initially by a resident.  You can mention that it a suggestion from me, a board certified oral and maxillofacial surgeon.

You don't mention where in West Virginia you live, but there are many highly skilled board certified oral and maxillofacial surgeons in surrounding states.  So see if you can be examined and if you need names of truly skilled ones, don't hesitate to get back to me for suggestions.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


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.


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

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

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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