After I had an upper wisdom tooth extracted in January, my cheek and nose were swollen. My nose started running with yellow mucus that smelled. The same yellow stuff was coming out of the tooth socket, too. I returned to the oral surgeon, and she said that I have a small sinus perforation. She prescribed Augmentin. The swelling went down, but after taking a CT scan, the surgeon said that the sinus was completely infected. I finished a Z-pack, but some yellow draining is still coming out of the tooth socket, although it is not as bad as it was. My gums feel okay, a 3-4mm hole is left, and I feel slight pain and pressure in my sinus. Now I irritate the site with a rinse the surgeon prescribed and a saltwater rinse. I use Flonase, too. Although I rarely am congested, I still feel sinus pain and pressure. Does it sound like the infection is improving, or should I visit an ENT? I’m anxious about needing surgery and sedation to correct this. Thank you. Kyle from GA
Thank you for your inquiry and thorough description. Although Dr. Finley would need to examine your tooth and CT scan, some things about your situation are unusual.
Sinus Perforation and Infection
It is unusual for a sinus perforation after wisdom tooth extraction to lead to an infection. Your tooth was probably severely infected before the surgeon removed it. Augmentation controlled the infection that caused facial swelling, but you need a Z-pack for the sinus infection. It seems that something might have infected your sinus during the extraction—maybe something was pushed into your sinus.
When an infection is still draining through a sinus perforation, the infection must be removed first. Otherwise, closing the perforation will trap the infection and cause it to spread.
Persistent Pressure with Sinus Infection
If you still feel some sinus pain and pressure, you may need a refill of the Z-pack. It would be best to continue taking the antibiotic until the infection is completely gone to prevent relapse and antibiotic resistance. Continue to take the Flonase as directed. It is a corticosteroid that will reduce sinus inflammation.
Although we do not have all the facts about your situation, it sounds like your oral surgeon’s treatment is effective. At this point, you do not need to worry about seeing an ENT and needing surgery and sedation. It is unlikely that your condition will get worse, but if it does, your oral surgeon will handle it or refer you to a specialist if needed. Ensure your oral surgeon knows about the draining, and she will probably refill or re-prescribe the Z-pack.
We hope you will have a steady recovery.
David Finley, DDS of Monroe, LA, sponsors this post.