Sinus infection following 3rd molar extraction?

[jdpharmd?]

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I had my #1 and #16 extracted a few weeks ago. I'm not a dental expert, but I think it would be called a soft tissue impaction (my bill says "type I" impaction if that's a standard term). The oral surgeon said that everything should go smoothly and as far as I know, it did.

I was on amoxicillin 500mg QID for 7 days post-extraction with no problems. That was 3 weeks ago. For the last 6 days or so, my face/teeth have been pretty sore, particularly on the top ("cheekbone", - bilaterally), although it's not very well-defined pain. I've also noticed EITHER taste disturbances (almost salty) OR some slight blood that I really do taste. I don't know which one.

I stopped by my DDS's office on Weds pm, but he was at lunch. I haven't gotten a chance to go back, but I'm aiming for tomorrow, after my test. The pain seems much less in the AM, but right now it's a little hard to concentrate (I'm supposed to be studying for micro, how ironic).

Anyway, my question is: "What is the likelihood that my pain is caused by a maxillary sinus infection, resulting from post-extraction complications?" I've heard of 3rd molars penetrating the sinus, but I have no idea how common it really is. I have never had a diagnosed sinus infection, and these antibiotics were the first I've been on in 15 years. Would the possibility of sinus involvement be evident on a panorex? I'll be sure to let you know the outcome. Thanks! 👍

 

[UBTom]

Hi,

As long as the Snyderian membrane that lines your sinuses are not breached in the process of extracting the 3rd molars, the extractions should not cause a sinus infex.

edit: To Bill: You are right. I kind of skimmed over his 3 week part.. My bad.

At the very least, maybe an x-ray can tell us if the bony floor of his sinus is still intact post-extraction.

HTH!

 

[aphistis]

Tom- do dry sockets form so long after extractions? I was under the impression they generally occur within the first few days.

 

[River13]

Tom- do dry sockets form so long after extractions? I was under the impression they generally occur within the first few days.

Dry sockets are earlier complications, not three weeks. By the end of the first week typically I would guess. They are extremely rare in the maxilla also. And if it was a dry socket, that guy's post would have said "extreme pain", "killing me", etc., and he would have waited till lunch was over to see the doc. even if he had to skip class...

My question is, why was he on antibiotics in the first place? A simple wisdom tooth removal doesn't merit that script, unless there was a sinus perf...assuming he's healthy...

If there was no perf. I would bet its a viral sinus infection and unrelated to the extractions.

Sometimes you can see clogged sinuses on a pan, not always.

He should plug his nose and gently blow and wait to see if he heard/felt anything through his mouth...that's controversial to do right after a suspected sinus perf., but 3 weeks out I would give it a try.

 

[UNLV OMS GUNNABE]

Side note: I learned that a script in this case is unnecessary as well. My question is, what has everyone learned to prescribe as primary antibiotic therapy. We were taught that pen vk is always your first choice for uncomplicated (no cellulitis or anything like that) infections. If no progress in 2-3 days add metronidazole. If they finish the whole pennicilin regimen and the infection has not resolved use clindamycin. In this case amoxicillin was prescribed and I've heard of a lot of other dentists prescribing the same. I was taught that amoxicillin was to broad spectrum for oral microbes. What do you guys think?