I had an upper molar removed and the root of the tooth had perforated into the sinus cavity. Previously, this tooth had a root canal treatment done because of an infection at the tip. However, I was in so much pain following that treatment that I decided my best course of action was to have it extracted. When the dentist did the extraction, he told me there was still an infection in both the root and the sinus cavity, which does explain all the pain I was in. This is a different dentist than the one who did the original root canal. My new dentist cleaned out the socket, filled the area with bone grafting, and closed everything with stitches. He put me on a round of clindamycin, which is my first time using that particular antibiotic. The pills were for one week and he gave me specific post-care instructions that I have followed carefully. It’s been a little over a week since the antibiotics ran out. This morning, I started having drainage on the side with the problem, along with some tenderness and pain. Is this normal following this type of procedure or should I seek help from my dentist?
Elaine
Dear Elaine,
Thank you for being so thorough. Having all of that information gives me a complete picture. Whatever happened with the first dentist, your second dentist has done everything right. He took all the right steps and prescribed you the correct antibiotic. My thought is, because you probably had that infection in your sinuses and tooth root for quite some time, you will need another round of that antibiotic to really clear things up. So, yes, I’d call the dentist. He will either give you a second round of the same antibiotic or try a different one. Either way, if after you finish that antibiotic, the infection is flaring up yet again, it will be time to do something more drastic.
It may be that some bone got pushed up into your sinus cavity during either of the treatments. In that case, you will want to seek out an ear, nose, and throat surgeon to do an x-ray and evaluate where to go from there. Some dentists can do oral surgery and some can’t. If there are bone fragments there you aren’t dealing with the mouth as much as the nasal category. An ENT is preferred in that case.
Once all that is settled, you will need to talk to your dentist about a good tooth replacement option, such as a dental implant. You want to be completely healed and over this infection, though.
This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.
