I Have a Lingering Sinus Infection After Wisdom Teeth Removal

I have a lingering sinus infection after wisdom teeth removal. Since I always need sedation at the dentist, resolving this issue will be stressful. In mid-February, I had two wisdom teeth removed. My cheek swelled afterward, and I had pus-like fluid coming from my nose and one of the extraction holes. My oral surgeon said my sinus was punctured. She gave me a prescription for Augmentin for swelling.

I was in so much pain that I went back to the office. She did a CT scan and said I had an infection. Now I have another drug – this time a Z-Pack to clear up the infection. I still have that pus-looking fluid coming out of the hole, and it has not entirely healed. My left sinus hurts a little and always feels like there is pressure. I called the office, and the surgeon prescribed a nose rinse. I also use Flonase. I think that the oral surgeon doesn’t know what she is doing, and I will need to see an ENT. I have a follow-up appointment next week. How long will this continue? I am tired of taking antibiotics. I hope I don’t need another dental procedure. Thanks. Kamil from AL

Kamil,

Dr. Sirin would need to examine the extraction site to determine why the infection lingers. But there are some unusual things about your case.

Treatment for Sinus Perforation and Infection

The treatment for sinus perforation and infection may include the following:

• Infection – Sinus perforations do not usually result in infection. Your tooth may have been infected before the oral surgeon extracted it, and you had two infections. Your dentist prescribed Augmentin to control the swelling in your cheek. When she discovered the sinus infection, she prescribed Azithromycin. Your sinus infection suggests that as the surgeon removed your tooth, something pushed on your sinus and punctured it. The CT scan should reveal if something is in your sinus and the surgeon needs to remove it. Based on your description, it seems like your oral surgeon treated your infections appropriately.
• Perforation – You did not mention if the oral surgeon closed the sinus perforation. If the perforation is small, it is easy to close. If it does not heal within three months, your oral surgeon will close it. But the surgeon needs to clear the infection before closing the perforation.
• Prescription medication – If you still feel pain and pressure and have drainage after finishing Azithromycin, you probably need a refill. You should continue the antibiotic until the infection is gone. Otherwise, the remaining bacteria can become resistant to the bacteria, and it becomes more challenging to get rid of the infection.

Flonase is a corticosteroid that reduces sinus inflammation, which you need to reduce swelling.

Will You Need Dental Sedation and Another Procedure?

Although it seems that your oral surgeon has taken the proper precautions and the infection is healing, you need to tell her that you still have a sinus infection. She will likely extend the antibiotic prescription. Although you may not want to take antibiotics, eliminating the infection can help you avoid a dental emergency. It is unlikely that you need to see an ENT or have an additional procedure that requires sedation to calm your anxiety.

This post is sponsored by Elgin, Illinois, dentist Dr. Steve Sirin.