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Nasal congestion after wisdom tooth extraction
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Nasal congestion after wisdom tooth extraction

Hi,

I had my last wisdom tooth removed in November 2010. It was the right upper wisdom tooth. In the same day after my wisdom tooth extraction, I developed nasal congestion in the right nostril. From that day till now, the nasal congestion has been present everyday and it alternates between nostrils from time to time.

I've visited the ENT twice. The first time, the doctor did a nose scope and confirmed that my nose was congested. She then prescribed me Nasonex nasal spray to be used for 6 weeks (2 puffs in each nostril, once a day). Throughout the 6 weeks, there had been no improvement to my nasal congestion.

After 6 weeks, I went back for my second consultation (yesterday) with the doctor. A skin ***** test was given to me and my results were that I was not allergic to any of the allergen given. Seeing that my situation had not improved, I was told to increase the dosage of the nasal spray to 2 puffs in each nostril, twice a day, for 3 months. Should there be no improvement, surgery was suggested.

Both the ENT doctor and dentist who removed my stitches said that the nasal congestion was not likely caused by an infected sinus as I had no yellow/green mucus discharge. The ENT doctor is unable to provide me with the cause of my nasal congestion.

However, seeing that the nasal congestion only came about after the wisdom tooth extraction and that I have absolutely no other nose/sinus/allergy problems prior to the extraction, I feel that my nasal congestion was somehow caused by the extraction.

Could you please help me with this? What could have happened during/after the extraction to have caused my on-going nasal congestion? I really do not want to resort to surgery!

Thank you very much!
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540545_tn?1377626518
Have they tried antibiotics to see if it'll clear up your sinus infection?  Sometimes during an extraction, you can get what we call an oro-antral communication although your dentist states that it didn't happen.  You may want to get a consultation with an oral surgeon to check the site.  An oro-antral communication is when a hole is left between the mouth and the sinus after a procedure such as an extraction.  If it doesn't close up and heal, things can get into the sinus and cause problems.  But if there isn't one, I'm not sure what else it could be.  Sometimes a tooth root can be pushed into the sinus as well.  An x-ray should reveal that if there is one.  I think an oral surgeon would be best qualified to find out for you.
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Thanks doctor, for the advice!

A week after my extraction, I was actually on a course of antibiotics. Also, I had an x-ray taken and the medical officer said that it was normal.

I will consult with the dentist who had performed the extraction for me, and I will ask about the oro-antral communication. In addition to that, could you please advise me on a list of any other questions I should raise regarding my case?

Thank you very much!
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540545_tn?1377626518
Well, my initial guess is an oro-antral communication.  I only guess that based upon the procedure and the timing of the nasal problem.  Have your dentist take a look and what they can do is have you blow your nose gently while they pinch your nose and look at the hole and see if any air comes out.  If it does, that means you're blowing air out of your sinus cause air shouldn't come out of the extraction socket.  I usually will check for that after the extraction if I feel that it was close to the sinus.  If there is one, surgery may be necessary to flap the gums down and cover the hole so that the sinus can be covered and reduce the food/bacteria penetration into the sinus.  But like I said, have your dentist take a look or get an oral surgeon to do it.  
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Irvine Modern Dentistry
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