Antral Opening

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I would really appreciate some information. My 17 year old daughter had an upper tooth removed. The dentist took xrays and everything, and it was determined that she needed the tooth pulled.  The tooth was breaking off, and the dentist said it was impacted.  Well, in the coarse of removing the tooth he found that the tooth was absessed and decayed all the way up to the sinuses. He showed me the xray.  He really had alot of trouble pulling the tooth, and he told me that he was concerned that she would have this trouble at her age.  I asked if I should bring her to the hospital, and he said that it could be treated in the dentist office.  He told her to be careful blowing her nose, and I guess when she got home she accidently made this very hollow sounding noise thru her nose.  It was alarming!  He prescribed Cephalexin 250mg. and Hydrcodone W/APA 7.5/750 TAB. Is this common?  Thank you.
 

It is impossible to give a precise answer without xrays and a hands-on examination, but it sounds to me like your daughter may have an oral-antral communication (mouth to sinus opening).  If she does she will need more treatment than she is presently getting and may even need further surgery, if it does not resolve.  The dosage of cephalosporin (250 mg) appears to be inadequate and she would also need a couple of additional medicines for the sinuses IF she has such an opening.  I would recommend she call the dentist and request that he refer her to an oral and maxillofacial surgeon for evaluation for an "oral-antral opening", or that she seek an oral and maxillofacial surgeon on her own, if she is concerned.  If she lives near a dental school, she could seek evaluation and a second opinion from the oral and maxillofacial surgery department there.

Roger E. Alexander DDS
Associate Professor of Oral & Maxillofacial Surgery
TAMUS-Baylor College of Dentistry
Dallas, TX

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