Question:
Some of you may remember me lamenting on, at the tail end of
last year, about getting my wisdom teeth removed. I ended up
in hospital for two days as a result,but most of my posts
were about teeth removal and diving. I was assured prior to the
op by the surgeon that there were no diving problems associated
- he actually said I could dive the next day. I yesterday
found out from my own dentist what went wrong. My back upper
left molar roots were so long that they were penetrating a sinus,
which wasn't sewn up properly and led to profuse bleeding.
At the second attempt they cauterized it and it's now healed
perfectly.
The implications of this for divers are obvious, my dentist
said not to dive for 2 weeks after getting upper teeth removed.
He also said that this isn't an uncommon occurence, I can't
remember the name of the sinus but he said if the hole hadn't
sealed properly my mouth and nose would be connected by the hole.
I am at a loss to understand why the surgeon never mentioned
this.
Anyone with medical/dental knowledge care to comment?
Answer:
I'm no medical boffin, but I believe I may suffer from a similar problem.
I recall as a much younger man that I got X-rayed for some dental work, and
you can see on the picture that my back teeth on the top go right through
the bone into a cavity there. I think it is called the lower antrum(?)
He was kind enough to point out to me that if I ever considered having any
upper teeth out I should make sure to point this out to the dentist so that
they could take appropriate precautions. If I recall correctly he said it
was possible for the space within the bone to become infected and cause a
lot of pain. (an abscess?)
Just thought I'd stick this in as nobody seems to have replied to you. I
guess us divers should take care if this cavity is pressure sensitive in
some way, as presumably it is. I suppose it is also a bad idea to be letting
sea water into a wound like this too.
The situiation that your are probably talking about is what is dento
medically termed an Oral Antral Fistual OAF for short .This is an open
connection from the socket of a upper tooth usual Molar or premolar with
the maxillary sinus aka Antrum. The roots of upper teeth can be closly
related & indeed almost make up the floor
of the maxilllary sinus . It is not unheard of for an OAF to be created when
a tooth is extracted though this can be clinically be difficult to diagnosis
at the time of the extraction .
With reference to way this was not mentioned by the Oral Surgeon he was
probably reserving his comments re wound healing to your lower wisdom teeth
extractions & the OAF created by the upper extraction was an unforseen
complication which was probably not indicated on the pre extraxtion
radiographs/ X-rays.
