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HomeAnswersOral and Maxillofacial Surgeryfistula surgeryI underwent surgery for an oroantral fistula a month prior, as well as an extraction where I had pus discharge. Should I be concerned about the pain?

Is it normal to experience pain for an extended period of time after undergoing oroantral fistula surgery?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At September 4, 2023
Reviewed AtSeptember 12, 2023

Patient's Query

Hello doctor,

I had oroantral fistula surgery one month before. Some important information: They pulled the tooth, and told me it is good. But the socket did not heal, there was pus, and I was in pain. After six weeks after the extraction, I went to an oral surgeon and he was in shock, that the dentist did not tell me to go and visit an oral surgeon. He had to make a debridement of dead bone, took out the pus, and made a buccal pad. The acute pain was there for three days, but now after a month of surgery, I still feel some pain. Some days I have very less pain, and other days medium pain. But no pain medication works for me. I was at an ENT specialist, and they made a CT scan of my sinuses, and the result of my sinuses are 100 % healthy. They also took a blood test, and everything was fine in the reports. Is it normal to feel pain after this type of surgery that long?

Please help me.

Thank you.

Hi,

Welcome to icliniq.com.

The pain had not subsided yet, right? I will be prescribing you accordingly.

Thanks and regards.

Patient's Query

Hello doctor,

Did you see some of your patients who had oroantral fistula with pain for that long?

Please answer me.

Thank you.

Hi,

Welcome back to icliniq.com.

Such things happen as post-operative complications for a long time only in extensive cases where bone debridement was done. What exactly is the kind of pain you are feeling like radiating, throbbing, or pulsing pain from that segment? Do you take any painkillers, when such pain repeats?

Thanks and regards.

Patient's Query

Hello doctor,

It is a dull ache in a place where surgery was done. Some hours are better, while others are worse, and there was a debridement of a lot of necrotic bone. I took many painkillers, but they did not work. There is a file with my sinus CT scan, you can see how many bones they had to take out.

Thank you.

Hi,

Welcome back to icliniq.com.

I have opened the link and examined it (attachments removed to protect the patient’s identity). See there is so much physical stress, tension, and trauma to the bone during debridement and surgery that the healing bone should take several months to form afresh again. And the sinus as we know is pneumatised meaning it is a hollow expansile space that is not exactly solid. So what I am trying to say is in extensive surgeries, you really need to have a lot of patience post such bone debridement and fistula tract removal surgeries because the healing bone and soft tissue formed should be much stronger. For that you will need to take vitamin supplements, vitamin C, and vitamin E every day after breakfast for 10 days at least a month, Neurobion forte (riboflavin, pyridoxine hydrochloride, nicotinamide, cyanocobalamin, calcium pantothenate, and thiamine mononitrate) tablet vitamin K-rich foods should be consumed in your diet if you are not on any medications. Oral hygiene should be very strict with chlorhexidine gluconate twice a day and with topical vitamin E, even 400 mg application to the gums over the surgical part as well. So all these remedies will reinforce strong bones over a period of time and eventually, you will start seeing some pain relief. Though as I said, such post-operative dull pain is uncommon, it is important to remember that surgical excision usually leads even to scar formation sometimes. so in such extensive surgeries like the removal of an oroantral communication, healing will definitely take a lot of time. If the pain still persists after trying a month or two even after these remedies, then certainly you have to visit the oral surgeon in the clinic. An antiseptic irrigation or local antibiotic prophylaxis by your oral surgeon in the clinic might help as a last resort in persistent pain. Take the medications after consulting your specialist doctor.

Thanks and regards.

Patient's Query

Hello doctor,

So you also think they took a lot of bone on the left side? If there is for example osteomyelitis, will it be seen on this CT? All the pill supplements you wrote I am using all the weeks.

Thank you.

Hi,

Welcome back to icliniq.com.

I think it is time for you to consult the surgeon in the clinic. Yes, it will be usually decipherable in a CT (computed tomography) scan, but I need to see some pictures. Maybe you would enclose them afresh now so I know exactly how is the healing and whether there is a risk of poor healing or osteoid issues that are causing pain?

Thanks and regards.

Patient's Query

Hello doctor,

I was at my surgeon three weeks ago and he did CBCT (cone-beam computed tomography) scan, told me it is good and there is nothing to do with treatment for me. So you think after these three weeks it is not a bad idea to make CBCT scan again and see some changes or healing?

Thank you.

Hi,

Welcome back to icliniq.com.

Yes, maybe you would re-confirm by clearing your doubts through another CBCT (cone-beam computed tomography) scan and then send me the reports for a second opinion. Do not worry, post operative pain may be very stressful but it is a reality. I guess that as long as you are on proper vitamins that will heal your nerves, I feel you should not worry too much about it. Go for a CBCT if you seek re-assurance of the same, but if the pain is still persisting past another 15 to 20 days. I think it is wise to get it done either way so I can assess it.

Take care.

Thanks and regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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