Patient's Query
Hello doctor,
I have undergone oroantral fistula surgery a few weeks ago. The healing was good, but I still feel some pain. Also, the tooth next to it is very tender to bite. How long is it normal to feel pain after this surgery?
Please help.
Hello,
Welcome to icliniq.com.
I went through your query and understood your concern.
If the vitality test is good and the tooth is not dead, it means you need to get that tooth treated endodontically. Root canal treatment is required. An oroantral fistula takes several months to heal correctly post-surgery. Currently, if you are on antibiotics, it will heal that tract much faster.
So, for complete healing to take place, it is normal to take time while having a bit of radiating pain from the adjacent tooth. If you have an issue with the adjacent tooth itself, then you will need to go for root canal treatment of that tooth.
I hope this has helped you.
Thanks and regards.
Patient's Query
Hello doctor,
Thanks for your reply.
So, the tooth cannot be only irritated from oroantral communication? I feel both cold and hot stimuli normally on this tooth. It is only sensitive to biting after this oroantral fistula surgery.
Please help.
Hello,
Welcome back to icliniq.com.
This condition is usually self-limiting. I would recommend you use Dentogel (Choline salicylate and Lidocaine hydrochloride 2 %). This will definitely help with the tooth. I suggest you apply this gel to the sensitive adjacent tooth for 15 days.
Kindly consult a specialist, talk with them, and take medicines with their consent. I hope this has helped you.
Thanks and regards.
Patient's Query
Hello doctor,
Thank you very much.
Hello,
Welcome back to icliniq.com.
This pain from surgery is quite common for a few months. There is nothing to worry about.
Thanks and regards.
Patient's Query
Hi doctor,
At my doctor's appointment, he told me the healing was fine. Now, it is 17 days after surgery. Most of the time, I have very little pain, but every two to three days, the pain worsens (and then again improves). Lidocaine gel is not sold in our country.
The back tooth with amalgam is painful when I bite something hard, but I do not know if the constant pain comes and goes, as I said, is from this tooth or the surgical site. My surgeon told me that pain after this type of surgery is common for one or two weeks. I was using Amoxicillin for 15 days.
The tooth with amalgam is vital and reacts normally to hot and cold. I have absolutely no signs of sinusitis. So, are you sure you had some patients with pain that long after this surgery?
Thank you.
Hello,
Welcome back to icliniq.com.
I have seen your images enclosed (attachments removed for patient identity protection). It is good to know your healing is absolutely fine.
In case you are experiencing pain on and off from this site of healing(complete healing takes several months ), it is still a pressure that you experience only temporarily because the blood and nerves there would be regenerating.
Whether that on-and-off sensitivity or pain long after surgery depends on your medical history. Do you have any vitamin deficiencies or any other medical issues like hypertension or diabetes, or any other regular medicines?
I will prescribe you the tablet needed only when you keep getting this repeated pain.
Thank you.
Patient's Query
Hi doctor,
No, I am an absolutely healthy person. I am only afraid it is normal if there were some other patients who experienced pain after this type of surgery for more than two weeks.
Thank you.
Hello,
Welcome back to icliniq.com.
I have come across such post-operative complications quite commonly in my experience. Up to one to two months, though uncommon, is quite possible, especially when the infection was severe in the first place.
I think it is best if I prescribe you a tablet you can take whenever you get this recurring pain, just in case. That antibiotic combination will help you counter new infections at the surgical site. Also, do you use any mouthwash generally?
Thank you.
Patient's Query
Hi doctor,
I use Chlorhexidine mouthwash two to three times a day. I have very strict mouth hygiene and no gum inflammation. My surgeon told me that because the communication was open for quite a long time (more than one month, there was a lot of pus in the socket, a lot of granulation, and part of the necrotic bone (of course, he made excochleation of all this bad tissue).
I have some painkillers (Acetaminophen and Codeine), but I think I am quite tolerant to these because even if I have, for example, a migraine, there is no improvement in pain.
Thank you.
Hello,
Welcome back to icliniq.com.
It is good that you are implementing such strict oral hygiene. Well, in my opinion, as a surgeon, the most effective method is topical. Daily oral application of Evion 400 mg or vitamin E over the extraction site.
This not only exerts an anti-inflammatory effect, but the daily application will prevent the frequent risk of reinfection or pain and swelling. Other than that, I would like to suggest Metronidazole 400 mg. Metronidazole 400 mg (BD or twice a day - one after breakfast and one after dinner ) for five days.
This antibiotic needs to be taken by you whenever there is pain again in that area. This is more effective than Amoxicillin. You would not develop any antibiotic resistance with this, and you can repeat this five-day antibiotic regimen whenever you keep getting repeated pain.
Pain is always a sign of infection. So, for some individuals, it might take a longer time, depending on many local oral factors. But vitamin E and a five-day Metronidazole tablet 400 mg combo will definitely help you prevent reinfection whenever you have pain.
Thank you.
Patient's Query
Hi doctor,
Can there be an infection still, even if the healing outside is good?
Thank you.
Hello,
Welcome back to icliniq.com.
The inner tissue that heals right within the gums, where the oroantral track used to exist before, their infection possibly would recur. This is the reason why I recommend vitamin E, particularly, and Metronidazole 400 mg will not give you any antibiotic resistance.
It is quite potent. So take the five-day course only when you get a pain or infection in that area again. Do not take it if you have no issue. Just continue vitamin E application regularly.
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
Would I have some sinus symptoms if the pain is sinus-related (not in the wound but from a sinus infection)? Or the odontogenic sinus infection can be without symptoms?
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, it would be that possibility, but it is very rare unless you exhibit symptoms of a sinus infection like rhinitis, nasal discharge, and heavy-headedness, to name a few.
I think in your case, you definitely need to wait one more month and continue with Chlorhexidine, Evion, and Metronidazole five-day regimen whenever pain recurs. That is the best you can do as of now.
You will eventually heal completely. Do not worry, and do not get tense.
Thank you.
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Answered byDr. Achanta Krishna Swaroop
Medically reviewed byiCliniq medical review team
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