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Suffer from sinus infection. Experiencing tooth pain. Chhek swollen. Finished taking augmentin. What to do next?

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I have been struggling with a sinus infection that just wont go away and the infection now seems to be moving around. It started by my experiencing pain (toothache like) in my upper gums on the left side of my mouth. It soon moved to the upper right for several day and then to the lower right side where my gums XXXXXXX the cheek. Today it is in my right cheek which is extremely swollen and feel like when novacain is wearing off. I have seem my ENT and just finished 2 weeks of augmentin and recently seen a dentist and it is not tooth related. What can I do next?
Posted Thu, 15 Aug 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 58 minutes later
Hi,

Thank you for your query.

1. A sinus infection lasting more than six to eight weeks even after medical treatment may be termed as a chronic sinusitis.

2. Get a plain CT PNS(Para Nasal Sinuses) Scan done with 1 mm coronal, axial and sagittal cuts. This will settle the issue by revealing the cause of your sinus related pain.

3. The shifting pain may be due to shifting fluid within in the blocked sinuses.

4. There is a new concept of 'biofilm' formation by the organisms (bacteria and fungi) which decreases the effectiveness of the medications.

5. If you can share the CT images, I will be able to give you an accurate assessment. Have you had any nasal swab cultured?

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Suffer from sinus infection. Experiencing tooth pain. Chhek swollen. Finished taking augmentin. What to do next? 35 minutes later
would you suggest trying a different antibiotic to deal with the infection and, if so, which one
 
 
Answered by Dr. Sumit Bhatti 58 minutes later
Hi,

Thank you for writing back.

1. You should wash your sinuses with a solution of normal saline with a pinch of salt and baking soda added to it. This alkaline nasal douche will help break up the Biofilm and allow penetration by other antibiotics.

2. You may add an antibiotic like tetracycline or chloramphenicol. However this should be done under medical supervision.

3. You may try higher generation antibiotics such as cefprozil or ceftriaxone, again to be administered only by your local doctors. You should draw their attention to Biofilm formation, which is a relatively new concept.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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