wisdom tooth extraction sinus perforation can wear cpap or not.

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wisdom tooth extraction sinus perforation can wear cpap or not.

Post by Cpap user » Mon Jul 12, 2021 1:22 am

I have one of my wisdom tooth extracted, the wall between the hole and the sinus has perforated.
The dentist said I am his first CPAP user patient, doesn’t have much knowledge about it.
Should I continue to wear CPAP, or which is the best position should I sleep?
Thanks

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Miss Emerita
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by Miss Emerita » Mon Jul 12, 2021 11:36 am

I think you have a really good question there, and I'd recommend talking asap with your ENT or sleep doc, or, in a pinch, your primary care physician. My quick cruise via google suggests that patients with perforations are supposed to avoid blowing their noses, sneezing, and coughing. I would thus strongly suggest not using CPAP until you get clear guidance from a physician.

A physician could also evaluate the need for any special measures to help the perforation heal properly.
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ILoveFlowers
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by ILoveFlowers » Tue Jul 13, 2021 5:40 pm

I don't have a good answer for you but I had this happen with a molar I had to have extracted, so I understand where you are coming from. My dentist didn't feel that cpap would be a problem so I went ahead and put it on, but the air pressure against that spot did not feel like a good thing, so I got worried and took it off. I did not want to delay or prolong the healing. I did a bunch of googling and found varying opinions. I finally decided I would opt for 'better safe than sorry', so I skipped my cpap until after my recheck with the dentist, when I was past the period where they worry about dry socket. I can't remember exactly how long that was now, I'm sorry. It seems like this might best be a question for the sleep doctor, I just got the "hmm, I don't know" response from my dentist and GP and didn't have a sleep doctor anymore at the time. YMMV but I wish you speedy healing!
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bierhere
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by bierhere » Wed Jul 14, 2021 5:25 am

Oral surgeons/dentists I have found don't provide useful advice on CPAP following tooth extraction. The ones I've used take a very, "it should be fine, or can you live a day without it" kind of advice, but I notice they don't seem to be very firm with the advice. For myself, I have a full face mask, but have purchased a nasal mask/chin strap that I have used when I'm having mouth/dental issues. While it doesn't work nearly as well for me, it gets me through the next day after major dental work.

I can't sleep without the CPAP at this point, so I might reduce the pressure the night after dental work as well. I have yet to have any impacts. I have had 1 wisdom tooth done and 3 other teeth pulled since starting CPAP therapy.

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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by Cpap user » Fri Jul 16, 2021 6:14 pm

You were right, my oral surgeon doesn’t know much about CPAP impact on sinus perforated.
Gave me a really vague answer like… it should be ok… even though I feel that it interferes with my healing progress.
(am using Resmed airsense 10, so I can’t lower the air pressure.)
Hope it doesn’t take me months before I can use the machine again, missing my good nights sleep 😓
Waiting for see ENT doctor in a few weeks, should I make an appointment to see sleep doctor first?
Thank you for your replies!

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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by ChicagoGranny » Sat Jul 17, 2021 7:29 am

Cpap user wrote:
Fri Jul 16, 2021 6:14 pm
(am using Resmed airsense 10, so I can’t lower the air pressure.)
Users can change pressure settings on all ResMed AirSense 10 models. You can find instructions to get into the clinicians menu and change settings on youtube. Most of the users in this forum manage their own settings.

However, I don't know how changing the pressure will help your situation.

In addition to seeing the ENT, I would call the sleep doctor's office.

So sorry you are having this problem. Going without CPAP would be very miserable for me.

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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by chunkyfrog » Sat Jul 17, 2021 9:07 am

There was a time when wisdom teeth and OSA were problems of different ages.
Those problems overlap a bit now, or at least the diagnoses do.
A sinus perforation during an extraction should trigger a consult with an ENT,
especially if the patient is using CPAP.
Medical specialization is proof that doctors are not as special as they think they are.
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edam
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by edam » Wed Nov 03, 2021 11:04 am

Im from the UK and had a back tooth extracted and in the dentists words "he could see into my sinuses". I am getting conficting advice about using CPAP. I feel that if Im told not to blow my nose then I shouldn,t be using CPAP either. Has anybody got more up to date information because Im not going to be using CPAP until Im sure it wony cause problems

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Miss Emerita
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by Miss Emerita » Wed Nov 03, 2021 11:43 am

I'm afraid I don't have more up-to-date information. I would have the same reaction that you do if I were in your place. Who are you getting the conflicting opinions from? Health professionals?
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by madcity cpap » Wed Nov 03, 2021 1:06 pm

Miss Emerita wrote:
Mon Jul 12, 2021 11:36 am
I think you have a really good question there, and I'd recommend talking asap with your ENT or sleep doc, or, in a pinch, your primary care physician. My quick cruise via google suggests that patients with perforations are supposed to avoid blowing their noses, sneezing, and coughing. I would thus strongly suggest not using CPAP until you get clear guidance from a physician.

A physician could also evaluate the need for any special measures to help the perforation heal properly.
I would echo this very good advise. I would also add that this is a significant and time sensitive issue and your medical professionals should be expected to reply with an appropriate level of haste. If you haven't had an answer from your ENT and sleep Dr. within a day or so I'd rattle some cages and or escalate until they do respond.

It's reasonable to expect the dentist to follow through with your existing medical professionals, too. If you are have trouble getting a response in a timely manner, the dentist may be able to impress on a gatekeeper the urgency of a reply in ways that you cannot.

I was told when I began CPAP many years ago that I should skip it on nights when I had a cold or upper respiratory issue. I've done this only rarely, but I think a perforation would definitely qualify as an occasion where I'd invoke that for myself.

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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by Hang Fire » Wed Nov 03, 2021 3:12 pm

madcity cpap wrote:
Wed Nov 03, 2021 1:06 pm
I was told when I began CPAP many years ago that I should skip it on nights when I had a cold or upper respiratory issue.
??

That's when a CPAP is most needed. Even a person who does not have sleep apnea can benefit from CPAP when he has a cold.

You receive bum advice.

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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by edam » Thu Nov 04, 2021 10:32 am

As I mentioned in a previous post Im from the UK

My sleep clinic ? can only supply the Resmed F20 mask when I think the f30i would put less pressure on the painful part of my face.

The Maxillo-Facial service at a local hospital who did the extractions have said that I can use my CPAP even though they perforated the sinus

My GP has suggested that I take Codeine-Paracetamol painkillers before I go to bed.

Above all I have found that 4 nights without CPAP is TOO much.

So tonight I will go back on my Airsense 10 using a Vitera mask with Simplus headgear and doped up with painkillers

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chunkyfrog
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by chunkyfrog » Thu Nov 04, 2021 10:46 am

Somebody should come up with a night guard/dressing
for troublesome extraction sites when the patient NEEDS therapy.
What about patients on VENTILATORS?
You don't just let then croak!
Do you?????
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rick blaine
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by rick blaine » Thu Nov 04, 2021 11:24 am

Hi Edam,

I'm posting from the UK, and if I may, some information.

I'm guessing that the sleep medicine department (SMD) you attend has standardised on the ResMed F20 – many SMDs have. They get a good price from ResMed UK when they buy in bulk, and it works quite well with most people.

But I doubt if the staff at the SMD will change it for you. They may not have any alternatives.

Ten years ago, when I had my first and fitting appointment, it was half an hour long, and the chief physiologist tried out half a dozen masks on me – different brands, and different types within a brand – all with the machine running.

But as GPs began referring more and more people – because they found out that treatment is both effective and cost effective – appointments got shorter and shorter, and in some SMDs trying on a range of masks has disappeared.

They give the patient the F20 – and there's no point in trying it on with the machine running, because they aren't offering any other masks to compare it with.

It's budgets, as in tight.

However, you can buy any one of a range of masks direct from ResMed UK, in Abingdon. They have a UK website, with 10 pages covering their range of masks, and the average cost (per mask) is £120. With no VAT.

You'll need a prescription – or 'scrip'. But (a) if you ask, ResMed UK will send you an blank electronic version, and (b) either your GP or the staff at the SMD can sign it 'on screen'.

A word about the codeine-paracetamol combo – UK GPs have recently been cleared to offer this for pain – usually at 15mg strength four times a day, with one to two 500mg paracetamol four times a day alongside it.

What your GP may not have stressed is that, for some patients, codeine is a respiration depressant, even at small doses. And for some reason this depressant effect is more likely with sleep apnea patients. You might be better off with just the paracetamol (and no more than 8 x 500mg per day).

I could add more about dry sockets and sinus perforations, and the need to make the 'gold standard for treatment' that a bone graft is done concomitantly with the extraction, but that's for another day.

Use the machine and get some sleep in whichever way you can. You need the time in delta-wave to get your mouth healing.
Last edited by rick blaine on Thu Nov 04, 2021 11:40 am, edited 1 time in total.

edam
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Re: wisdom tooth extraction sinus perforation can wear cpap or not.

Post by edam » Thu Nov 04, 2021 11:40 am

My sleep clinic has improved. When I first started the could supply a machine but no full face mask so had to buy one just to try out a machine.

I have visited Resmed at Harwell Campus a couple of times and have bought numerous bits from them, I might buy a F30i from them but will do it from there website as i can get free returns.

Thanks for your advice about Codeine . I will stick to just Paracetamol.