Conversation: The conversation between human and AI assistant.
[|Human|] Hi. I have really bad teeth, that a little at a time I have been getting pulled out due to costs. I had an infection for the better part of 4 or 5 months but it didnt abcess until recently. I could just feel a huge puss pocket.  I finally got it pulled after being on 4 rounds of antibiotics on the 18th. It is a top back molar on my left side. The dentist informed me that the infection had completely eaten away the whole bone leaving my sinuses or sinus cavity exposed. Ever since then I have not been able to breathe out of my left nostril. I have been having pain since then in my jawbone on that side. Each day it gets worse but its spreading. Now its right in the front of my ear a little above, in my ear, behind my ear and then wraps around the back of my head. The pain just gets worse each day. The dentist told me it shouldnt be hurting and he doesnt know what it is. I do not have medical insurance as well, so Im tryin to avoid hefty ER bills if I dont need to go. Im just concerned this could be something more serious. Do you have any idea what this could be or what I should do? Thank you, Jennifer Duffy
[|AI|]  Dear Patient, I can understand your concern and feel sorry for the pain you are suffering from. You are informing me that when you got the upper molar extracted, the dentist told you that the bone between the sinus and tooth is destroyed and sinus cavity is open. Roots of upper molar often are found inside the maxillary sinus, which causes opening of the sinus cavity while extraction of the tooth, creating an oro-antral fistula, that is a direct connection between oral cavity and sinus cavity. In this case, the food or water you take has chances of passing infection in the sinus through mouth and the infection does not resolve. It is mandatory to close this connection between mouth and the sinus. It could be done by the dentist by taking stitches in the area when he found that sinus has opened, but it can also be done now. However, as about 2 weeks has passed since extraction, the opening would not be as much clear as it would have been during extraction. A blood clot may have filled the area. So what you need to do now is, go to an oral surgeon or an ENT specialist. I know you have insurance problem, but there seems no other solution to your problem. You might have to go for x-rays and probably CT Scan of the area to diagnose if oro-antral fistula actually exists and if it does, you might have to go for a little surgery to close the communication between mouth and sinus followed by antibiotics to resolve the infection. I hope this information helps. Thank you for choosing Chat Doctor. I wish you get well soon. Best,