I want to include as much information as possible so excuse for a long post.

Early November I experienced pain in a Root canaled tooth, my second molar on the left hand side. I am from another country and had not been to a dentist in the USA, I did my research and found one nearby that had good reviews. I made an appointment they referred me to an endodontist who took a CBCT cone beam scan and confirmed I had a vertical root fracture thus the tooth needed to be removed.

on 24/11 I had the tooth removed by the original DDS. She was very good and talked/explained everything to me as we went along. I asked her about placing a bone graft and she said it depends on what the site looks like when they get in there. However given the CBCT scan and the xray did not show infection it would be possible most likely. She got in there and said there was a small infection present but she cleaned out the socket and placed the bone graft (which I got a discount for because I had no insurance and she felt bad for me). She said there is a slight chance the bone graft could fail, but she was just doing her due diligence and informing me of all the possibilities. I was prescribed 10 days amoxcillin and sent on my way.

After about a week two nights in a row I experienced bad pain for about 2 hours. I was concerned I phoned her on her cell phone which she had given me incase I had any concerns. She only works 1 day at the office near me however given my concerns she came in and saw me first thing in the morning before going to her other office. She looked at the site and said it looked OK but I was healing a bit slow. She said there is a chance I may need to get the graft removed but she would rather prescribe me some clindamycin and see if that helped.

I saw her three weeks later, during which time about 3 days after finishing my clindamycin prescription I noticed pus had been accumulating in the site along with a terrible taste. She looked at the site and again said I had a lot of under developed tissue, along with the pussing the best process would be to remove the graft. She went in there removed the graft, rinsed 3-5 times with a saline solution filled syringe and scrapped the site. After all of this she said it would be possible that i have slight pain up to 4-8 weeks after, given the infection and everything that has gone on. She said not to hesitate to call her if the pain got really bad or was not relieved with ibuprofen/affecting my everyday life. I was presrcibed with 7 days of amoxcillin.

I saw her after one week for a post-op check up and she said the site looked great and looked 100% better then it had previously. She said it wasn't completely closed over and that I should still be careful when rinsing/spitting and no alcohol etc.I saw her after two weeks for a post-op check up and again she said the site had closed over and it looked really good, no signs of infection.


However now it is 2 and a half weeks after this debridement and I have some concerns. I may go in and see her again on Monday (when she is there next) but I really do not want to bother her unnecessarily as she has gone out of her way multiple times - i must stress at no stage has she expressed/showed me to be a burden etc and she has been more then happy to help. I have not noticed any pussing etc at all.

My concerns are these:

1. The extraction site looks fine for the most part, 3/4 of it is kind of light purpleish color, hard to describe but something you would expect skin to look like. However part of the extraction site, the area closest to my biscupid is red. Is this normal could it just be underdeveloped granulation tissue/new tissue?It's far enough from the biscupid to not be related to plaque etc. The area gets redder after I rinse vigorously presumably because I am irritating it.

2. I am experiencing mild pain, I am not even sure if i would call it pain. The extraction site just feels irritated sometimes. It is NOT a thobbing/deep seeded pain it feels more like the pain is on top of the extraction site. Again I'm not sure pain is the right word, it feels hmm twingy?

3. Sometimes when I swallow hard I notice this odd pulling sensation from the extraction site. It's not painful it kind of just feels like some one tugging at the site. Is this simply because my mouth is getting used to no tooth being there and since there is no bone under the site things are sort of 'moving'?

4.. IF, and a big IF say I notice something that indicates an infection, would antibiotics fix it? As I understand the original antibiotics during the bone graft could have been useless because they can't get to the bone graft site? But now with a blood clot etc there more antibiotics could actually help? I really don't want to go through another debridement and recovery period.

I am travelling a lot in the next 14 days and will be returning home. So I really want this period to be pain free. IF (worst case scenario) I have another infection, will antibiotics be adequate to get me through this period?

I have attached a picture, I'm sorry it's not the best but if you look closely you can kind of see the redness I'm talking about


Sorry for the long post and thanks in advance.

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