Hi toothtroublesgal,
Anytime the oral surgeon has to go back in an debride the surgical site it is considered a serious issue in that it will need further follow up monitoring for a few months or so to be sure that the problem is resolving.
It is a good sign that he found the bone to be healthy when he did this last debridement. It is also good that he did a very thorough debridement which can be more effective than just antibiotics alone.
The incision that he made was done in an area that allowed him to gain access to the bone without causing too much more trauma to the area. It sounds like the over growth of tissue with the second molar was problematic in that debris was getting caught underneath and causing irritation to build up. So hopefully removing that tissue will help the area to heal better and you will be symptom free from here on out. If all goes well, it would be a good idea to see him or your dentist on your first break from college for a clinical look see and a periapical xray to make sure the area is doing okay.
Regarding the antibiotic.... It would be best for your overall health to supplement with a probiotic starting immediately and continue for at least 3 months or longer. Many people, myself included, take a probiotic supplement on a daily basis as a routine thing to reassure that the intestinal bacteria is consistently abundant in healthy bacteria. Antibiotics kill off the good intestinal bacteria in order to get to the bad bacteria. Unless your diet consists of a lot of healthy fermented foods on a daily basis, you will be deficient in good bacteria. Therefore, it is essential to replenish the good bacteria with a supplement to avoid an intestinal infection or other health problems. One product that is easy to get a drug or food store is called Culturelle. You can buy it online too. Take one per day first thing in the morning or last thing at night on an empty stomach. If taken in the AM, be sure to take the antibiotic an hour or so after the probiotic to avoid cross reaction.
I hope this information is helpful to you. If you have any further questions or concerns, let us know. Otherwise... hope all goes well and have fun in college!!
Bryanna
Quote:
Originally Posted by toothtroublesgal
I am an 18 yr old female who had all 4 unerupted wisdom teeth (and as far as I know none were impacted) removed on June 17, 2015. I was prescribed ten days of cephalexin post-op and while I seemed to have sort of a painful recovery, it was otherwise all right and my oral surgeon said things looked good at a 7 day followup.
About a week and a half later, around the beginning of July while I was on vacation out of state, I developed a tender, hard, lump on the left side of my lower jaw accompanied by some trismus. There was relatively no swelling and it didn't have palpable borders like a cyst. I figured it might be masseter muscle irritation (TMJD runs in my family) and left it alone since I had no other symptoms of infection like pus or bleeding or fever. Around July 15, I developed this strange tissue growth up around the extraction site and my second molar. It didn't hurt, but bled when poked and seemed flappy, not firm. I was concerned about how it looked (and still had that lump in my jaw) so I decided to head back to the oral surgeon on July 20th. I was almost 5 weeks post op at this point. Upon examination, he declared that the area around my second molar was "unhealthy." Some background info: I have a very small mouth and have always had gum tissue covering the surface of my left second molar (I believe it's called an operculum). I saw this same oral surgeon when I was around eleven or twelve for the "gum flap" covering my second molar, and he decided against any treatment since I was asymptomatic. Back to the present. In addition to the "unhealthy" gum area, he said that I had an infection because the gum covering the molar was harboring bacteria that migrated into my wisdom tooth extraction site. He never said exactly what the strange looking tissue was, but proceeded to perform a debridement of the area and scrape the socket to reintroduce bloodflow. When I asked about the jaw lump, he said it was in response to the infection and "unhealthy" area. The whole visit, he stressed that this infection was due to my anatomy, not based on any fault of my own in keeping the area clean. I was prescribed another 10 day course of cephalexin, and by the time I saw him again a week later on July 27th, the jaw lump was totally gone, the extraction hole looked great, and I thought things were finally getting better.
On July 29th, the day I finished my course of antibiotics, I felt the jaw lump and trismus beginning to return. I was once again out of state on vacation, so I wasn't able to get in to see the oral surgeon until today, August 3rd. When I saw him, he said the extraction site looked good (none of the strange tissue had grown back) but that an infection must be persisting if my jaw inflammation returned. He recommended another debridement procedure, and this time in addition a removal of the gum tissue covering my second molar (an operculectomy by my research-he never uses the medical terms for anything). I underwent both, this time with a much deeper debridement of the tissues in my wisdom tooth hole and cheek and a lot more "cleaning out." He did comment during the procedure that my bone looked healthy and that he was glad "he could get in there" because "this was doing a lot more good than the antibiotics would be able to." Honestly, I feel like he never explains properly what the situation is because of my age. There is a suture holding a small vertical incision in my gum above my extraction site, making me think that he really got deep into my cheek. I suspect there was an infection in my cheek and he was cleaning out the infected tissue. I don't know for sure, though. Once again, he prescribed me cephalexin, this time a 14 day course.
He has not made this entire affair seem terribly serious, and he's said that he's confident the infection will be resolved by the time I leave for college on August 20th. I'm not so sure, though.
Is this more serious than he's making it out to be? I really don't have any symptoms of a serious infection, and I do believe him when he says it's the operculum that keeps causing the infection of the extraction site and underlying tissues. I basically would just like to know if I should be more worried or seek a second opinion. This seems like a neverending saga and I'm really tired of it.
Thank you and sorry this is a novel!
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