Hi bchristine,

Welcome to Neurotalk and our dental forum

We have a commonality in that I too am a holistic (and nutritional) health advocate. So I do understand where you are coming from.

If you are open to answering a few questions, that may be helpful. These are not intended to be judgmental, they are basic questions that help give a history and help tell the story. I will also answer your questions in bold type as it makes it easier to follow.

1) Did you or do you smoke, anything?
2) Do you have regular dental care or has it been awhile since you have been to the dentist? What is the health of your gums?
3) The upper right molar extracted tooth #2, had it been root canaled?
4) Do you know if the oral surgeon thoroughly debrided the extraction site after he removed the tooth? You would know this was done by the amount of scraping that was done and the time it took to do that.
5) Did the OS place a bone graft in the site?
6) Did the OS mention anything about the tooth being in close proximity to your sinus and/or did he check for a sinus perforation?
7) Tooth #3, the first molar, is that root canaled? Did the OS comment on the decay in this tooth?
8) The gum area behind #2 that was sore, had that area ever swelled up?
9) Do you recall ever having any drainage seep from around the circumference of #2 and/or #3?
10) Have you had or do you have any sinus issues, congestion, drainage, post nasal drip, pain in sinus areas on your upper right side?
11) Do you have other teeth that are root canaled and/or decayed?

<<My question: Prior to the extraction and even now, I have some swelling and pressure that begins at my jaw and goes all the way to the top of my cheek. It hurts to smile and I talk like I have a mouthful of mush. I feel a VERY sore little lump back in that area. I am worried about this.>>

I ASSUME YOU ARE REFERRING TO THE RIGHT SIDE, CORRECT?
DOES THE SWELLING AND PRESSURE BEGIN AT YOUR LOWER JAW OR THE TMJ AREA (NEAR YOUR EAR) AND RADIATE UP TO THE TOP OF YOUR CHEEK?
IS THE SWELLING VISIBLE ON THE INSIDE AND/OR OUTSIDE OF THE FACE?
THE PAIN WHEN YOU SMILE INDICATES THERE IS TISSUE INFLAMMATION AND POSSIBLE MUSCLE INFLAMMATION AS WELL. WAS THIS OCCURRING PRIOR TO THE EXTRACTION OF #2?

<<I went back to see the OS this week and he seemed unconcerned, but gave me an Rx for CLEOCIN (I did not fill it). He overcharged me and without getting into details, I do not want to go back to him.>>

YOU MAY NEED TO FIND ANOTHER ORAL SURGEON TO EVALUATE THIS AS A GENERAL DENTIST GENERALLY WOULD NOT BE IDEAL AT DIAGNOSING OR TREATING IT. ARE YOU OPEN TO SEEING A BIOLOGICAL DENTIST?? ARE YOU FAMILIAR WITH THAT REALM OF DENTISTRY?

<< I saw another general dentist that same day and she said I do not have dry socket, but there appears to be some real inflammation around the extraction site. She gave me an Rx for Penicillin VK 500 mg which I have been taking for 2 days now. I do not notice any real improvement, but it's not getting worse. >>

ANY OTHER DENTIST GETTING INVOLVED WITH THIS CASE WILL NEED TO HAVE A RADIO GRAPHIC HISTORY OF THIS TOOTH AS WELL AS THE REST OF THAT QUADRANT. THEY WILL NEED TO HAVE THE SURGICAL REPORT FROM THE OS WHO REMOVED THE TOOTH TO TELL THEM IF THE SITE WAS THOROUGHLY DEBRIDED. THEY SHOULD ALSO TAKE NEW XRAYS OF THAT QUADRANT TO 1) HELP EVALUATE THE HEALTH OF THE BONE, 2) TO SEE IF THERE ARE ANY RETAINED TOOTH FRAGMENTS OR BONY SPICULES, AND 3) TO CHECK FOR A SINUS COMMUNICATION.

<<This will be my 3rd course of antibiotics in a months time. I was previously taking Amoxicillin 500 mg. >>

I ASSUME THAT YOU KNOW THE SYSTEMIC REPERCUSSIONS OF TAKING ANTIBIOTICS AND THAT THEY SHOULD NOT BE USED CARELESSLY AND UNFORTUNATELY DOCTORS AND DENTISTS GIVE THEM OUT LIKE CANDY.
ARE YOU TAKING PROBIOTICS? IF SO, COULD YOU SHARE WITH US WHAT YOU ARE TAKING?

ORAL ANTIBIOTICS FOR DENTAL INFECTIONS ARE HELPFUL SO LONG AS THE SOURCE OF THE INFECTION IS REMOVED. THE TOOTH WAS THE ORIGINAL SOURCE OF INFECTION. HOWEVER, IF THE PERIODONTAL LIGAMENT WAS NOT REMOVED AND/OR THERE IS STILL DISEASED TISSUE AND BONE RESIDING IN THAT AREA, THEN THESE TOO ARE STILL SOURCES OF THE INFECTION STILL PRESENT. ALSO IF THE SPECIES OF ANTIBIOTICS IS NOT APPROPRIATE FOR THE TYPE OF BACTERIAL INFECTION, IT WILL NOT BE USEFUL AT KILLING IT. BUT THE MEDS WILL KILL THE GOOD BACTERIA NONE THE LESS.

SO IT IS IMPORTANT TO HAVE THIS AREA PROPERLY DIAGNOSED AND IF NECESSARY, HAVE AN OS OPEN THE SITE, DEBRIDE IT THOROUGHLY AND TAKE SAMPLES OF BACTERIA THAT CAN BE SENT TO AN ORAL PATHOLOGIST FOR BIOPSY AND CULTURE. BIOLOGICAL DENTISTS ARE MORE INCLINED TO TAKE THIS APPROACH COMPARED TO CONVENTIONAL DENTISTS... FYI.

<< I am a holistic health advocate and hate taking these Rxs. I just want to know if this sounds normal or if it's something I should be concerned about. I have been dealing with these dental issues for too long and just want some relief. >>

OKAY SO AGAIN YOU KNOW THE PITFALLS OF TAKING ANTIBIOTICS AND YOU CAN SEE THAT NOT ONLY AREN'T THEY HELPING BUT YOUR ORIGINAL SYMPTOMS ARE STILL PRESENT. YOUR SYMPTOMS ARE "TYPICAL" OF AN INFECTION. THEY ARE NOT "HEALTHY NORMAL" POST OP HEALING OF A TOOTH EXTRACTION.

THERE IS A POSSIBILITY THAT YOU HAVE A FEW THINGS GOING ON IN THAT QUADRANT THAT HAVE CONTRIBUTED TO THE LONGEVITY OF YOUR SYMPTOMS AND COULD BE CONTRIBUTING FACTORS AS TO WHY THE AREA IS NOT HEALING WELL.

1) THE TOOTH DECAY WAS A FACTOR. IF THE TOOTH (AND/OR ADJACENT TOOTH #3) WAS ROOT CANALED, THAT TOO WOULD BE A FACTOR.

2) THE REMOVAL OF YOUR WISDOM TOOTH MAY HAVE BEEN INCOMPLETE WHICH COULD BE A FACTOR AS TO WHY YOU HAD INTERMITTENT SWELLING BEHIND TOOTH #2.

3) THE REMOVAL OF TOOTH #2 MAY HAVE BEEN INCOMPLETE.

4) THERE COULD BE A SINUS INVOLVEMENT THAT IS CONTRIBUTING TO INFECTION AND INFLAMMATION.

5) YOU COULD HAVE OTHER DENTAL PROBLEMS LIKE GUM DISEASE FOR EXAMPLE WHICH CAUSE A GENERALIZED BACTERIAL INFECTION.

6) OUR SYSTEMIC, MENTAL AND EMOTIONAL HEALTH, AUTO IMMUNE DISORDERS, DIGESTIVE ISSUES, ETC ARE ALL KEY FACTORS IN HOW OUR IMMUNE SYSTEM HANDLES INFECTION, INFLAMMATION AND HEALING.

I am happy to try and help you. So any information you can provide would be welcome. Also, if you feel comfortable, you can attach the xrays of that quadrant to a post on this forum.