Originally Posted by Bryanna

Hi JWang,

First of all DO NOT go back to this dentist. Irrelevant of what or if he is charging you, he has not treated you properly from what you have written here.

A couple of things instantly come to my mind...

One, the intensity and duration of the swelling and pain that you stated is not normal for even an impacted wisdom tooth removal unless there is an unresolved and/or new infection. And yes, the infection can travel to your jawbone. If you have been reading earlier posts here about NICO or osteomyelitis...... this type of oral trauma is how many of those conditions occur in the first place and they become long term problems which are very difficult to erradicate. Your situation requires the proper care and this ******* dentist is not taking your situation seriously enough, IMO.

Secondly, what I'm about to tell you is not meant to frighten you but to let you know of the possible seriousness of an oral infection with severe swelling which is can occur with a lower tooth extraction it is a condition called Ludwig's angina. This is a rapidly spreading bacterial infection associated with cellulitis that can compromise the airway. This condition can be fatal if not properly diagnosed in a timely manner and treated accordingly. IF this is what you have, the oral antibiotics may hold it at bay temporarily, but they won't cure it.

Thirdly, your jaw is very tight because of the intense swelling. Opening your mouth wide enough to brush your teeth may be impossible and you should not force it open because you can injure the ligament, cause spasm in the muscle and end up with chronic TMJ problems. Use a q-tip dipped in diluted peroxide and try to maneuver that along the gumline behind the second molar. It will be difficult but do the best you can. Keep rinsing with warm salt water 4 times a day especially after you have eaten and before you go to sleep at night.

Fourth, it is imperative to eat a soft diet of nutritious food. Soft like the consistency of eggs, nothing chewier than that. Avoid sugar and empty carbs as these hold no nutritional value whatsoever. Fiber rich foods, even fiber supplements will help eliminate the toxins from the infection. Drink at minimum of 8-10 glasses of water a day to keep your renal collecting system functioning well... this also helps to eliminate the toxins. Seventy five percent of our immune system is within our digestive tract and any meds, trauma and infection will deplete our intestines of good healthy bacteria which we need to if we want to heal properly. If you're not doing so already, take a probiotic daily to replenish the good bacteria that the antibiotic and infection has destroyed. A probiotic is meant to be taken one hour prior to or 2 hours after any oral antibiotic pill to avoid any contraindications. A great probiotic for anyone taking antibiotics is called Culturelle. You can buy it online or in most large drugstores.

Also, avoid smoking as the nicotine and other carcinogens cause restriction in the formation of red blood cells depriving the surgical site of oxygen. Also avoid the comsumption of alcohol as it supresses the production of saliva causing the plaque to build up twice as fast and alcohol also disrupts the formation of the blood clot leaving the jawbone dry....exacerbating the dry socket.

You should also know...... a dry socket alone without exudation (pus) is cause for concern and needs intervention as early as possible because this condition alone can prevent the jawbone from regrowing which can lead to NICO (Neuraliga Inducing Osteonecrosis) and/or osteomyelitis.

Again, if this were me... I would not go back to this dentist. Not only is his abruptness and rudeness with you totally uncalled for but he should have treated you sooner than he did. As far as reusing instruments or not taking extreme precautions with using sterile instruments..... absolutely unacceptable!! Of course my suggestions here are based on what you have stated. Get all of your xrays, pre and post op, before you seek another dentist as they will tell the story in it's entirety.

I'm so sorry you are going through this nonsense....... please keep us informed on how you are doing!

Bryanna