Originally Posted by Bryanna

Hi J,

Thank you for not getting upset with me for being so blunt! I see your situation so frequently in patients who come in from other offices.... and it always upsets me how neglectful dentists can be with their lack of following a basic protocol in serious situations along with their lack of detailed post op instructions to their patients. In every dental office that I have worked in, along with my other responsibilites, I have been given the role of the patient advocate. I am the one who goes over all of the details with the patients and follows up with them post operatively when necessary. Unfortunately, there are only a handful of assistants in my capacity because it requires alot of clinical experience and a constant willingness to take on this role even when the dr has left no time in the schedule to do it. At my age, I am not shy to express my philosophy which is .... I am here for the patient, period. I will take the time no matter what and even call a patient later on to go over the instructions again if I think they may have missed something. Do I think I'm special, nope. I think this should be done in every dental office!

Back to the subject, sorry I digressed a bit.......
The description that you originally gave of pain, swelling, pus, inability to open your mouth a few days post op extraction .... all indicates dry socket. The reason the dentist did not use the paste is because the area where the lower wisdom tooth was located was only partially in the bone. After the extraction there was little to no bony socket to put the paste because that area was mostly gingival tissue. However, in those cases, the surgical site is debrided, a good blood flow is established and an impregnated piece of gauze (with a clove tasting medicament) is packed in that area at least a few times within the next several days. The gauze acts as a barrier to debris and the clove oil is actually therapeutic at that stage of healing. Why he chose not to use this, I really am not sure about that.

Ok, I understand that you were mistaken about the gum tissue being closed over on day 10. I know exactly what that area looks like as you have described the hole being more near the cheek than the bum. This is how the wisdom tooth was laying in your mouth... partially in the bone but partially only in gum tissue.

When a patient is instructed to irrigate an open oral wound, it means to gently flush out debris. It does not mean to get in there and sweep it clean. But you wouldn't know that because it was not explained to you properly. I didn't tell you to stop irrigating because I didn't know for certain the exact post op instructions you were given and I didn't realize you were being so thorough.

Do not use a pair of tweezers or put clove oil in the surgical hole. Ether rinse with warm salt water 3-4 times a day vigorously with a drawing motion as to naturally pull debris from that area or fill the syringe with warm salt water and gently irrigate the area. This is the post op instruction that is generally given to patients on post op day 7 until the gum tissue heals closed.

Please do not feel embarassed about anything! You have not done anything wrong. You did what you thought was best and now you know to back off a bit

I am glad that you are seeing a new dentist. I am crossing my fingers and toes that he gives you good news!!!!

Keep me posted ok....

Bryanna

Originally Posted by Bryanna

Hi JWang,

Well that dentist didn't seem very helpful She is correct in that there are many people unknowingly walking around with cavitation. However, not everyone of those people has had the dental complications that you have had post extraction. So in spite of the frequency, you may or may not be in a different situation. If that area does not close within the month, I would see an oral surgeon for evaluation.... or ask that dentist to refer you to one who also belongs in the IAOMT organization.

The intestinal problems that you are having could be related to the clindamycin or it could be something else that is less worrisome. There is no need to take MASSIVE amounts of a probiotic or saccharomycees boulardii. Too much of a good thing can disrupt the intestinal flora just as badly as not enough.

May I ask what probiotic were using and how much of it and the s. boulardii were you taking?

Bryanna







Just to give an update, I saw a iaomt dentist to check up on the condition but she seemed unfamiliar simply becuase she was a dentist and not a mallofaxial surgeon. She told me to give it another 6-8 weeks and if it doesn't close up, then she'll get me to a specialist. She also said there are thousands of individuals walking around with cavitations without any issue. This was around post op day 35. Unfortunately I have to report that I've stopped worrying about it because on post op day 43 I developed diahrea. I was taking massive amounts of probioitics (acidophillus supplements and s. boulardi supplements) while on clindamycin and afterwards but on post op day 43 I developed diahrea and severe stomach pains whicH I suspect to be a c diff infection. I don't have insurance so I'm really trying to keep the bills down but it seems impossible. I'm seeing my doctor on march 11 which is post op day 55 or so, and will have him order stool tests for c diff.

Sigh, it never ends. Again bryanna, thank you for all your help. Of all the professionals I've visited and paid hard earned money to, I believe the advice I received here was the most honest and helpful.