Thanks, I should have done that earlier. At this point I dont' believe he is charging me for the care so that's my only incentive to stay at the same doctor's office. Him being an ******* is very offensive but my main concern is my health, then it's my money, and finally the emotional distress from dealing with him. As an update


I saw him today and took vicodin 30 minutes before. He did the same procedure and had a jar called "Dry Socket Paste". He irrigated the area with what I believe is Perioguard and then suctioned it off and squeezed it (it hurt badly, but wasn't as bad as yesterday) and said there was no puss coming from the area. I told him there is basically a huge lump on my jaw and I can't open my mouth, while I feel infinitely better today than I did yesterday, these main symptoms have not really got any better. He said it will take 1-2 weeks before I can open my mouth without pain again.

At this point I"m feeling a little better about it all but I am still not totally sold. I have another appointment on monday with him and I'm assuming he's just going to do the same thing and possibly treat for dry socket (he didn't use the paste this time). It sounded to me like the infection is supposed to heal within 3-4 days from yesterday and then I'll just be dealing with dry socket. So I'm still wondering

Do I need to be more concerned? I'm on clindamycin 500mg 3X a day for 7 days, is that strong enough to cure my infection? My jaw is pretty swollen and I fear it might need to be drained manually. The doctor did take a panoramic X-ray and he said it looked fine (doesn't mean much, but to me it means there's evidence of what he's examining so he would be afraid to not be somewhat conservative).

Is there a protocol I should follow? I have been rinsing with salt water and brushing after every meal but there is still plaque buildup behind my second molars and for the love of god I simply cannot get to it. It hurts pretty badly just to be able to brush the tops of those molars, I honestly feel like my jaw would snap or burst open if I were to open it wide enough to brush the back. (I'm not even sure I could if my life depended on it, I probably could).

dry socket hurtsss and whatever he called the infection.. sorry sounds awful.. he should have responded better the day 4...as I just had two wisdom teeth taken out thsi past week. They told me to let them know if hurting after few days... I am ok.. take care, sorry, sarah

My son had 4 wisdom teeth removed at once not too long ago.

One of them didn't do well..started to hurt. The surgeon was very considerate and offered him a numbing shot, before he irrigated it. Fortunately there was no further problem, and no infection really got in there. But all in all it was a very professional handling of the post operative pain.

This post sounds really brutal to me. I would NEVER go to a brutal dentist or oral surgeon...never. That guy appears to have little empathy for you, and that is a very bad sign...that he is not concerned about suffering.

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

Bryanna,

Thank you so much for your response. What you have told me is basically what I've been afraid of, but was uncertain what to do. Today is post op day
10 and clindamycin day 3 and I'm feeling much better. I can open my jaw another cm without pain but the inflammation is still there and it is very hard (i'm assuming this is as close to proof as possible of a bone infection as opposed to a gum infection?)

My gums have now completely healed, I don't know when this happened but it may have happened 2 days ago or so but I'm wondering if this is good or bad. Does this make it harder to access the infected area? I have another visit with the doctor from hell tomorrow @ 230pm and will decide what to do after then but I'm taking away 2 things from the relief of my symptoms and the responses on here. Please correct me if I'm mistaken but

1) Infections are a serious problem. Even if Clindamycin appears to work, that does not mean it will completely rid me of the infection.

2) I cannot trust this Doctor. He clearly doesn't care or have any empathy for me (and at times it seems like he might have done something wrong and knows it, so he takes out his rage on me because he needs to believe it's my fault).

With the two top statements being true, that means regardless of how much better I get, I need to have a second opinion correct? Sorry for being so wishy washy, my health is the most important but my financial situation is fairly dire and unfortunately has a big impact on my decision making. Essentially though I'm wondering, if the doctor says everything is fine tomorrow (barely trust him regardless) but then the hard swelling dissappears on its own as well, would I be reasonably in the clear?

Also I have been taking immense amounts of probiotics each day and I've had no negative side effects from the clindamycin digestion wise. This is in stark contrast to the past where I became violently ill or had bad diahrea from antibiotic use, so thank you for reminding me about that and cementing how important it is, it has really made a difference!

Hi Jwang,

The hard swelling is inflammation from the infection and the surgical trauma. Think of that area as a tight space with no where to expand except to go outward. The hardness is from the tight space around the muscular anatomy. If it were your arm the inflammation would have room to expand as it would find a soft place to travel to. In the lower jaw there is no such place, so that is why any large swelling on the lower jaw can compromise the airway. Does that make sense to you?

Answer to your questions:

1) Infections are a serious problem. Even if Clindamycin appears to work, that does not mean it will completely rid me of the infection.
>>Correct. This is a very serious infection. Sometimes the patient has to be put on IV antibiotics because the oral ones may not be enough. IV antibiotics bypass the digestive tract allowing the body to absorb a more concentrated amount of the meds. That's why they are more effective when dealing with serious bone infections. It is not uncommon for people who have had this experience to eventually revisit this situation if it is not cleared up at the onset.<<

2) I cannot trust this Doctor. He clearly doesn't care or have any empathy for me (and at times it seems like he might have done something wrong and knows it, so he takes out his rage on me because he needs to believe it's my fault).
>>Yup....... could very well be. I would not trust him for a few reasons. One, he may have contributed to the infection/dry socket in the first place during the removal of the wisdom tooth. Two, he did not address the seriousness of the situation sooner than he did.<<

You do not have a gum infection. It is in the jawbone. That's what a dry socket is..... dry infected bone. The gum tissue can heal closed while the bone is infected, not unusual. However, you wouldn't know that is happening unless it was seen on an xray and/or via a surgical exploration. The bone under healthy circumstances will take a year to completely fill in but in the meantime the gum heals closed.

If the swelling subsides you may or may not be left with a residual problem. The area should be monitored with xrays every 3 months for the next year to evaluate the progression of the healing.

Clindamycin can cause what is called Clostridium Difficile or C-diff for short. This is a serious bacterial infection of the intestines brought on by the use of antibiotics because they destroy all of the good, essential intestinal bacteria. Taking probiotics and eating nutritiously..... avoid sugars and empty carbs.... can help prevent this condition from occuring. However, once you have had this condition, you are prone to getting it again even after you stop the medication. That's why it is imperative to take probiotics every day of your life to maintain a good supply of healthy intestinal bacteria just in case you need to take meds for any reason.

It's good that you are being diligent with your meds and probiotics. I know you are going back to the same dentist....... please do the best that you can to have this area monitored at least once every 3 months with a small xray to keep tabs on the healing. Let us know what he says at your appt.

Bryanna

Bryanna,

Thank you so much for answering all my questions. You've clarified quite a bit. I went back on monday which was post op day 11 and he just irrigated the area. I was a little more firm with him this time (though not firm enough) and questioned him.

"What is this hard lump on my jaw, is it an abscess? Spasmed muscle?" and he said it was just residual "stuff" from the infection and that it would subside on its own. I then asked him what to look out for to know if I should be worried. He said "nothing, just keep taking the clindamycin" I pressed politely again and he said "Swelling and extreme pain, but that' won't happen".
'
On the inappropriate side, the Doctor had switched nurses (and all of the nurse staff at least for that day) and she chuckled at how anxious I was in the room. She obviously didn't know what I had been through in there. I told him I was healing but the worrysome symptoms were still around like the lump and being only able to open my mouth a bit and he stretched my mouth open and said "hurts less huh?" yea downgraded from excruciating to torturous, and finally to just inappropriate on his end in my opinion.

I have another appointment with him tomorrow (post op day 13) and at this point my fever is all gone. I only have 2 more days left of clindamycin and all swelling besides the lump in my jaw is gone. I can open my mouth enough to brush all my teeth and I irrigate the holes with a waterpik. The most passive option I am going to take to continue is certainly the checkup every 3 months which you have suggested but I'm still not sure if that's all. I'm worried because the Clindamycin is basically finished but the hard lump still remains, is that a cause for concern? It has been shrinking as far as I can tell, but it seems like it will take a month to go away on it's own, if it even does. Do lumps like these actually resolve themselves without some sort of physical drainage?

Also I thank you for all your help and input and I know how stubborn of a patient I've been. You guys here have made it clear that I'm being mistreated severely but due to financial reasons I keep going back to this doctor I obviously can't trust. I think of it as a poor free clinic at this point. One thing I was wondering, is there an apprpopriate avenue to complain about his behaviour? I would just like it on his record somewhere because I'm sure I'm not the first to complain and I won't be the last. My initial plan was to write a letter to his partners (who are both his senior), but now I'm thinking I should write a letter to the ADA and CC all 3 of the partners?

Hi JWang,

First let me say that you should not be taking any blame for any of this. You are trying to communicate with the dentist but he sounds like he's not interested in communicating much of anything. He legally has to give you a full explanation of what is going on as well as what to expect in the near future. This is not rocket science and he sees this all of the time. But he is once again dismissing your situation as unimportant. His attitude is lackadaisical to say the least.

The opening of the jaw is limited because of the swelling. Remember how I described the area as being small and with no place to go but ouward? As the swelling subsides, so will the tightness on the ligaments that hold the jaw joint tight. Did he suggest anything to help loosen the jaw or reduce the swelling?

The hard swelling can be an accumulation of infection......and/or alot of inflammation. He would know that better than I would because he's seeing it clinically. If it's from the inflammation, yes it will subside on it's own eventually. Could take several weeks or more. If it is infection, then you will develop symptoms of an infection..... fever, malaise, pain. This is a wait and see situation at this point. The main key here is to be aware of any change in how you are feeling in the next few months and to monitor the area radiographically.

Dry sockets and/or surgical abcesses are a serious matter. They can be difficult to treat and require frequent evaluation until the area is healed completely. Sometimes residual infection resurfaces months or years down the road which would require some type of intervention. This is why the area gets monitored......

I'm not sure what type of dental facility you are going to but if it is a free clinic or some sort of that, your complaints may be fruitless. However, that would not stop me from writing to the owners of the establishment expressing my concerns over the way I have been personally mishandled and the fact that my questions have not been answered to my satisfaction. You are right, if he is treating you this way, he is doing the same to others. So chances are someone else has complained also.....

Please keep us posted on how things are going!

Bryanna

Thanks so much Bryanna. You make me feel a lot better about my situation and make me feel justified, in well, the way I feel since this doctor clearly wants me to think I'm crazy.

It is not a free clinic, in fact it is a upper class Oral Surgery practice where my surgeon is the 3rd partner (or maybe not even, his name is on the title though). Right now I'm feeling good, it's post op day 14 and I can open my jaw about 75% of the way I could before surgery and the pain is all but gone. I just finished my last dose of clindamycin but I have also been taking colloidal silver, olive leaf extract, and Vit C religiously. I also have a waterpik and have been putting periogard in it and irrigating the wound area.

The hard swelling is still about a minimum of 60% of it's maximum, honestly it might even be 90% which is the most scary to me. I had an appointment with the surgeon on post op day 13 (yesterday) and it went pretty well, he said "I really turned the corner" and he answered most of my questions. Seems like the better condition I'm in the better treatment I get, but as soon as anyhting goes wrong he refuses to acknowledge it. In any case I asked him exactly what the hard swelling is and he said "it's just stuff left over from the infection", so I think he basically has no idea. I questioned him because I said if it is from the infection, how is it going to go away on its own and won't it just reinfect me once I'm off antibiotics? He said it would just go away and it won't. I have an appointment for post op day 21.


I also read another one of your posts where you recommended The dental organization IAOMT.org. I did some research and found a practitioner in my area and I will likely pursue a CAT scan of the lump area and make an appointment with a participating provider. Thanks so much for the help, I will keep posting updates on my situation for follow up purposes!