Hi there,
After having pain following the 2nd part of root canal treatment, on my upper left 1st molar, my dentist informed me there was an infection around the tooth. He told me he could give me some antibiotics and try to finish the root canal or extract the tooth. I was already taking some antibiotics (Cefalexin) prescribed from my Doctor for something else. I decided to have the tooth extracted last Friday (09/09/11). According to my dentist, the infection came out with the tooth, I continued with my cefalexin. During the weekend the gum tissue around the extraction area became increasingly sore and tender and my gum closest to my cheek feels a bit swollen, the gum tissue around the extraction area continued to sting when any liquids or even if my tongue slightly touched the area. I followed the correct aftercare advice. I did not start the salt water mouth wash until 24 hours later. Yesterday I went back to my dentist, he seems to think it is an infection in the gum, but not in the socket. He injected my gum with anaesthetic, which was very painful, as it was already sore. He removed some sort of "debris" from the socket, used a corsodyl filled syringe to wash/clean, then packed it with some clove paste. He told me to stop taking my cefalexin and he prescribed 500mg Amoxicillin 3 x daily for 5 days. After my dental visit I was feeling a strange itchy/burning sensation around all of my gums, is this usual? It seems to happen more after using the alcohol free corsodyl, however the itching/burning stinging sensation is always present around the extraction site. Is the stinging usual on the gum tissue around the socket? I am a little concerned about dry socket, I just used a mirror and light and it looks like (what can only be described) as a white half moon shape around one side of the extraction site and i can still see the hole, is this normal after having the extraction only 4 days ago? Last but not least, how long untill the extraction site heals enough for me to be able to eat properly? Sorry for all these questions, but I am going on holiday in 2 weeks and a little worried in case I feel no relief
Thank you

Hi anj,

I can offer you some information to help you clarify some things. When there is a suspected dry socket, the dentist will numb the surgical area and use a curette instrument to remove the blood clot and scrape the bone inside the socket. This procedure is done to remove necrotic (non-vital) bone and granulation tissue that was left behind after the extraction. The scraping of the bone also causes a good amount of blood flow so a new blood clot will form. The clove oil is used to help soothe the surgical site, keep the clot from dissolving too quickly and speed the healing. If there were an infection on the gum or outside of the surgical wound, the socket would not have needed to be debrided and clove oil would most likely not been used.

STOP using the Corsodyl (chlorhexidine).... the burning and itching reaction indicates an allergy or sensitivity to it. I've had many patients who cannot tolerate that chemical and get the same reaction. Just use warm salt water rinses 3-4 times a day... no other mouthwash.

The white half moon area may be your bony ridge, which would be normal. The wound will remain open for several days but keep in mind that the blood clot inside of the socket is healing the wound from the inside out even though the wound is open. Eating a soft diet for the next several days is recommended so as not to disturb the surgical site.

If you smoke, drink alcohol or use mouthwash that contains alcohol, the surgical site may not heal well or at best it will take much longer to heal. Did your dentist suggest that you come back to see him in a few days to check the wound?

Bryanna

Thank you so much for your reply. I am so glad you told me about the corsodyl I will stop immediately. My dentist didn't mention dry socket, he had just packed it and put me on amoxicillin 500mg for infection in the gum which i will finish tomorrow night. He didn't invite me for a recall either The gum tissue is still extremely sore and stinging, but I am now getting worried, I am experiencing pain, like a burning/cutting - (like when a tooth is trying to push through the gum) in my upper and lower gum behind my wisdom teeth? the left upper area (left upper is where I had my extraction) where the wisdom tooth has actually been removed a good few years ago. I am also experiencing itching around all of my gums and my mouth feels incredibly hot. It soothes instanly if I eat some icecream, but comes back instantly also. It seems to occur stronger during the evening. I am taking ibuprofen, codeine and my antibiotics, I also try to keep it as clean as possble by gentle brushing and using syringe with salt water. I have stuck to the soft food diet and drink water regularly. Could the corsodyl mouthwash have caused this strange itching? It is alcohol free.
Sorry to bother you again, your help is greatly appreciated

Hi anj,

Yes, the corsodyl can cause burning and itching of your entire mouth if you are sensitive or allergic to it. It may take a few days after you stop using it for that to calm down.

The only time you pack an extraction site is when a dry socket is suspected. Otherwise, it is best to leave it undisturbed. I don't understand why you are not scheduled to see the dentist for a follow up evaluation??

I would suggest that you stop using the syringe to irrigate the extraction site and use the warm salt water to "rinse" your entire mouth with. You may be irritating the surgical site with the irrigation and perhaps you are using too much salt also. It is not necessary to use alot of salt as the salt could cause the gum tissue to become irritated and inflamed. The warm salt water rinses are used for soothing, cleansing and healing purposes. A1/4 teaspoon max to a 3-5 ounce glass of warm water is adequate.

Hope this info helps!
Bryanna

hi
For a tooth extraction, id give it a couple weeks.
I can understand your pain! ive had about 2 molar extractions and it took about 2 weeks before i felt better. i think its just the nerves
re-channeling themselves.

Thanks Jerry. Did you develope dry socket? Be interesting to hear others experiences... Feels like the pain will never go

Thanks once again for your replies. I went to an emergency Dentist yesterday because the burning/blistering pain was getting ridiculous. He told me instantly I had complete dry socket. He placed some soothing antiseptic gel and packed it with some dissolving paste. I felt instant relief. He still was not sure why I had the inflamed burning in the gums and mouth but thought it could be due to the Amoxicillin, as he was going to give another lower dose course of these, but he decided to change them prescribed antibiotics Clidamycin 300mg 4 x daily and I was advised not to rinse for 24 hours. I have barely eaten and sipped water, tried to do everything right, as I am so afraid to disturb the site. As my gums and soft tissue are badly damaged and very sore, the pain started to come back gradually After taking one dose of the antibiotic I felt terribly sick and dizzy, could this be a reaction to the antibiotic? I have stopped taking them and called the Dentist again to try to change back to the amoxicillin. I know I keep writing with these long stories and questions, but i am so worried that this will not clear before my long flight on Monday 26th. I wondered if there is anything else I can have a gel for the sores/cuts like the one used at Dentist to numb the pain? How long does it usually take for the dry socket to heal once packed? Do I need to keep having this re-packed? He mentioned it dissolves. Is there anything else I may need to do to speed up the process? Is there any particular reason why my gums on the lower set, beneath socket and further back should be sore and painful? Sorry for all these questions, just feeling so desperate.

Hi anj,

It is not a good idea to take the clyndamicin on an empty stomach. You could have had that unpleasant reaction after you took it because your stomach was empty and you were dehydrated. It is imperative to drink as much water as possible every day to keep yourself hydrated because the dry socket and surgical wound will not heal properly if the body is dehydrated. Do not be afraid to drink water from a cup.... this is perfectly ok and will not disturb anything.

I was sure you had a dry socket based on what you had described here. That's why I couldn't understand why your dentist was not being more proactive in treating it and then re-evaluating it in a day or so. Usually, the socket is retreated a few times during the the initial 7-10 days from the first packing. Did the emergency dentist tell you to see your dentist for a follow up?

I still think that the corsodyl and the repetitive irrigations of the socket that you were doing has irritated your mouth and gums. Of course you were only doing what you had been told, but in retrospect it was obviously doing more harm than good because you are sensitive to the chemical and you had a dry socket which should not have been irrigated at home. Corsodyl is commonly an allergen or sensitive agent for many people, we don't even use it in our office at all. Again, drink as much water throughout the day as possible to stay hydrated and this will also repetitively rinse off the oral tissue.

I know you are concerned about your flight on the 26th... I would see the dentist at least 1-2 more times this week to re-valuate the socket and if need be re-pack it. A severe dry socket can take several weeks to heal. That doesn't mean it will hurt that whole time, it just means the bone takes longer to heal because the blood clot was disturbed or it never formed properly in the first place due to residual infection in the surgical wound. Your dentist should be able to tell by the end of this week how things are going... but I would see him sooner to recheck it and then again a few days later.

I hope this information is helpful to you... I know you are very worried. Please keep us updated on how things are going.

Bryanna



QUOTE=anjjiel;806493]Thanks once again for your replies. I went to an emergency Dentist yesterday because the burning/blistering pain was getting ridiculous. He told me instantly I had complete dry socket. He placed some soothing antiseptic gel and packed it with some dissolving paste. I felt instant relief. He still was not sure why I had the inflamed burning in the gums and mouth but thought it could be due to the Amoxicillin, as he was going to give another lower dose course of these, but he decided to change them prescribed antibiotics Clidamycin 300mg 4 x daily and I was advised not to rinse for 24 hours. I have barely eaten and sipped water, tried to do everything right, as I am so afraid to disturb the site. As my gums and soft tissue are badly damaged and very sore, the pain started to come back gradually After taking one dose of the antibiotic I felt terribly sick and dizzy, could this be a reaction to the antibiotic? I have stopped taking them and called the Dentist again to try to change back to the amoxicillin. I know I keep writing with these long stories and questions, but i am so worried that this will not clear before my long flight on Monday 26th. I wondered if there is anything else I can have a gel for the sores/cuts like the one used at Dentist to numb the pain? How long does it usually take for the dry socket to heal once packed? Do I need to keep having this re-packed? He mentioned it dissolves. Is there anything else I may need to do to speed up the process? Is there any particular reason why my gums on the lower set, beneath socket and further back should be sore and painful? Sorry for all these questions, just feeling so desperate.[/QUOTE]