Hi
I had #19 molar extracted and a bone graft over a week ago, I am still in pain, in the extraction area, my jawbone, my cheek, and when I talk too much it becomes sore or lean over, and have a kinda burning as well. Before the procedure I started a course of Azithromycin. After reporting the pain 5 days after I went to see my DDS he put me on Clindamycin, (I am on day 4 of a 7 day course), and said it looked like it was healing extremely well and didn't see a reason for the pain. He did say the tooth was big with long roots into my small jawbone and it was a difficult extraction. Under my jaw is bruised. And it was probably from that. Since starting the clindamycin the pain has retreated slightly but is still quite significant. I was taking percocet but it didn't do anything but make me drowsy with pain, only when I take Ibuprofen 600 + does the pain subside for a bit but it keeps coming back.
Can this be nerve pain or muscle? Can a bone be bruised so bad that is hurts like this? Could this be from the needle going into a nerve? I had the opposite tooth #30 removed a few years ago by a different DDS and didn't have this kind of recovery.
Thank you

Hi cleverwabbit,

I assume your general dentist did the extraction and bone graft... and not an oral surgeon?

The burning sensation can be the pulling of the tissue when you over use your jaw. So cut back on using your jaw. Eat only soft foods and avoid talking a lot.

The bruising underneath the jaw is common when a dentist or assistant places their hand there as a leverage to hold the jaw open.

Muscle pain is also typical after a difficult extraction due to the trauma of manipulating the jaw during the extraction.

All of those things will subside over the course of a few weeks providing you ease up on using the jaw.

Be very mindful of taking that much Ibuprofen at one time. It can do a real number on your kidneys and digestive system for a long time. Try to take less at one time and spread out the dosages. Keep rinsing with the warm salt water 3-4 times a day.... no smoking..... no use of mouthwash or mouth rise what so ever as the chemicals can disrupt the healing process and cause the surgerized tissue to burn.

I hope this is helpful to you. If you decide to do those things for a few days.... check back and let us know how you're doing!

Bryanna

Thank you so much for your reply, the DDS is an implant specialist who has oral surgery training. I was given periorx to rinse with 3x a day for a week. I have been trying to limit the ibuprofen was told to piggy back it with Tylenol but I haven't because Tylenol has never worked for me and it is hard on the liver. Today I am having quite a bit of pain, it isn't subsiding I am trying to keep the 600 ibuprofen at 8 hours or more apart. My fear is that he is going to put me on another antibiotic or up the clindamycin which has been hard on my system and even with probiotics I have had a lot of gastrointestinal unpleasantness, despite my bland,soft diet.
I am scared something is wrong, I had an implant done on the opposite side at the same time and it is healing great, I can't even feel it. What is the usual protocol if the antibiotics aren't working? How do know if there is even an infection that is causing the pain? The burning is happening even when I don't use my mouth.
Thanks so so much for your help, I am losing my patience and very anxious about this.

Hi cleverwabbit,

Are you developing any sores or ulcerations in your mouth? Sometimes people are sensitive to peridex rinse and that could cause a burning sensation. If so, then just use salt water instead.

The ibuprofen and tylenol mix is meant to be used together so the tylenol may work in combination with the other. They are both hard on the liver and kidneys.... and stomach :/ So it's best to eat something when you take them.

The pain should not be increasing. It sounds like you are getting a bit run down which could be from the intestinal upset and/or the lack of nutrition and water. It is best to keep as hydrated as possible with water only. Of course the pain and pain meds make you feel awful too. You can also try applying moist heat (not hot, comfortably warm) on the outside of your jaw. Just wet a washcloth and put it in the microwave until it's warm and then apply it to your jaw covered with a hand towel.

I would call the surgeon tomorrow and go in and let him have a look. There is no way I can tell you if there is infection brewing or not. I can tell you that you've been through a lot... extraction, bone graft and dental implant on the other side.... that is a lot of trauma to your jaw muscles at one time. I would expect you to be uncomfortable for a couple of weeks or so. But the pain should not be increasing at the extraction site.

If you are having moderate gastrointestinal problems, it is best to call the surgeon and tell them as they may change the antibiotic. Clindamycin can have some long term affects on the system even after you are finished with the prescription. Also, sometimes it is advantageous to take a combination of pre and probiotics.... a pre biotic called Saccharomyces Bourlardii works synergistic-ally in the digestive tract to help metabolize the probiotic. The pre and pro can be can be taken together.... but about 2 hours before or after the antibiotic.
Here is a link for that:
http://www.livestrong.com/article/50...an-antibiotic/

I hope you get relief soon. Please keep us posted....
Bryanna



QUOTE=cleverwabbit;970759]Thank you so much for your reply, the DDS is an implant specialist who has oral surgery training. I was given periorx to rinse with 3x a day for a week. I have been trying to limit the ibuprofen was told to piggy back it with Tylenol but I haven't because Tylenol has never worked for me and it is hard on the liver. Today I am having quite a bit of pain, it isn't subsiding I am trying to keep the 600 ibuprofen at 8 hours or more apart. My fear is that he is going to put me on another antibiotic or up the clindamycin which has been hard on my system and even with probiotics I have had a lot of gastrointestinal unpleasantness, despite my bland,soft diet.
I am scared something is wrong, I had an implant done on the opposite side at the same time and it is healing great, I can't even feel it. What is the usual protocol if the antibiotics aren't working? How do know if there is even an infection that is causing the pain? The burning is happening even when I don't use my mouth.
Thanks so so much for your help, I am losing my patience and very anxious about this.[/QUOTE]

Hi Bryanna,
I don't have sores the burning is from the inside like under my skin, the pain is steady to moderate, like I want to put ice on it still, it feels better when I do. I also feel a small nodule underneath my jawbone ridge on the inside of my mouth that is sensitive, I don't know it that is a random bone graft piece that moved to that location. I am taking florastor, eating yogurt and probiotics 3 hours hours after the clindamycin.
Thanks again for your help, it is greatly appreciated, I am so nervous about this, I have a sordid dental history and I went to several DDS for consultations for the extraction and implants before I had this done because I have had bad dental work done in the past and didn't want to relive it. I am praying this isn't failing.
Thank you again


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Hi cleverwabbit,

Stop putting the ice on. That is only meant to be used the first 24 hours. After that it is not beneficial and may add insult to injury. Moist heat is best at this stage because it encourages blood flow in that area.

The bone graft material does not migrate away from the hole it was placed in and the hole is not deep underneath the ridge of your jawbone. If that bump has just appeared, you should have it evaluated.

The florastor and probiotics are okay... you can take them 2 hours after the antibiotic. No need to wait 3 hours. The yogurt should be plain sugar free or sugar substitute free and without the fruit already in it. Any form of sugar, whether chemical or raw will destroy the good bacteria in the yogurt. Eat the plain (organic is ideal) and add your own fresh fruit. This gives you the benefit of the good bacteria.

The burning can be nerve pain indicating injury or healing. It can be difficult to determine. If you feel it is not improving then call the surgeon and go in for him to check it. Many people make several trips back to the oral surgeon for various reasons, it is a very common occurrence.

I hope you get relief soon.... if not, see the surgeon.

Bryanna





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Hi
I went to my DDS to check it out again this time he did an X-ray and didn't see anything he seemed concerned but annoyed said he didn't have anyone come back like this. I am not making this up, I would rather be doing other things than dealing with this. I am done with the clindimycin and the pain has subsided but there is still a presence. I get little jolts and my cheek and lip feels fuzzy and the site is still healing. I personally think it is a nerve. He said if it didn't resolve he would put on flagyl which I so do not want to take after the harshness of the clindimycin. If that didn't work he said he would have to open it up clean it out and redo it. Which I don't have the money or the mental fortitude for. I go back next week hopefully it will have calmed down more. If there is an infection in there how long does it take to raise its ugly head again after the antibotic?
I will stay away from the ice and do warm. Thanks for the heads up about the yogurt who knew, even fruit!!!
Thank you so very very much for you kind wisdom.

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Hi Cleverwabbit,

He should be concerned but not annoyed in the least. Patients often go in to see the surgeon post operatively when something doesn't seem right... who is he kidding :/

You said he was an implant specialist with oral surgery training........ I'm not sure what you mean. Is he an oral surgeon? Is he a general dentist who took a course in placing dental implants?

What did he say about that lump you were feeling under the jaw?

As for the infection aspect..... everyone is different. You just have to pay attention to your symptoms and if they are spreading, becoming more severe or frequent, how you're feeling in general..... these are all indicative of what may be going on.

Bryanna





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