Hello there,

I've been having a host of problems after my wisdom tooth extraction but today being Sunday, I am unable to reach my dentist I would be grateful if I could get advice from those of you in the dental field.

Some time in July, I was supposed to have my 2 bottom wisdom teeth pulled. I started my amoxicillin 1 day prior to extraction date as directed by my dentist. Unfortunately, I freaked out on the day of (after being told that there will be more bone-cutting and higher risk of nerve damage and whatnot) and I postponed my surgery, contemplating going to an oral surgeon.

On Aug 2 (guessing ~2-3 weeks after the aforementioned day) I had 1 bottom tooth pulled. There wasn't much oozing afterwards. I took postoperative good care (saline rinse, etc) and it healed well. Instead of getting a new prescription, I took the remainder of the amoxicillin from the July appt. and finished it as directed. Didn't need to take many tylenol pills. I could take the pills on an empty stomach fine.

On Aug 23 (Friday, from 10-11) - I had my other bottom tooth pulled. It only took ~10-15 min to pull out in 2 pieces, but my dentist stitched it for what felt like 20 minutes. She told me it was necessary to cut more this time to access the tooth, which was 90 degrees turned one way and another 90 degrees another - so in a funky place is all I know.

This time, there was a lot more oozing. Even as she was stitching me up, I could feel & taste a lot of blood coming out. 1 hour after the surgery I replaced the gauze because it was soaked through. Then it was hell. I oozed heavily for 7 hours straight, having to empty my mouth of the blood-saliva (lots of blood - red-brown liquid, not like pinkish) mixture often. Sometimes I just didn't open my mouth for a while so as to avoid the dumping and refilling.

Finally, pressured by the need to take my antibiotics (which should have been soon after the procedure!! ), I took the gauze out. Blood oozed out immediately, but after ~20s, it trickled to a small, manageable amount like for the previous tooth.

So finally I had some soup and took my amoxicillin (500mg) and 2 tablets of Tylenol III at 6pm. I set my alarm & took my meds as before at 2am on an empty stomach, and went back to sleep.

I woke up at ~7:30am and within 15 min I started feeling very nauseous/like vomiting. I called health services and the nurse told me to hydrate myself and eat something, so I drank water, had soup, brushed teeth, did the saline rinse, and probably took amoxicillin. Then I went back to sleep... Woke up a few hours later and and from this point, the whole day it was a cycle of extreme nausea, bit of water, sleep and repeat. I took Gravol at ~3pm (it had expired the previous month, but the pharmacist said it should be alright) and it didn't help. I think I may have gone back to sleep... But by 7pm I couldn't take it anymore and went to a Medicentre. I finally puked there - ~25ml, only a little bit. GP told me to just take more fluids, EAT! and go seek help if I'm still nauseous after 3 days, take Gravol... He also looked at my surgical site and told me I had an infection.

Got back home, had Gravol (found an unexpired one this time) which still didn't help at ~8:30pm. I tried eating to no avail and just went back to sleep. So... yup! I missed my dose of amoxicillin at 6pm, and only did the saline rinse 2 times in the day... Terrible, I know

I woke up the following day (today) at 3:40am, and forced myself to eat - this time a proper meal with soft rice, cut up veggies, tofu, etc. and took amox. at 5am. Did the brushing and saline rinse drill and went back to sleep. I didn't feel nauseous.

I woke up 9:30, ate until 11...haha and took amox. at 11:30, 6.5h after my previous dose, so 1.5h sooner than I should have.

I haven't felt nauseous the whole day BUT now, I think I have symptoms of a slight fever... Maybe it's that infection at the surgical site? My head feels a bit heavy and I have muscle pains around my lower neck/shoulder area. I don't know about my body temperature though.

When I took a look at the surgical site, albeit with a limited view, I saw stitches and nothing particularly striking...
The part of my lower cheek that the doctor had touched the previous day to tell me I feel tender there b/c of the infection -- that area has now increased... More of my cheek when lightly pressed feels tender and hard... But I remember my cheek feeling tender from my last tooth as well :/..

I have been doing saline rinse every hour since my last meal today.

Sooo... Am I doing things right??? Do I just keep taking my antibiotic and the infection will go away? Is there any other measure I should be taking?? I am worried about the infection -- because I missed a dose and took my antibiotic 15h hrs after my previous one, could I have caused more resistance in the bacteria to the drug??

I'm so sorry this post is long - I'm just a bag of problems these last couple days
But if anyone could offer me advice on my conditions I'd be ever so thankful!!

Sincerely,
Battered patient

H dee bee,

Well first let me say that it is never wise or recommended that you stop taking an antibiotic before the last dose unless you are allergic to it or your doctor has prescribed something in it's place. The reason being is that it takes 24-24 hours for the meds to kill the protective good bacteria and reach the infection and then over the course of several days the meds reduce the bad bacteria. If you stop before the last dose you have successfully killed off all of the good bacteria and left the bad still brewing at the infection site. Then when you start the meds up again at a later time... the bacteria may have developed additional species of bacteria that are now more difficult to kill off. So never stop the antibiotic unless there is a valid reason to do so. Your dentist should have informed you of this.

Taking an antibiotic like amoxicillin on an empty stomach will cause nausea. Also it is not necessary to get up in the middle of the night to take a dose. Spread the dose out over the course of your waking hours... it is not imperative that it be taken at specific hourly intervals. For ex... if the rx says take 4 times a day.... that means ex: 8am, 1 pm, 6 pm, 11 pm or something similar.

Stop rinsing every hour. It is not necessary and will cause irritation to the surgical site. Rinse with warm salt water 3-4 times a day, once before bedtime after you brush your teeth.

Once you have the antibiotic in your system for several days, it is not crucial that you take the meds exactly every 4-6 hours... you can mess up on one dose, its okay.

If the physician at the medicentre said you had an oral infection and/or you feel that you have an infection... call your dentist tomorrow morning and tell her your present symptoms.

Bryanna