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Old 01-24-2014, 10:43 PM #1
ParsonsP0403 ParsonsP0403 is offline
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Confused Infection after Wisdom Tooth Extraction

I had my top and bottom left side wisdom teeth extracted at the end of November 2013 and was taking Clindamycin 150mg/4x a day. I felt as though the bottom never healed correctly as there was always a salty (I thought it was blood) taste in my mouth and sensitivity around the site. I returned to the dentist the first week of January and it was determined I did have an infection which they irrigated and prescribed Clindamycin 300mg/4x a day for. I went back after a week only to have the debridment procedure performed and more Clindamycin 300's prescribed. It has now been an additional 3 weeks, and the hole from the debridment procedure is still visible and quite "raw" with more foul tasting/smelling discharge. Here is a health history to better understand why I am concerned;

As a child I had scarlet fever multiple times (and yes, I am being serious. True diagnoses that baffled my small town doctors 3 summers in a row) and I've been told I should have been taking antibiotics prior to the procedure due to a higher risk of infection since I have had that illness before..not sure if this is true or relevant

I am allergic to Penicllin and it's family of antibiotics and I am wondering if Clindamycin is not strong enough to fight this infection.

I am currently breastfeeding so I am unable to go under IV sedation or take a stronger dose of antibiotics. I am considering weaning asap however if they need to do the debridment procedure again as I can not mentally be aware again for that (I was only under LA for the extraction in the first place) because now I am terrified of the pain and dentist.

Should I be concerned about such a persistant infection? Should I be seeking a second opinion from a different dentist/oral surgeon? Please offer any advice possible. I have heard horror stories of infections..
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Old 01-26-2014, 12:04 AM #2
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Hi Parsons,

Wow that is a lot of clindaymcin to take in a short amount of time. I do believe this drug passes into the breast milk. Has your baby had any signs of intestinal distress? Even though you are no longer taking this drug it would be wise for you to take a probiotic every day and also give your baby one too for at least 30 days or longer. Ideally most people and children should take a probiotic daily for optimal health irrelevant of whether they have taken antibiotics or not. The brand Culturelle makes probiotics for infants and toddlers as well as adults.

Regarding the IV for oral surgery..... it is a light sedation called twilight. Yes you are asleep but the drugs used are not at all the same as general anesthesia. If you decide to have the surgery with the IV sedation, and you are not ready to stop nursing, you may be able to pump enough milk ahead of time to feed your baby for 24 hours which would be the day of your surgery. Then resume nursing on the next day. Just a thought....

It is not a question as to whether the clindamycin is strong enough to kill the bacteria.... it is whether or not the clinda is sensitive to the bacteria causing the infection. The only way to know which antibiotic is ideal for the bacteria is to have the site swabbed during the debridement and sent to a pathologist for culturing. Oral surgeons do this stuff routinely. Or I should say in cases where it is imperative to determine the proper antibiotic rather than keep prescribing the same one.

I think the site should be evaluated again by an oral surgeon. Discuss the treatment options prior to having anything done so you can plan ahead what you need to do for your baby.

Chronic jaw bone infections can become serious, so it is something that you really should have evaluated soon.

Please check back with us,
Bryanna







Quote:
Originally Posted by ParsonsP0403 View Post
I had my top and bottom left side wisdom teeth extracted at the end of November 2013 and was taking Clindamycin 150mg/4x a day. I felt as though the bottom never healed correctly as there was always a salty (I thought it was blood) taste in my mouth and sensitivity around the site. I returned to the dentist the first week of January and it was determined I did have an infection which they irrigated and prescribed Clindamycin 300mg/4x a day for. I went back after a week only to have the debridment procedure performed and more Clindamycin 300's prescribed. It has now been an additional 3 weeks, and the hole from the debridment procedure is still visible and quite "raw" with more foul tasting/smelling discharge. Here is a health history to better understand why I am concerned;

As a child I had scarlet fever multiple times (and yes, I am being serious. True diagnoses that baffled my small town doctors 3 summers in a row) and I've been told I should have been taking antibiotics prior to the procedure due to a higher risk of infection since I have had that illness before..not sure if this is true or relevant

I am allergic to Penicllin and it's family of antibiotics and I am wondering if Clindamycin is not strong enough to fight this infection.

I am currently breastfeeding so I am unable to go under IV sedation or take a stronger dose of antibiotics. I am considering weaning asap however if they need to do the debridment procedure again as I can not mentally be aware again for that (I was only under LA for the extraction in the first place) because now I am terrified of the pain and dentist.

Should I be concerned about such a persistant infection? Should I be seeking a second opinion from a different dentist/oral surgeon? Please offer any advice possible. I have heard horror stories of infections..
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Old 02-02-2014, 02:18 PM #3
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Confused

Thank you for the response.

I went into the office again last Monday and the dentist packed the wound full of a fibrous clove oil pack. I went back in on Thursday and the surgeon removed the packing, gave me nitrous and LA and performed the debridement procedure again. I was on Zithromax for 5 days.

I am a little concerned with the infection because the surgeon seemed worried. He and his nurse both exclaimed how they have never seen such an aggressive infection inside the socket. He did not suture the wound up this time, hoping it will heal from the inside out. He did tell me to protect this blood clot with my life because the next step if the infection persists, is a biopsy of the tissue and the potential for jaw surgery.

What is the best way to ensure the blood clot stays in place, besides the obvious no touching or vigorous rinsing, small food etc? I'm terrified of this continuing, and having a more invasive procedure done. I've been doing the softest rinse with medicate mouthwash he prescribed to keep the area as germ free as possible.
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Old 02-02-2014, 04:25 PM #4
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Hi Parsons,

Is this dentist as oral surgeon or a general dentist? I ask because oral surgeons routinely see various degrees of dental infections. They usually do not mess around with multiple prescriptions of antibiotics since they could just swab the area during the debridement and send it to a pathologist for biopsy and cultures. General dentists tend to treat chronic oral infections with multiple antibiotics and rarely if ever think to take a swab of the bacteria as they are not equipped with the specimen containers or information of a pathologist.

If it is not an oral surgeon, then I suggest you make an appointment with one asap.

There are only so many times that you can safely go back in and debride the socket. This must be done, especially in your case, by an oral surgeon not a general dentist.

In some cases of jaw bone infections, the wound is not sutured closed. It is imperative to NOT eat anything on that side of your mouth. Avoid spicy and citrus foods to avoid irritation of the wound tissue. Avoid seeds, rice, nuts, crusty bread, anything small that could get lodged in there. Eliminate sugar, white flour, simple carbs or reduce your intake drastically or the bacteria in your gut will become un- tameable and you will set yourself up for a severe digestive/intestinal problem. Are you taking a probiotic?

Even with the rinsing there will still be debris collecting in that area. Just try to be very mindful of your eating habits and do not attempt to clean out that socket with anything other than your gentle rinses.

Bryanna


Quote:
Originally Posted by ParsonsP0403 View Post
Thank you for the response.

I went into the office again last Monday and the dentist packed the wound full of a fibrous clove oil pack. I went back in on Thursday and the surgeon removed the packing, gave me nitrous and LA and performed the debridement procedure again. I was on Zithromax for 5 days.

I am a little concerned with the infection because the surgeon seemed worried. He and his nurse both exclaimed how they have never seen such an aggressive infection inside the socket. He did not suture the wound up this time, hoping it will heal from the inside out. He did tell me to protect this blood clot with my life because the next step if the infection persists, is a biopsy of the tissue and the potential for jaw surgery.

What is the best way to ensure the blood clot stays in place, besides the obvious no touching or vigorous rinsing, small food etc? I'm terrified of this continuing, and having a more invasive procedure done. I've been doing the softest rinse with medicate mouthwash he prescribed to keep the area as germ free as possible.
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Old 02-03-2014, 05:21 AM #5
ParsonsP0403 ParsonsP0403 is offline
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Hi Bryanna,

He is an oral surgeon. And to clarify, when i went in Monday and had it packed it was just the regular dentist who did that and prescribed the Zithromax.

This oral surgeon is apparently very good, and he's been very helpful, even providing me with his cell# to send photos or questions too. However, I am surprised, like you said, that he has no swabbed the area yet to determine the bacteria. He told me yesterday this is the defining period, and we should know by Wednesday (a week from the last procedure) if the clot had been strong enough.

I am taking probiotic drops and have been very careful with my diet. Thank you for your help and I'll let you know how it all goes from here!
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Old 02-03-2014, 12:56 PM #6
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Hi Parsons,

Is this a type of clinic that you are a patient of? Or a multi practice office?

I would urge you not to let a general dentist touch that area again. The surgeon may have taken the culture and handled this differently. Any follow up care to your oral surgery should only be handled by the oral surgeon only. I really cannot stress that enough.

Very glad to hear that you are taking a probiotic. I would seriously consider giving your baby a probiotic supplement as well because antibiotics can wreak havoc on the intestinal system even days to weeks++ after they are stopped. Babies, small children, anyone with a compromised or delicate system is most susceptible to developing the problem.

How are you feeling today?

Bryanna





Quote:
Originally Posted by ParsonsP0403 View Post
Hi Bryanna,

He is an oral surgeon. And to clarify, when i went in Monday and had it packed it was just the regular dentist who did that and prescribed the Zithromax.

This oral surgeon is apparently very good, and he's been very helpful, even providing me with his cell# to send photos or questions too. However, I am surprised, like you said, that he has no swabbed the area yet to determine the bacteria. He told me yesterday this is the defining period, and we should know by Wednesday (a week from the last procedure) if the clot had been strong enough.

I am taking probiotic drops and have been very careful with my diet. Thank you for your help and I'll let you know how it all goes from here!
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