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Old 02-25-2014, 01:25 AM #1
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Default Infection after complicated wisdom tooth extraction

Dear Bryanna,

I would like to thank you in advance for all of your expertise and reassurance. I've been reading many of the related topics before posting my question. Here it is.

I have undergone quite a complicated wisdom tooth extraction on Friday, 14th February. My 38 was impacted, partially in the bone and in the gum, however not errupted. The roots were pretty deep and one was hook-like. My surgeon had to section it into four parts and it took him about 45 minutes to take it all out, clean and stitch the site. I had massive swelling and felt really uncomfortable, but that was expected. What surprised me was quite an uncomfortable case of sore throat, it was painful for me to swallow.

On Wednesday it felt as if my stitches came undone, so I booked an appointment with another surgeon the same day. She said I had contracted a post-op infection, opened the site, cleaned it and prescribed me doxycycline (one pill twice daily for five days) and metronidazole (3*250mg for seven days), along with syringe to clean the extraction site. She told me I don't have to come for a checkup unless I feel worse.

I have been experiencing mild discomfort similar to irritated gums along left side of my mouth over the weekend, but almost no pain and it gradually subsides. There's no discomfort at present. The extraction site and surrounding gums are not painful, still a bit swollen, but only a very little. My surgeon had to hack quite a bit into my bone so I guess that's expected. I still can't open my mouth fully, but enough to eat and I guess that only needs time.

However I wonder - how do I know the infection is gone? My swelling is down, almost gone, the pain isn't there, the only thing is a bit of dry mouth in the morning, but I presume that's due to the antibiotics (it's listed as a side effect). I brush my teeth regularly and irrigate the hole with the syringe I've been given, along with some local gel to treat the gums. Can I presume as long as there's no pain, everything is healing nicely? I'm worried as I'll be travelling abroad next week and I hope there aren't any nasty surprises in store for me.

Thank you very much for your kind answer!
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Old 02-25-2014, 12:52 PM #2
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Hi Tinky,

The bacteria is going to be present for several+ more days. Pain is not always an indicator of the extent of the problem. So it is best to have the original surgeon look at the site at least 2 days before you travel.

What gel are you using on the gum? It is best to use nothing that contains alcohol, chemicals, or any irritants as this will cause further irritation. Warm salt water rinses are the ideal remedy for post operative care.

Be careful with the irrigating syringe. It is ideal to use it gently with little force on the plunger and only use warm salt water in the syringe .... it is meant to gently flush out debris, not force it out like a hose. The body forms a sticky bio film tissue to help protect and close the site. Any forceful irrigation will interrupt the formation of this film and either slow down the process or prevent it from healing completely.

Bryanna





Quote:
Originally Posted by Tinky View Post
Dear Bryanna,

I would like to thank you in advance for all of your expertise and reassurance. I've been reading many of the related topics before posting my question. Here it is.

I have undergone quite a complicated wisdom tooth extraction on Friday, 14th February. My 38 was impacted, partially in the bone and in the gum, however not errupted. The roots were pretty deep and one was hook-like. My surgeon had to section it into four parts and it took him about 45 minutes to take it all out, clean and stitch the site. I had massive swelling and felt really uncomfortable, but that was expected. What surprised me was quite an uncomfortable case of sore throat, it was painful for me to swallow.

On Wednesday it felt as if my stitches came undone, so I booked an appointment with another surgeon the same day. She said I had contracted a post-op infection, opened the site, cleaned it and prescribed me doxycycline (one pill twice daily for five days) and metronidazole (3*250mg for seven days), along with syringe to clean the extraction site. She told me I don't have to come for a checkup unless I feel worse.

I have been experiencing mild discomfort similar to irritated gums along left side of my mouth over the weekend, but almost no pain and it gradually subsides. There's no discomfort at present. The extraction site and surrounding gums are not painful, still a bit swollen, but only a very little. My surgeon had to hack quite a bit into my bone so I guess that's expected. I still can't open my mouth fully, but enough to eat and I guess that only needs time.

However I wonder - how do I know the infection is gone? My swelling is down, almost gone, the pain isn't there, the only thing is a bit of dry mouth in the morning, but I presume that's due to the antibiotics (it's listed as a side effect). I brush my teeth regularly and irrigate the hole with the syringe I've been given, along with some local gel to treat the gums. Can I presume as long as there's no pain, everything is healing nicely? I'm worried as I'll be travelling abroad next week and I hope there aren't any nasty surprises in store for me.

Thank you very much for your kind answer!
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Old 02-28-2014, 05:23 AM #3
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Hello Bryanna and thank you for your answer. My dental gel was Metrodent - with metronidazole and Chlorhexidine Gluconate. I am now mostly on salt water rinses, not using any kind of mouthwash or other gargling solution. I am being extra careful with the syringe and eating only on the other side of my mouth to eliminate the possibility of any food getting stuck in.

As the swelling went down, I have now another complication - since the gumline went down on the back of my mouth, my only one erupted upper molar on that site is irritating my cheek. I guess it would also have to go away as my surgeon suggested.
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Old 02-28-2014, 08:54 AM #4
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Hi Tinky,

Glad to hear that you are steadily improving.

As far as the molar irritating the inside of your cheek..... that's not a real common complaint after wisdom tooth removal. However, there could be some puffiness still remaining in the cheek tissue which may be rubbing against the tooth. Is the tooth sharp at the edge? Sometimes during a tough extraction the adjacent tooth is nicked with the forceps and a piece of tooth can can chip off. That could make it feel a bit sharp which could irritate any cheek tissue that rubs up against it.

Keep up with the warm salt water rinses.

Bryanna




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Originally Posted by Tinky View Post
Hello Bryanna and thank you for your answer. My dental gel was Metrodent - with metronidazole and Chlorhexidine Gluconate. I am now mostly on salt water rinses, not using any kind of mouthwash or other gargling solution. I am being extra careful with the syringe and eating only on the other side of my mouth to eliminate the possibility of any food getting stuck in.

As the swelling went down, I have now another complication - since the gumline went down on the back of my mouth, my only one erupted upper molar on that site is irritating my cheek. I guess it would also have to go away as my surgeon suggested.
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Old 03-03-2014, 03:41 AM #5
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Hello Bryanna,

once again, thank you for your time to answer my questions. Your help and reassurance were greatly appreciated. I have final update, even though I couldn't make an appointment with my dental surgeon at convenient time, I went to see a GP which has office hours at my work. She checked my mouth and throat and, hooray, told me she didn't see any infection.

I was very glad to hear this, now I only need to prepare myself for one final surgical extraction of #18 molar which is impacted completely inside the bone, but my surgeon recommended me the extraction due to possible cyst by the roots. Guess I'll do it in two months or so. After that, I'll be celebrating and hoping I won't have any further trouble with my teeth. I love visiting my dentist if it's only for regular checkup and dental hygiene
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Old 03-04-2014, 04:38 PM #6
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Hi Tinky,

Glad to hear that you are doing well!!!

Tooth #18 is a lower left second molar. Generally these teeth are not impacted. Do you mean tooth #17 is the one being extracted next?

Bryanna



Quote:
Originally Posted by Tinky View Post
Hello Bryanna,

once again, thank you for your time to answer my questions. Your help and reassurance were greatly appreciated. I have final update, even though I couldn't make an appointment with my dental surgeon at convenient time, I went to see a GP which has office hours at my work. She checked my mouth and throat and, hooray, told me she didn't see any infection.

I was very glad to hear this, now I only need to prepare myself for one final surgical extraction of #18 molar which is impacted completely inside the bone, but my surgeon recommended me the extraction due to possible cyst by the roots. Guess I'll do it in two months or so. After that, I'll be celebrating and hoping I won't have any further trouble with my teeth. I love visiting my dentist if it's only for regular checkup and dental hygiene
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Old 03-19-2014, 02:48 AM #7
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Hello Bryanna,

I gave the wrong number then. It's the wisdom tooth on the upper right side of my mouth. Do you think two and half months after previous extraction should be enough time in between two extractions? The impacted tooth there is giving me no problems, but, as I've said, my surgeon told me there is something he can see on the X-ray, cyst forming and he recommended observing it and, eventually, taking it out.

Thank you!
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Old 03-19-2014, 08:44 AM #8
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Hi Tinky,

The upper right wisdom tooth is referred to as tooth #1 in the US. It is not too soon to have this tooth removed providing that you have healed well from the first extraction.

If the dentist sees a cyst forming at the end of the root then yes the tooth should be removed before the cyst gets larger.

Bryanna


Quote:
Originally Posted by Tinky View Post
Hello Bryanna,

I gave the wrong number then. It's the wisdom tooth on the upper right side of my mouth. Do you think two and half months after previous extraction should be enough time in between two extractions? The impacted tooth there is giving me no problems, but, as I've said, my surgeon told me there is something he can see on the X-ray, cyst forming and he recommended observing it and, eventually, taking it out.

Thank you!
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