I had tooth extractions and bone grafts 10 days ago and the (dissolvable) stitches have started to come out. I have been having a few bone particulates come out of my mouth off and on (a total of about 10-12 small particles). I am particularly concerned about my bottom left first molar, I can see the stitches but underneath is a large hole. Also, my first top right molar had a failed root canal and was also extracted with bone graft and feels particularly raw and has a large hole with the feeling of small pieces. I have been careful not to brush the site or poke and prod excessively. Should I contact the doc?

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Hi Htown,

Thanks for posting the pictures.

It is normal for some tiny particles of bone graft material to come out of the sockets until the wounds close. If a lot more than a few, say like a small clump of material came out then that could be a sign that you are losing the graft.

The upper site does look inflamed. I can see plaque accumulating in some areas on both sites. Be sure to clean the teeth around the extraction sites. If you are uncomfortable using a soft toothbrush on those teeth then use a wet q tip dipped in salt water to remove the plaque before it hardens to calculus. Are you rinsing with warm salt water? It is wise to continue to do that until the sites have closed. Please refrain from using any mouthwash as the harsh chemicals will only irritate the wounds and can disrupt the healing.

Are you scheduled for a post op appointment with the oral surgeon? It is always best to see him within 2 weeks of the surgery.

Bryanna

Hi Bryanna,

Thanks so much for the reply!
I have been rinsing my wisdom tooth removal sites with warm salt water but not the whole mouth. Will start.
No clumps have become dislodged. I have been a bit afraid to use a toothbrush near the sites (being the first molars and wisdom were removed at the same time, it is a bit sore and healing). Will definitely begin using a q-tip! Thanks for the advice!
No follow up was scheduled, the surgeon works at many clinics and rotates each day (only at my dentist 1x/month).
I have been using chlorohexidine 2x/daily as prescribed and using a syrgine to dislodge any trapped food particles.

Hi Htown,

Be easy with the irrigating syringe as that can dislodge the graft material. Best to eat carefully... no seeds or anything that can get lodged in the wounds. Brush and floss all of your teeth thoroughly to keep the plaque down and rinse your entire mouth with warm salt water several times a day.

I would also schedule a post op with the oral surgeon...not the general dentist. It is best for the surgeon to see you. In private practices an appointment is always scheduled within 7-14 days post op.

Regarding the chlorhexidine.... it is not unusual for people to be sensitive to this stuff. That could be why your wounds look irritated and sore. To be truthful..... this rinse is prescribed mainly because people become lackadaisical about their brushing/flossing during the healing phase so plaque and bacteria accumulate. The best post op care is to maintain good oral hygiene and rinse with warm salt water several times a day until the wounds close.

Bryanna