[pawsdoc]

Hi there,

I had 4 wisdom teeth extracted last week (May 9) and was told that 3 out of 4 were impacted and that the right side was significantly more difficult to take out.

Throughout that week, I had a very rough recovery and was in pain pretty much for 7 days straight. My oral surgeon fit me in this past Friday (May 16) because for days, I would wake up in this stinging pain (not like the pain they describe in a dry socket) and would wake up in the morning to this gross, nauseating taste in my mouth of blood/pus mixture. I finally lifted my cheek to see what the heck was going on on May 15 and realized something crazy was going on in there and there was bone exposure - hence why he fit me in.

On Friday, he flushed/irrigated the area and switched me from penicillin to clindamycin 150 mg QID and the pain has since subsided. He said that if the area does not close, he would throw in my sutures. 3 days have now passed and I am no longer in a lot of pain BUT

a) I have this feeling of a hard lump at the level of the gums rostral to the extraction site - sort of where they seemed to have done a gum flap. Should I request another radiograph? Or is it normal to feel the lump? It only hurts when I press on it hard.

b) I'm still seeing this tiny hole in there and there is another one more caudal that you can't see in this picture (same size). Is it going to continue to heal by second intention or would they likely need to open the area up, explore, and re-suture?

I'm just so terrified of going through this immense amount of pain again. I'm also scared of brushing that area too hard - hence the staining now that is occurring. It's been such a horrible recovery and I just want all of this to be over. I've done everything by the books including salt-water rinses multiple times a day and irrigating EVERY time I eat anything.

Thanks

[Bryanna]

Hi pawsdoc,

I believe this photo is of your lower right side, yes?

The dentist made a very long incision when he removed the wisdom tooth. The tooth must have been horizontally impacted and he needed to flap the tissue down to gain access.

The gum tissue along the incision is pulled away from the gingival ridge (the bone) and you have developed a lot of fibrous and granuloma tissue which is normal but it also is why the incision line is not closing. This tissue would feel lumpy and you could have more of it in other areas as well.

Did you have this build up of tissue when you saw the oral surgeon on friday or did it develop since then?

It is sometimes best not to suture this incision closed as it is acting like a drain for bacteria to come out of. Generally this type of incision will heal on it's own but it may take a few weeks. But if the tissue grows a lot more bulky or you develop pain/ swelling or anything that indicates it is not healing then you should see the surgeon. It is also best not to use your tooth brush in that area as you could push debris into that opening. You could use a clean soft cotton q-tip dipped in diluted peroxide or salted water to clean that area. It is not necessary to remove this tissue at this stage as it will slough off on it's own. Just gently clean the plaque off of the tooth as best as you can with the wet q-tip and keep rinsing with the warm salt water.

Also, it looks like you have a moderate amount of tartar build up on those teeth. Once this heals, it would be wise to have your teeth cleaned to remove that tartar.

Hope this information is helpful to you. Thanks for posting the picture!

Originally Posted by pawsdoc

Hi there,

I had 4 wisdom teeth extracted last week (May 9) and was told that 3 out of 4 were impacted and that the right side was significantly more difficult to take out.

Throughout that week, I had a very rough recovery and was in pain pretty much for 7 days straight. My oral surgeon fit me in this past Friday (May 16) because for days, I would wake up in this stinging pain (not like the pain they describe in a dry socket) and would wake up in the morning to this gross, nauseating taste in my mouth of blood/pus mixture. I finally lifted my cheek to see what the heck was going on on May 15 and realized something crazy was going on in there and there was bone exposure - hence why he fit me in.

On Friday, he flushed/irrigated the area and switched me from penicillin to clindamycin 150 mg QID and the pain has since subsided. He said that if the area does not close, he would throw in my sutures. 3 days have now passed and I am no longer in a lot of pain BUT

a) I have this feeling of a hard lump at the level of the gums rostral to the extraction site - sort of where they seemed to have done a gum flap. Should I request another radiograph? Or is it normal to feel the lump? It only hurts when I press on it hard.

b) I'm still seeing this tiny hole in there and there is another one more caudal that you can't see in this picture (same size). Is it going to continue to heal by second intention or would they likely need to open the area up, explore, and re-suture?

I'm just so terrified of going through this immense amount of pain again. I'm also scared of brushing that area too hard - hence the staining now that is occurring. It's been such a horrible recovery and I just want all of this to be over. I've done everything by the books including salt-water rinses multiple times a day and irrigating EVERY time I eat anything.

Thanks

[pawsdoc]

Hi Bryanna

Thank you so much for your reply! I ended up going for a recheck with the oral surgeon today and he has decided not to put sutures in and just see if it'll continue to heal. Prior to my sx, I did not have fibrosis or hyperplasia in that area. I'm due for another recheck in a week

I'll follow your q-tip suggestion! Thanks!

Also - I do agree with that tartar! I kept putting it off because I no longer have health benefits but then...if I can pay for a $2000 oral surgeon, maybe I might as well spit up another $99 for a cleaning but I need a break to heal from this insanity and also...for my credit card bill to cry a little less :P. Thanks again, Bryanna!!

Originally Posted by Bryanna

Hi pawsdoc,

I believe this photo is of your lower right side, yes?

The dentist made a very long incision when he removed the wisdom tooth. The tooth must have been horizontally impacted and he needed to flap the tissue down to gain access.

The gum tissue along the incision is pulled away from the gingival ridge (the bone) and you have developed a lot of fibrous and granuloma tissue which is normal but it also is why the incision line is not closing. This tissue would feel lumpy and you could have more of it in other areas as well.

Did you have this build up of tissue when you saw the oral surgeon on friday or did it develop since then?

It is sometimes best not to suture this incision closed as it is acting like a drain for bacteria to come out of. Generally this type of incision will heal on it's own but it may take a few weeks. But if the tissue grows a lot more bulky or you develop pain/ swelling or anything that indicates it is not healing then you should see the surgeon. It is also best not to use your tooth brush in that area as you could push debris into that opening. You could use a clean soft cotton q-tip dipped in diluted peroxide or salted water to clean that area. It is not necessary to remove this tissue at this stage as it will slough off on it's own. Just gently clean the plaque off of the tooth as best as you can with the wet q-tip and keep rinsing with the warm salt water.

Also, it looks like you have a moderate amount of tartar build up on those teeth. Once this heals, it would be wise to have your teeth cleaned to remove that tartar.

Hope this information is helpful to you. Thanks for posting the picture!