Hi,

I'm a newby here and after much 'googling' I couldn't find my answer so stumbled across this forum.

Here's my story/question:

6 days ago I had an upper molar extracted due to a nasty abscess that had formed at the root, the tooth was broken & was re-built about 5 years ago but since then an infection had gotten in & got pretty set in there, it could be felt as a pea sized lump in my gum above my tooth with a fistula poking through. Anyway, after a lengthly extraction (not pleasant!) the wound seems to be settling down and healing well, however, I have finished the prescribed course of antibiotics (amoxicillin) and the abscess still seems to be there just as big but even more sore from all the poking around. My dentist said that it would just "drain away by itself" but almost a week in it hasn't improved at all & I can feel it still there even more prominent than ever. I guess my question is, how long does it normally take for an abscess to go away after the offending tooth has been removed? and when should I be going back to my dentist to get him to have another look at it?

Apologies for rambling & Thanks for your patience!

Hi glatus,

I am in the dental field and can offer you some information here. I will re post some of your post and answer you in bold type.

<<6 days ago I had an upper molar extracted due to a nasty abscess that had formed at the root, the tooth was broken & was re-built about 5 years ago but since then an infection had gotten in & got pretty set in there, it could be felt as a pea sized lump in my gum above my tooth with a fistula poking through.>>

WAS THIS TOOTH ROOT CANALED? IF SO HOW MANY TIMES WAS IT RE TREATED? DID IT HAVE AN APICOECTOMY SURGERY?

<< Anyway, after a lengthly extraction (not pleasant!) the wound seems to be settling down and healing well, however, I have finished the prescribed course of antibiotics (amoxicillin) and the abscess still seems to be there just as big but even more sore from all the poking around.>>

SOME EXTRACTIONS CAN BE DIFFICULT AS THE TOOTH AND BONE BECOMES VERY FRAGILE FROM INFECTION. ONCE COURSE OF ANTIBIOTICS MAY NOT BE SUFFICIENT. DID AN ORAL SURGEON OR A GENERAL DENTIST PERFORM THE EXTRACTION? WAS BONE GRAFTING PLACED AFTER THE TOOTH WAS REMOVED?

<<My dentist said that it would just "drain away by itself" but almost a week in it hasn't improved at all & I can feel it still there even more prominent than ever.>>

INFECTIONS IN THE JAW BONE DO NOT "DRAIN AWAY BY THEMSELVES". THEY PROLIFERATE IF NOT TREATED PROPERLY. IF THIS HAS BEEN A LONG STANDING INFECTION, AND IT SOUNDS LIKE IT HAS BEEN FROM YOUR DESCRIPTION, THEN THE BACTERIA HAD MIGRATED BEYOND THE TOOTH AND MAY STILL BE PRESENT IF THE BONE WAS NOT DEBRIDED THOROUGHLY AFTER THE TOOTH WAS REMOVED.

<<I guess my question is, how long does it normally take for an abscess to go away after the offending tooth has been removed? and when should I be going back to my dentist to get him to have another look at it?>>

AN ABSCESS DOES NOT GO AWAY ON IT'S OWN. IT NEEDS TO BE TREATED WITH A COMBINATION OF THINGS....
1) ENTIRE REMOVAL OF THE SOURCE OF THE INFECTION
2) REMOVAL OF ALL NECROTIC TISSUE AND BONE THAT CAN BE CLINICALLY AND RADIO-GRAPHICALLY SEEN AND FELT WITH AN INSTRUMENT
3) PROPER ADMINISTRATION AND DURATION OF AN APPROPRIATE ANTIBIOTIC
4) THE SITE SHOULD BE CHECKED WITHIN 7-10 DAYS POST OP THE EXTRACTION.

A word of caution here.... if your general dentist removed this tooth and he is not extensively trained or experienced in removal of badly infected teeth, then it would be wise to obtain your x-rays and consult with an oral surgeon before allowing this to go on any further.

<<Apologies for rambling & Thanks for your patience!>>
THIS IS NOT RAMBLING.... HAVE YOU READ SOME OF THE PREVIOUS POSTS FROM OTHERS?? ONLY KIDDING FEEL FREE TO RAMBLE HERE.

Hi Bryanna,

Thank you for your prompt reply, I will answer your questions as below:

WAS THIS TOOTH ROOT CANALED? IF SO HOW MANY TIMES WAS IT RE TREATED? DID IT HAVE AN APICOECTOMY SURGERY?

No, the tooth hadn't had a root canal on it. Back story is, probably 50% of the visible tooth broke off around 5 years ago after eating something hard, the dentist at that time saved the tooth by inserting a very deep filling. All was good & I was happy my tooth had been saved. Fast forward to today and the filling obviously degraded over time letting an infection in. My current dentist said that due to the advanced state of the infection & the fact that there wasn't actually much physical tooth left, it would be best all round to remove the tooth. I was ok with this as I felt I had it 5 years longer than I should have anyway.

SOME EXTRACTIONS CAN BE DIFFICULT AS THE TOOTH AND BONE BECOMES VERY FRAGILE FROM INFECTION. ONCE COURSE OF ANTIBIOTICS MAY NOT BE SUFFICIENT. DID AN ORAL SURGEON OR A GENERAL DENTIST PERFORM THE EXTRACTION? WAS BONE GRAFTING PLACED AFTER THE TOOTH WAS REMOVED?

Yes it wasn't the easiest! The tooth had 3 roots and one was attached to the jaw bone, which made it a bit of a nightmare to be honest. It was just a regular dentist, I am from the UK and we have National health service dental surgeries, (the extraction cost me £50 or $83) No bone grafting, the "hole" was just left to form a clot & heal by itself, which it has done thankfully.

INFECTIONS IN THE JAW BONE DO NOT "DRAIN AWAY BY THEMSELVES". THEY PROLIFERATE IF NOT TREATED PROPERLY. IF THIS HAS BEEN A LONG STANDING INFECTION, AND IT SOUNDS LIKE IT HAS BEEN FROM YOUR DESCRIPTION, THEN THE BACTERIA HAD MIGRATED BEYOND THE TOOTH AND MAY STILL BE PRESENT IF THE BONE WAS NOT DEBRIDED THOROUGHLY AFTER THE TOOTH WAS REMOVED.

I'll be honest it's been there for a while, I travel a lot with work & just not had the time to get it sorted, lame excuse I know & it wasn't really causing me any pain. I was a bit dubious when my dentist said it'll just go away, I had the feeling that it would need something else doing to it, but basically all he did was remove the tooth & send me on my way with 5 days supply of antibiotics, which I have now taken. In truth he didn't even touch the abscess or attempt to clean/drain the infection itself.

AN ABSCESS DOES NOT GO AWAY ON IT'S OWN. IT NEEDS TO BE TREATED WITH A COMBINATION OF THINGS....
1) ENTIRE REMOVAL OF THE SOURCE OF THE INFECTION
2) REMOVAL OF ALL NECROTIC TISSUE AND BONE THAT CAN BE CLINICALLY AND RADIO-GRAPHICALLY SEEN AND FELT WITH AN INSTRUMENT
3) PROPER ADMINISTRATION AND DURATION OF AN APPROPRIATE ANTIBIOTIC
4) THE SITE SHOULD BE CHECKED WITHIN 7-10 DAYS POST OP THE EXTRACTION.

Well, my next appointment was scheduled for 6 months time!! I think you've definitely made my mind up about making an appointment to go back very soon, it sounds like he's tried to get me out of there as quickly as possible as my extraction took around 45 mins, time is money & all that.

Thank you so much Bryanna, you're a star, I will be making another appointment for next week and let you know what the outcome is.

Many thanks,

Grant

Hi Grant,

Thank you so much for the precise and detailed reply. It clarifies the situation very well.

I understand that healthcare is very different in the UK compared to the US. However, it may not be in your best interest to let your general dentist handle this dental issue unless he is also well educated and experienced in oral surgery. I know that sounds a bit wonky as we assume since the dentist went to dental school he should have learned how to do this stuff. The truth of the matter is.... the oral surgery portion of the curriculum was brief compared to the restorative education. Although some colleges put a bit more emphasis on the surgery than others, the majority of what a "general dentist" learns is "tooth carpentry".

If you are correct in that the dentist did not do much to "debride" the socket after the tooth was removed, that tells me he was not thorough in the procedure. This is commonly seen even here in the US with general dentists as they just lack the education in oral surgery. The problems that can occur from the infection still residing in the bone can become widespread over time causing other teeth and beyond to become infected.

Is there any chance you could see an oral surgeon within a reasonable amount of time to evaluate this? To see your dentist will not get you very far as he will not be the best one to diagnose a problem if there is one brewing.


QUOTE=glatus;1072507]Hi Bryanna,

Thank you for your prompt reply, I will answer your questions as below:

WAS THIS TOOTH ROOT CANALED? IF SO HOW MANY TIMES WAS IT RE TREATED? DID IT HAVE AN APICOECTOMY SURGERY?

No, the tooth hadn't had a root canal on it. Back story is, probably 50% of the visible tooth broke off around 5 years ago after eating something hard, the dentist at that time saved the tooth by inserting a very deep filling. All was good & I was happy my tooth had been saved. Fast forward to today and the filling obviously degraded over time letting an infection in. My current dentist said that due to the advanced state of the infection & the fact that there wasn't actually much physical tooth left, it would be best all round to remove the tooth. I was ok with this as I felt I had it 5 years longer than I should have anyway.

SOME EXTRACTIONS CAN BE DIFFICULT AS THE TOOTH AND BONE BECOMES VERY FRAGILE FROM INFECTION. ONCE COURSE OF ANTIBIOTICS MAY NOT BE SUFFICIENT. DID AN ORAL SURGEON OR A GENERAL DENTIST PERFORM THE EXTRACTION? WAS BONE GRAFTING PLACED AFTER THE TOOTH WAS REMOVED?

Yes it wasn't the easiest! The tooth had 3 roots and one was attached to the jaw bone, which made it a bit of a nightmare to be honest. It was just a regular dentist, I am from the UK and we have National health service dental surgeries, (the extraction cost me £50 or $83) No bone grafting, the "hole" was just left to form a clot & heal by itself, which it has done thankfully.

INFECTIONS IN THE JAW BONE DO NOT "DRAIN AWAY BY THEMSELVES". THEY PROLIFERATE IF NOT TREATED PROPERLY. IF THIS HAS BEEN A LONG STANDING INFECTION, AND IT SOUNDS LIKE IT HAS BEEN FROM YOUR DESCRIPTION, THEN THE BACTERIA HAD MIGRATED BEYOND THE TOOTH AND MAY STILL BE PRESENT IF THE BONE WAS NOT DEBRIDED THOROUGHLY AFTER THE TOOTH WAS REMOVED.

I'll be honest it's been there for a while, I travel a lot with work & just not had the time to get it sorted, lame excuse I know & it wasn't really causing me any pain. I was a bit dubious when my dentist said it'll just go away, I had the feeling that it would need something else doing to it, but basically all he did was remove the tooth & send me on my way with 5 days supply of antibiotics, which I have now taken. In truth he didn't even touch the abscess or attempt to clean/drain the infection itself.

AN ABSCESS DOES NOT GO AWAY ON IT'S OWN. IT NEEDS TO BE TREATED WITH A COMBINATION OF THINGS....
1) ENTIRE REMOVAL OF THE SOURCE OF THE INFECTION
2) REMOVAL OF ALL NECROTIC TISSUE AND BONE THAT CAN BE CLINICALLY AND RADIO-GRAPHICALLY SEEN AND FELT WITH AN INSTRUMENT
3) PROPER ADMINISTRATION AND DURATION OF AN APPROPRIATE ANTIBIOTIC
4) THE SITE SHOULD BE CHECKED WITHIN 7-10 DAYS POST OP THE EXTRACTION.

Well, my next appointment was scheduled for 6 months time!! I think you've definitely made my mind up about making an appointment to go back very soon, it sounds like he's tried to get me out of there as quickly as possible as my extraction took around 45 mins, time is money & all that.

Thank you so much Bryanna, you're a star, I will be making another appointment for next week and let you know what the outcome is.

Many thanks,

Grant[/QUOTE]