I'm worried I could still have a lingering infection in my extraction site. The tissue is very tender and although I still have pain in my jaw joint as well, my pain is also felt in my jaw/cheek above the extraction site. Although I no doubt have some TMJ pain, I would hate to think that I'm not paying attention to a possible infection. I'm going to the dentist on Monday - do you think he should be able to tell by looking if there is still an infection in the gums? And will a course of antibiotics take care of it? I'm so tired of having pain in this area. I no difficult extraction sites can take some time to heal but I'd really just hate to think another infection (or the same one) is brewing and that I'm not paying attention to it.. Thank you Bryanna…. or anyone else with advice!!

CWMB,

Did you have this tooth, as well as the wisdom tooth, extracted by an oral surgeon or a regular dentist? Do you know if the dentist cleaned out the socket of both areas very well? You would know if that were done because you most likely would have felt a lot of pressure from the scraping.

Every time a tooth is extracted, it is imperative that the bony socket be thoroughly scraped of all diseased tissue and bone. If it's not scraped clean, then bacteria can continue to live in the nooks and crannies of the bone and the antibiotic may not be able to get to where it is.

I cannot tell you if you have an infection or if an antibiotic would be helpful. The dentist who did the surgery would know if he cleaned out the site or not. I would suggest that you have the dentist take an xray of that area, irrelevant of what they see or don't see clinically. It will not show any growth of new bone as it is too early for that, but it can be helpful if there is something abnormal going on.

Just curious... are you seeing an oral surgeon or a general dentist on monday?

Bryanna

I am seeing both a periodontist on Monday morning, and then my normal dentist in the afternoon (for another filling… small, thank goodness!). I'm really hoping the periodontist can tell if there is an infection in the bone near the extraction site. The gums/bone are just so tender. I'm trying not to touch them, but when I do, the tenderness worries me. I don't have a fever though and feel generally well, and there is no pus nor do I have a bad or salty taste in my mouth, so I'm hoping these are all good signs. I will keep you posted. What would the cure be for an infection in the bone if there does end up being one?

Also, as for my TMJ, pain - it is very bad. I've been trying not to open my mouth too wide, have been eating soft food, etc. But, today when I looked in the mirror as I opened my mouth wide, I noticed that on the very sore side, it almost looks like a bone pops out to the side, just above my ear. Is it possible it is dislocated?? Like I said, I am being sent for a MRI, but that could take months to get in. Do you think my dentist could see if it is dislocated on a normal dental x-ray?? I really can't wait for the day when this is all a distant memory. It just feels like as soon as one issue clears up, another gets worse. I so appreciate the support of Bryanna and everyone on this site as I deal with all of this.

I should also say that it does look like the extraction area is swollen compared to the other side, as well as tender.

CWMB,

May I ask why are you seeing the periodontist and not an oral surgeon?

Can you tell me if an oral surgeon performed the extractions?

Yes, a dentist can tell if the jaw is dislocated. It is imperative that you explain in detail the problems with the jaw and have it thoroughly evaluated.

I would also suggest that temporarily avoid any restorative dental work, like those little fillings unless they are urgent, until the jaw situation gets diagnosed and starts to heal. It is imperative that you not hold your jaw open for any length of time. TMJ problems are exacerbated by holding the jaw open... by opening and closing the jaw... holding the jaw open for extended periods of time.... chewing... grinding and clenching your teeth... anything that puts stress on the jaw joints and jaw muscles should be avoided.

Your bite is most likely misaligned if the jaw is not positioned properly on the joint. This could make it impossible to get a proper bite alignment with new fillings. So that is another reason to not have the restorations done until the jaw problem is diagnosed and healed. I hope I have explained that okay.

Bryanna

My normal dentist did the extraction. I am seeing a periodontist tomorrow as well because I am having him to do a consult for a dental implant (which I'm still undecided about… especially because of this persistent problem at the site of the tooth extraction.. I will at the very least be waiting until all signs of infection have been cleared up before I proceed).
I will be seeing both my dentist and the periodontist tomorrow.

My gums at the extraction area are now really swollen. Puffy, and whitish in colour surrounding the hole. They look MUCH bigger than the other side of my mouth. I called my dentist on his cell just now and he said it's possible there is a remaining infection. I still have some Clindamycin pills leftover from a previous prescription that they changed, so he told me to start taking those again. I just want this infection to be gone. He said they might have to go in and do more scraping. With the scraping and the strong antibiotics for 10 days, will this infection clear up? What if it is right in the bone?? I feel so upset about this.

CWMB,

I am going to suggest that you see an oral surgeon. The reason being is that oral surgeons have much more education and experience over general dentists in dealing with this dental problem.

Your continued problem could be that your general dentist did not debride the surgical site well enough after he removed those teeth. Meaning if there is infection, it is most likely due to bacteria that was not removed at the time of the extractions. Unfortunately that is more common than I care to admit :/

You could also have a sinus involvement which your general dentist is most likely not trained or equipped to handle whereas an oral surgeon would be. A periodontist is also a surgeon but they are not as experienced is this type of problem as an oral surgeon is.

In my opinion based on all of our conversations, I think it is way too early to have an implant consultation because you still have some issues that need to be addressed and until they are remedied, no one can tell you if your bone is healthy enough to receive an implant.

I am just giving you my opinion from being in dentistry for over 30 years and having seen cases like yours where unresolved issues become bigger problems because the site was treated properly and the dentist was too eager to do the implant.

I know this has been very difficult.... please think about what I'm suggesting and decide if it makes sense for you to change direction a bit.

Keep us posted........
Bryanna

Hi Bryanna. I thought I would give you an update. I saw the periodontist this morning. As you suggested, I am holding off on any dental implant consult, but since I had the appointment my dentist suggested the periodontist also look at my troublesome area. He said there is no sign of infection. The socket is healing nicely and although it looks swollen to me, it really isn't. He was very thorough and empathetic to the ordeal I have been through. He took a CT scan and said it looks like there has been 'sinus communication.' He asked if I've also had a sinus infection recently - which I did develop around Dec 28th and still seems to be somewhat present. He thinks my gums are suddenly more tender/sore because of this sinus communication, and that it could also be the reason for the salty taste in my mouth if the sinus is draining. He also thinks that based on how problematic the area has been and how difficult the extraction was, this could be the reason for ongoing tenderness in the bone as it heals. He put me on Amoxicillin/Clavulin, which he said is a strong antibiotic that should clear up an infection whether it is sinus or in the gums (which he doesn't suspect). We are going to wait a week before looking further at whether a surgery needs to happen to block the passage to the sinus (I think that's what he said). He said he doesn't want to do any kind of major procedure unless it's necessary. I am also waiting for an appointment with a Ears, Nose, Throat doctor.

CWMB,

Thanks for posting the update.

My gut feeling is that there was a sinus communication long before now most likely caused by those infected teeth and the dentist that extracted your teeth either didn't notice it or he didn't mention it to you.

The area probably feels swollen to you because it is most likely very inflamed underneath the gum tissue up into the sinus. That would give you a heavy or bulky sensation in that area.

Do you recall how many times you have been prescribed antibiotics in the last year for dental problems? I think you said you had been, but I just don't recall exactly.

What did the periodontist say about your TMJ?

Bryanna

I had suspected the same thing. I doubt it is a coincidence that all of my sinus issues started at about the same time as what I now know was that awful tooth infection began. I was put on antibiotics in the past, but obviously they weren't helping because the infected tooth was still there, with the abscess attached to the root. I'm hoping that now that the tooth is gone, these antibiotics will help to clean up the sinus infection that I now have? And you described the feeling so correctly… like a heavy feeling in the extraction site!! Bryanna, I think your knowledge is truly amazing. So, do you think that the sinus antibiotics will help then? I'm not sure how I got in so quickly, but I just got a call this morning that they got me into to see an ENT specialist on Monday. I think it's possible that I also have a deviated septum on the same side of my face. Even when I don't feel congested or like I have a cold, I almost never am able to really breathe out of my right nostril. Or perhaps just a really bad sinus infection on that side. Another odd thing… since my sinus issues started, I've had a coated tongue. Could this be from the post-nasal drip/bacteria gathering in my mouth?? To ease my sinus discomfort, I'm also using a steroid nasal spray that was prescribed, and if the pressure gets really bad, I take Sinutab. I'm also sleeping with a humidifier next to me. On another note, I completely forgot to mention my TMJ to my periodontist. I feel like I have so many issues going on, it's hard to cover them all in an appointment (and I don't want them to think I'm a hypochondriac or something… when I'm really not at all). I am going to mention it to my dentist on Monday. I found out yesterday that I have to wait until JUNE for my TMJ MRI. Ridiculous wait time. Do you think a normal x-ray would show any problems with my jaw joint? Sorry for all of the questions…. again. I can't tell you how much I appreciate your help and support.