Originally Posted by Bryanna

Hi toothtroublesgal,

Anytime the oral surgeon has to go back in an debride the surgical site it is considered a serious issue in that it will need further follow up monitoring for a few months or so to be sure that the problem is resolving.

It is a good sign that he found the bone to be healthy when he did this last debridement. It is also good that he did a very thorough debridement which can be more effective than just antibiotics alone.

The incision that he made was done in an area that allowed him to gain access to the bone without causing too much more trauma to the area. It sounds like the over growth of tissue with the second molar was problematic in that debris was getting caught underneath and causing irritation to build up. So hopefully removing that tissue will help the area to heal better and you will be symptom

free from here on out. If all goes well, it would be a good idea to see him or your dentist on your first break from college for a clinical look see and a periapical xray to make sure the area is doing okay.

Regarding the antibiotic.... It would be best for your overall health to supplement with a probiotic starting immediately and continue for at least 3 months or longer. Many people, myself included, take a probiotic supplement on a daily basis as a routine thing to reassure that the intestinal bacteria is consistently abundant in healthy bacteria. Antibiotics kill off the good intestinal bacteria in order to get to the bad bacteria. Unless your diet consists of a lot of healthy fermented foods on a daily basis, you will be deficient in good bacteria. Therefore, it is essential to replenish the good bacteria with a supplement to avoid an intestinal infection or other health problems. One product that is easy to get a drug or food store is called Culturelle. You can buy it online too. Take one per day first thing in the morning or last thing at night on an empty stomach. If taken in the AM, be sure to take the antibiotic an hour or so after the probiotic to avoid cross reaction.

I hope this information is helpful to you. If you have any further questions or concerns, let us know. Otherwise... hope all goes well and have fun in college!!

Bryanna

Originally Posted by toothtroublesgal

Thank you so much for your quick and helpful reply! I am definitely taking probiotics and I know they're helping my digestive system handle the antibiotics a little better. I'm glad to know that you think my surgeon is handling this correctly, and it helps to get some peace of mind from an informed source.

I do have one more question. While my surgeon is fairly confident the operculectomy will resolve the repeated infection issues, he said that if this continues to be a problem or the gum flap grows back, I may have to get that second molar pulled and possibly the corresponding top second molar to resolve the problem. He says that most people don't have enough room for wisdom teeth in their mouth, but I don't even have enough room on that side for my second molar (which does seem likely.) Would this be a reasonable course of treatment if the area cannot heal properly?

Originally Posted by Bryanna

Hi toothtroublesgal,

You are welcome

Based on your description of the size of your jaw, I can tell you that the oral surgeon had a heck of time removing your wisdom teeth. Again based on the information you have shared here, you have done really well considering.

I would agree with his general assessment about your second molars. He was not implying that you should run out and have them removed. He was trying to forewarn you about the complications that can arise due to the inability to keep that area clean and healthy. If you were to remove the lower second molar and not replace it with an implant, the upper molar that bites against this lower one would drift downward into the open space below because there would be nothing preventing it from doing that. Regarding the implant to replace the molar, if it should come to that.... depends on the health, depth, and width of the bone in that lower right molar area as to if it is sufficient to hold the implant.

So it seems that the best course of action you can take is preventative. The surgeon has removed the excess tissue so to try and prevent or minimize the problem from reoccurring, you may need to alter your brushing habits a bit.
Use a child size soft head toothbrush or a child size electric toothbrush. Make sure to angle the brush so that the bristles are angled against the back portion of that molar and use a circular motion to clean that area. It will take some practice to get the hang of it. Using an electric brush may be easier for you because all you have to do is angle the brush and it will do the work for you. The idea be thorough but not aggressive as you do not want to injure the tissue. The idea is to repetitively, gently shock the tissue so that it does not want to grow back and so that the gum line toughens up as this will inhibit the tissue from over growing.

As soon as the extraction site and newly surgerized area feels comfortable, start the new brushing routine. Initially it may bleed a little, but that's okay. You do not want to make it sore, so let that be your guide as to when you should be more gentle.

Do you use an electric toothbrush?

Bryanna

Originally Posted by toothtroublesgal

I do not use an electric toothbrush, but coincidentally I just started using a child size toothbrush a few days ago after throwing my old one out thinking it probably wasn't good to be using the same toothbrush after an infection. I think having a smaller head on the toothbrush is really helping me clean the area better and fit in all the tiny nooks and crannies in my mouth

I am also doing salt water rinses after I eat today. The oral surgeon said I should begin irrigating the extraction hole tonight with my syringe, would it be beneficial to use salt water to do this too?

Thank you for your help!

Originally Posted by Bryanna

toothtroublesgal,

I think you will find the smaller toothbrush much more effective. After the site heals, invest in spin head or a small head electric brush. I really think you will be amazed at how well they work!

Regarding irrigating the socket... you can use warm mildly sated water in the syringe. The syringe is meant to be used very gently and not forcefully. It is suppose to be a gentle irrigation, similar to the same force you get when you rinse. If you irrigate too hard, it will hurt and you can reopen the wound. So steady and very gentle.

Bryanna