Hi Jan,

Not only has it been my professional experience but if you were to google "dry socket packing by dentist" you would find that the repetitive nature of the information pertains to extreme pain that began on the 3rd to 4th day post op the extractions and the recommendation is to pack, remove, repack every 24-48 hours as needed. Nothing indicates leaving the packing in for longer than that. In fact, the packing usually falls out by the second day if it is not purposely removed. A dry socket causes A LOT of pain not just discomfort.... even in someone who has a high pain tolerance. So I am thinking that for whatever reason this OS packs routinely almost as a precautionary measure. The problem with that is the packing is for soothing pain only as it can delay the healing because it disrupts the natural healing process. So it's used to get people out of pain during the peak times of pain and really for no other reason. Does that make sense to you?

I would ask him what he is using exactly and if it has something in it that promotes healing. Perhaps he has his own formula of something that he uses that is not the same as dry socket paste. The fact that he gets annoyed with you when you inquire about something is not a reason for you not to ask questions. He is obligated to inform you of everything he does and uses. You are not questioning his judgement, you are inquiring about his post op protocol and nothing more.

It's not really fair to you to assume that your situation is the same as the other persons situation. She may (or may not) genuinely have dry socket. Everyone is a bit different.

It is common to experience cold sensitivity in the areas near the extraction sites. This is due to some recession of the gum tissue on the adjacent teeth as the inflammation subsides and the tissue is healing. Sometimes a bit of root becomes exposed on the second molar and most often the sensitivity goes away. It also occurs because the extraction site is open to the jaw bone which makes it vulnerable to temperature changes, cold in particular. As the bone fills in and the tissue closes over the sensitivity generally subsides.

Bryanna

Hello,

Yes, I fully understand that. That has been a big reason why I've been questioning the frequency and duration of the packing process. The packing in mine have not fallen out at all, I think he packs it quite deep inside the socket and it stays in even when I eat. I really have no idea what to do, I will wait until Tuesday and have all the packing removed then hope for the best and let my body heal naturally - I hope. The top extraction site has been feeling strange as today has gone on and it hurts. I do not want to consult the oral surgeon about this as I really do not want him to put any packing in it and call it a "maybe dry socket" and I have a feeling that is exactly what he would do. I wonder if I should go to my regular dentist and have them take a look at it? I'm scared he disrupted the natural healing that was taking place up there when he packed it and now I'm worried about an infection.

I will ask him next time I go in what he was using to pack the sockets, although once it's all out it wont really matter, will it? I have one other question... he has told me to use the syringe to flush out the sockets once the packing has been removed for good. I understand this is common practise.. but he also wants me to use the syringe to push the gum apart - pry it really... for 6 weeks so it can heal from the bottom up and not close over from the top... is this normal? Is it really normal to PUSH my gums apart and not let them close to prevent an abscess?!

Thanks a lot for your correspondence with me! :)

Jan

Hi all and apologies for disrupting your correspondence, but I cannot help but think of this possibility, however unlikely it may seem, and that is the financial interests of the surgeon. So, does he charge you for doing the packings (ie. for anything after the surgery itself), or is it all free ever since he did the surgery?
Once again sorry for even thinking about that, but I've heard of similar situations before where doctors would try make their patients visit them unnecessarily or for longer than actually required.

Hi Siobhan,

No worries, I take no offence haha. I don't think his motivation is financial, my insurance is covering it... but if my insurance wasn't covering it I believe I would have to pay each time actually... so not entirely sure... good question.. I like to believe he wouldn't do that though! I hope...

Jan

Jan,

Generally, the ideal at home oral care for tooth extractions is to avoid over chewing and eating food that will get lodged in the socket which means eating a soft food diet, rinse with warm salt water a few times a day and leave the site alone until the gum tissue heals closed. Unless there is a specific reason to keep repacking a socket or to suggest to aggressively use the syringe to irrigate underneath the flap of the healing tissue.... those things are not necessary and best to avoid doing.

I really think he should be explaining to you his reasons for this aggressive post operative care.

FYI... your general dentist will most likely be clueless as to the reasons why the OS is doing this as I said, it is not the norm. Also your general dentist will probably not want to get involved in this current situation because he has no idea what actually transpired during the oral surgery.

Regarding the upper extraction site... are you feeling sharp, throbbing or dull pain..... intermittent or constant .... more when you lay down, stand up, after eating or just at random times .... is it in the socket itself or in the sinus area above the socket or near the ear???

Bryanna

Jan,

Based on my experience, dentists do not charge to remove and repack the extraction site. However, I would ask the receptionist if he is charging your insurance company each time because if it were me.... that would raise a red flag.

Bryanna

Hi Bryanna,

I will check with my insurance company and with the receptionist to make sure he isn't charging me each visit. He said the socket needs to be repacked until I am at "zero pain. not even a point one." that's what he keeps repeating and that's why I still have the sockets packed. Most of today my top site has been fine, I've come to notice it IS actually the sinus above that is causing the pressure/quite mild pain. Not sure what this means.

He said the reason for aggressively keeping the socket open after the packing comes out is to "let it heal from the bottom up and not close over from the top. Apparently if it closes over from the top I could get an abscess. So there fore, he would like me to push my gums apart for 6 weeks until it heals from the bottom. Seems like such a long time :( He said he gives the same instructions to every patient. I'm feeling confused about his care, but I feel I'm so close to being done, that I just want it over with.

Thank you again,

Jan

Hi Jan,

I have never known of any dentist packing an extraction sight repetitively for several weeks post op unless there was a specific reason to do so. In fact, some oral surgeons do not even pack a dry socket unless it is very severe because the packing can interrupt the healing. I wonder what he is packing it with and what his reasoning is for doing that for such a long period of time? Tooth sockets always heal from the bottom up even if the gum tissue closes. In fact, the gum tissue closes over (the hole gives the appearance that it is slowly growing smaller) fairly quickly in people who have no post op complications. So I'm puzzled as to the reasoning he gives you. Do you recall having a taste or smell of cloves after he packs the site?

Just to give you a simple description ..... The extraction site is similar to a deep cut on a limb that has reached the bone. Everything is done to clean the wound and then help the wound close because the closed skin protects the inside of the wound from bacteria, etc. The visible cut in the skin is superficial compared to the depth of the actual wound. The only time a deep wound is repetitively packed or left open is when it needs to drain. Otherwise it's best to close it up.

He must have specific reasons for following this protocol with you. Maybe he's using something that has healing properties because regular packing paste does not. That's why I am puzzled as to why he's telling you the sites are fine, but then continues to pack them. I don't mean to keep harping on this. I just want you to heal okay and I'm curious what he's using as it may be something that promotes healing.

Bryanna




QUOTE=JG1993;1187012]Hi Bryanna,

I will check with my insurance company and with the receptionist to make sure he isn't charging me each visit. He said the socket needs to be repacked until I am at "zero pain. not even a point one." that's what he keeps repeating and that's why I still have the sockets packed. Most of today my top site has been fine, I've come to notice it IS actually the sinus above that is causing the pressure/quite mild pain. Not sure what this means.

He said the reason for aggressively keeping the socket open after the packing comes out is to "let it heal from the bottom up and not close over from the top. Apparently if it closes over from the top I could get an abscess. So there fore, he would like me to push my gums apart for 6 weeks until it heals from the bottom. Seems like such a long time :( He said he gives the same instructions to every patient. I'm feeling confused about his care, but I feel I'm so close to being done, that I just want it over with.

Thank you again,

Jan[/QUOTE]

He says the repetitive packing is because I am not at absolutely zero pain yet. He said I need to have no pain what so ever for 48hrs with the packing in before he will take it out. He classifies even a .1 as pain. I'm really not sure why. I don't believe the dry socket was EVER severe, he has some strange very strong philosophy about preventing even the smallest amount of pain. He packs it with a gauze that is covered in oil of cloves and I think one other thing mixed in. I'm not sure completely. I know without a doubt it is clove oil though. He always says they are "looking good and the tissue looks healthy". As for the sinus pressure/discomfort, what should I make of this?

I agree that the site should be allowed to close and it puzzles me that I have to push it open 3 times a day! All my other friends say they didn't have to do that after their extractions. I just want this stuff out of my mouth so I can heal normally. I keep thinking that its no doubt I still have very mild pain in my mouth because I have open wounds that are being forced to stay open with the packing in!

What should I do :(?

Jan

Oh, also I'm terrified now to get the packing out when I have even slight pain because he said the pain will return if I do that. I'm so confused.