Jan,

The only thing I can think of is maybe he is using a hemostatic agent called ActCel and perhaps he's adding tetracycline to it. Why he would add the clove oil too.... at this stage, I'm not sure.

Actcel is basically used to control bleeding. But it has been shown to reduce the incidence of dry socket in sites where there is no infection present. Because it degrades to a biocompatible state (glucose and water) it does not cause disruption in the healing process. Basically it is a water soluble sterilized cellulose (plant fiber) that expands 3-4 times its size when it comes in contact with blood. It rapidly turns into a gel like substance so it plugs up the socket pretty well. It completely dissolves in about 1-2 weeks but it can be dissolved sooner with saline or hydrogen peroxide.

He may use this routinely for 3rd molar extractions because he may be getting good results with it. Perhaps you could ask him if this is what he is using? However, the irrigation of the sockets by pushing the gum tissue open is something I would be cautious about doing... especially if the sites are healing okay.

The sinus pressure .... did he mention anything about a sinus opening or perforation when he removed your teeth? Pressure and discomfort in the sinus area generally indicates inflammation. Have you or are you getting any drainage from your nose into your mouth? Do you feel pressure or anything unusual like throbbing in your sinus when you drink water or when you put your head down towards your feet?

Bryanna

None of those products sound like something he would be using, I'm really not sure. I know for sure it's cloves though, haha.

In your personal opinion should I still have the packing in if I have a bit of pain still? I'm due to get it out tomorrow but I'm scared because I have had some random pains over the last couple days...but on the other hand I really don't know that it's a good idea to keep putting packing in the socket. I guess you can't fully tell me unless you know what specifically he is using to pack it. The sinus pressure and pain seems to have gone away completely over the last day. He did not mention or perforation or anything like that. No pressure or water leakage either. I guess if the pressure/pain is gone that's good news?
Thank you so much, your replies really ease my mind.

I'm so nervous for tomorrow :(

Jan

Jan,

I don't know why he's still packing the site or what he is using so I cannot say you if he should continue to do it or not.

Intermittent pain for several weeks post op tooth extractions is normal and does not mean that there is a problem. Severe, throbbing, sharp pain and/or swelling are indicative of a problem.

You could tell him that friends keep asking you why he keeps packing the sockets if everything is healing okay. If he tells you it is to control pain.... I would ask.... what are you using that controls the pain and why would I have pain this many weeks after the extractions if everything is healing okay?

Is it possible that you gave him the inclination that you could not tolerate any pain and that's why he keeps packing it?

If the sinus has calmed down then that is a good sign. Hopefully it will stay that way and the site will heal well.

Bryanna

Hi Bryanna,

So, I got the dressings out about an hour ago and so far so good. I've been having some discomfort from the top site this morning, but I'm thinking I will wait to see if it calms down again. I really think it's just from being packed.

My sister said that she used oil of cloves directly in her dry socket when she had the same issue. She said she just used one drop and it provided immense relief and that the socket closed in a couple days this way. Is this a bad idea? I have some oil of cloves I can use if it's a good idea :)

The OS did tell me once again to use the syringe to push my gums open and not let them close from the top.. however, I don't think this is a good idea based on what you and most people have told me.. So I will just gently irrigate the socket and let it close. Hopefully all heals well and I don't have to make another trip to see this OS. Oh and PS, I'm in Candada.. don't know if that makes a difference on the advice my OS has given me.

Thanks for your continued advice, it's so much appreciated

Jan

Hi Jan,

Thanks for the update.

Clove oil is used as a soothing agent, not a healing agent. Therefore, it is meant to be used in the early stages of a dry socket to help soothe the pain. Otherwise, it really is best to just leave the surgical socket alone and let your naturally produced healing cells take care of it. If you keep disturbing it, the healing cells will be diminished and it will take longer to heal.

Your sister most likely only needed to use clove oil once, maybe twice a day for a couple of days. You have had the surgical sites packed with clove oil and who knows what else for a month! If you can, it is best to just leave them alone and let them heal on their own.

The typical post operative protocol following wisdom tooth removal is universally similar. It can vary slightly, as it did with your os, from one dental practice to another based on a personal/professional preference.

Hopefully you will not have too much discomfort from here on out and all will heal well!

Bryanna

Hi!

Thank you for the information. I seem to be doing good without any pain killers or clove oil. Am I likely to develop an abscess if I let the gums just heal over on their own and do not engage in the act of pushing apart my gums to let the hole remain open? Provided I am rinsing with salt water and maintaining good oral hygiene and that nothing gets caught in the socket while it's healing. I am really nervous about keeping my gums open like that, I just want them to be able to close :(


Jan

Hi Jan,

If the sockets are healing well, as your dentist has told you, then there is no need to have to irrigate the sockets with a syringe. Thorough oral hygiene and rinsing with warm salt water 3-4 times a day until the gum tissue closes completely is all that is necessary.

Bryanna

I've read through all of this with interest - my bottom right molar was extracted last Monday and I developed dry socket really quickly and went back to have it packed on the Wednesday. (The dentist didn't advise me not to use a drinking straw after extraction, so I did. Duh). I've had a completely different experience, lots of pain and discomfort, but he just sent me away and told me the packing would eventually come out and only to go back if it came out really quickly. The site looks whitish now with some brown residue that I suspect is what's left of the packing. I've been really miserable as the pain has come and gone and I've been treating it with toothache kit. But the hole does look slightly smaller as if it's healing over. I am so glad I didn't have to go back to the dentist as I found the whole thing very unpleasant and think I'd need sedation of some kind! My main problem has been pain and discomfort, there is no swelling or any other symptom and now I've got some referred pain across my other teeth. I'm on day six nearly day 7 of dry socket so hoping it will all settle down very soon.

Hi shell,

What is in the "toothache kit"?

When a person has pain, intense pain, beyond the 3rd or 4th day of a tooth extraction and it is due to a dry socket.... then having the site packed every day or two brings great relief. This would require that the previous packing be removed in order for the new packing to be placed.

Basic post operative instructions following a tooth extraction to be carried out for about the first 2+ weeks:

Avoid drinking through a straw.
Avoid smoking and drinking alcohol.
Avoid mouthwash.
Avoid chewy foods as it requires too much effort of the jaw and jaw muscles. Eat a soft food diet instead and do not eat on the affected side until the swelling is gone and the site is comfortable and the gum tissue is closing over.
Brush and floss all of your teeth to reduce the accumulation of plaque.
Rinse with warm salt water 3-4 times a day.

Referred pain can be due to a number of things:
Dry socket can cause a radiating pain.
Clenching or grinding your teeth... often occurs when someones mouth hurts.
Could be overuse of your jaw and jaw muscles when chewing. If you think that could be, then stick to a soft food diet.
If the gums on the adjacent teeth are sore and achey, then it could be due to an accumulation of plaque. If that's the case, they brush and floss better.

If the site is healing and there are no other contributing factors (some of which I have mentioned), then it could take a few weeks before it calms down completely. However, if the pain you have today does not get continuously less each day, then do not hesitate to go back to the surgeon for him to take a look.

Hope this info helps and you start to feel better soon.
Bryanna

Thank you for your answer Bryanna. Since I posted, I had increased pain and felt very miserable and forced myself to have a good look at the site (I get pretty freaked out by it). I also noticed heightened sensitivity of the surrounding gum which appeared white and thought it might have got infected. So I steeled myself and went back to the dentist, I was shaking I was so nervous but he cleaned out the hole and repacked it. He said the hole was smaller and he has prescribed Metronidazole (Flagyl) for three days. The pain has eased quite a bit now but I feel miserable - I have anxiety issues and am also going through the menopause so suffering with some depression, all in all I have not been dealing very well with the dry socket situation psychologically. I don't know if everyone gets depressed when they go through this. I have high hopes that the situation will now resolve, but the dentist said if it hasn't settled by next week he will refer me to the hospital. I had never heard of dry socket until last week but now feel like an expert I have read so much! Thanks again.