Hi everyone, I hope you are all well. I come to the forum for the first time in a time of need. On 11/06 I had all 4 wisdom teeth taken out by an oral surgeon. He said the extractions were complex because they were all impacted and that the surgery took much longer than expected. I am a 22 year old female in good health typically. After the surgery I followed all instructions (I do not smoke) but on the 3rd day after extraction I had a follow up appt with the surgeon. He told me I had dry socket which was a surprise to me because I was NOT experiencing unbearable pain. Anyways, he packed both of the lower sockets with the clove dressings and I was on my way. On 11/26 the surgeon took out the packing and thought I should be ok without it.. a couple hours later the throbbing pain returned so I went back to get them repacked. It is now 12/02 and I thought I was doing very well, although the surgeon has still been packing the sockets a couple times a week. My last packing was last night during which he said that it would be my last packing and I would come back on Thursday to get the packing out.... well... he then asked me if I had any pain at all.. I told him I had mild pain when clenching or biting down hard on the top on my left side.. He then proceeded to get very worked up and told me I "may have a dry socket on the top" and then despite my saying I did not want him to put anything in the top socket or touch it at all.. he packed the top socket.. well now of course the top socket has been in pain since being packed.. I feel this packing was completely useless but now since I am in pain I'm terrified he has created a dry socket where there wasn't one. It seems hard to believe I would have a dry socket on the top after almost 4 weeks...

I really don't know what to do, I don't want this packing in my top socket but I'm scared that it will begin to hurt now if the packing gets taken out. Can anyone offer me any advice? I feel like this has all been going on so long. Up until he packed and irrigated that top socket I was in no pain in the top or the bottom. I'm at a loss and I'm starting to really not trust his opinion. Oh.. I forgot to mention he also cut my lip during surgery and it needed 6 stitches..

I'm so upset I've been having a mental breakdown for the last 24 hours since he packed the top one.

Hi JG,

There is no benefit to packing a surgical extraction site unless a dry socket is without question determined to be present. It sounds like this OS is rather eager to pack the sites which makes me wonder why he was so quick to do that?? If you feel that this dentist is not caring for you properly, please don't assume this is normal and go on suffering, consult with a different oral surgeon this week. FYI... you would need to have your pre op xrays for that "new" appointment.

Please let us know how you're doing.
Bryanna

Hi Bryanna,

Thank you for your reply. I have another appointment with the same oral surgeon tomorrow morning first thing. I will see what he does during this appointment then decide whether to seek out another opinion. I really just want to heal. It doesn't seem like there is any infection present so I don't see why I can't just get the dressings out and be ok. Its been nearly a month

Is there anyway he CREATED a dry socket on the top site by packing it and irrigating it?!?! I'm so worried.

Again, thank you!

JG

Hi JG,

If the extraction sites were healing on their own, then disturbing them could result in ......... less than ideal healing as the initial blood clot and healing cells were disrupted .......... or a bone infection and inflammation called Osteomyelitis .... or prolong the healing time.

A dry socket is called Alveolar Osteitis which basically means inflammation of the jaw bone. Surgical dressings for this condition are intended to soothe the inflammation and promote healing. Depending on what type of dressing was used, the non dis-solvable type are not intended to be left in the socket for longer than 2, 3 days max without being removed and changed if needed. Depending on the severity of the condition, some patients need to have the dis-solvable packing replaced or undissolved packing removed and a new one placed once a day for several days. Due to the fact that extraction sites are holes in the jaw bone, food debris can collect inside the hole. This is not a problem if the food debris is minimum and rinsing with warm salt water is able to keep the sites relatively debris free. The dry socket packing is like an insulator to prevent food debris from embedding inside of the socket. However, to leave a non dis-solvable packing in the socket for longer than 2-3 days is like leaving a dirty band-Ade over a deep wound which would prolong the healing of the site.

If you get the sense that this dentist is making light of your situation and perhaps not treating you properly, then please consult with another oral surgeon.

Bryanna

Hi Bryanna,

Oh man. Well this morning I went back and he took the non-dissolvable packing out of the top extraction site. It doesn't hurt and hasn't since he took the packing out. He did re-pack the bottom sites and I'm supposed to have this packing out on Tuesday. I'm not in much pain anymore. I'm terrified now though that I will have complications with the top site. If I'm not feeling any pain what is the chance I would have any of these complications ? How will I know if any of these things happen to the top site?

Thank you!!!
JG

JG,

No pain on the top with the packing out is a good sign. If that site stays quiet... great ... if it should start to hurt, then it's not a good sign.

So he packed the lowers again today and wants to leave that packing in for another week?? I would question if it's "ideal" to leave that packing in for that length of time. Is he doing that for convenience of less appointments on his part and yours? How did the sites feel when he removed the packing? What is he instructing you to rinse with?

Bryanna

Hi there,

Still no pain in the top and it's been all day - so I'm pretty happy about that. He has left the packing in this long before during this whole process, said it's perfectly okay to do so.. I'm not entirely sure why, I don't think it matters to him how many appointments I have. I've been kinda confused during the process why I needed to leave the dressings in for so long and have so many dressings. When he changes it and takes the packing out it feels fine and doesn't hurt, but I imagine I would have to wait a while before pain set in after taking it out? We took the packing out last week and within a few hours the pain returned so I called his office and he put it back in for me that afternoon.

He hasn't really told me to rinse lately.. he told me at the very beginning of this all to use warm salt water so I've still been doing that about 3 times a day. My mouth feels ok for the most part and it seems like everything looks ok when I look inside it. So far no signs of infection (I've had an infection in the wisdom tooth area before). I guess I should just continue doing this until I get the packing out? He gave me a syringe to use to flush the sockets out with once the packing comes out for good.

Thank you for your advice,

Janice

Hi Janice,

I am stumped as to why the dentist leaves the packing in for so long. To my knowledge that is not commonly done so I am thinking he has a specific motive for doing that.

The dry socket packing is used to soothe or reduce the pain associated with a dry socket and it works super well for that. However, other than soothing the pain, the ingredients have basically no healing abilities. If it is used unnecessarily or for too long a period of time, the healing of the sockets will be delayed. So based on your symptoms and the post operative time frame, I am puzzled as to why he keeps packing the sockets and why he leaves it in for so long a period of time. This could be something "he" does routinely, but I have no idea why he would do that.

Has he told you that you have an extreme case of alveolar osteitis? Do you have unusual extenuating circumstances that he is concerned about?

I would keep rinsing with the warm salt water since it seems to be helpful in spite of the packing in the sockets.

Bryanna

Hi!

Yes, I'm really not sure why he leaves it in for so long. I don't know if I should just ask him to take it out or be patient since I'm not really in any severe pain or anything and wait for Tuesday to roll around. He has not said that my case is extreme or extenuating. There is another girl who seems to be my age who had her teeth extracted on the same day who also has dry socket and who has been getting hers packed just as long as I have. I feel it is not common for them to be packed still after 4 weeks? Every time I go in to get the packing changed all he says is that it looks good. He never really gives me any details or says his opinion. It's hard to think about getting a second opinion as he is very well known around my small city and I don't want to cause any conflict or anything.

I have been experiencing sensitivity to cold in my upper extraction sites, is this normal? I don't want to ask him because I'm scared he will just pack the top ones again like a mad man lol.

Thank you so much for your helpful replies, I sure do appreciate it.

Janice

Oh, and another thing... I don't see how in any case my situation could be extreme. I have not been in extreme pain at ALL through this whole ordeal. I would not say the level of pain has been high. Mainly it's just been uncomfortable. I don't know if that helps.

Jan