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Old 10-12-2020, 08:46 AM #1
Jenseen Jenseen is offline
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Default Large Dental Fistula Remains Post-Extraction

Hello! Four days ago I had two broken, adjacent upper teeth extracted and recovery was easy. No pain, no muss. But I am concerned about the large, firm fistula that remains in the gum. I'm wondering how, with the extraction area healed, the fistula will drain? My dentist told me a piece of the tooth (which he extracted) had been lodged within the gum. He seems an excellent dentist and is, in fact, the head dentist in the clinic. I was given no meds pre- or post-op and don't seem to need any. I am avoiding getting food near the area and doing salt water rinses. There is no pain but a bit of sensitivity, especially if I press on it.

This is a fistula of years standing because for several reasons I did not go for an extraction, although I did get cleanings and x-rays. Near the start of the failed root canal/implant failure (I don't recall which) the dentist fixed things so the abscess/fistula would drain - which it occasionally did.

I see these things usually resolve within a month and it's early yet, but some do not go away at all. In the past I'd tried to shrink/help it with garlic and salt.
Do I seem to be on track for it to progressively get smaller and go away? This is my reason for posting, mainly for reassurance, if that seems to be the case here. I live far from a dentist and he did not mention a check-up is needed. I will be going back in April for cleaning and x-rays.

Thank you for all replies! Any other questions happily answered.

PS I am 70 years old with a strong immune system although root canals after age 60 did not 'take' - possibly after a half-century of dental x-rays, although they were not extensive.
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Old 10-19-2020, 07:30 AM #2
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It's been 10 days since the extractions and everything's healed up great. I do have one concern: It's still draining - infection? - and this large fistula, of years standing, hasn't shrunk much, if at all. Thank you!
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Old 10-24-2020, 08:54 AM #3
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Hello again! Wondering if the dental person, Bryanna, still comes here?

Today makes 15 days since the double extraction. Healed nicely BUT lately I'm having drainage, the same as when the tooth was in, occasionally..

It's said it's a bad thing then, and in the last few days it's been draining again. Same odd taste in my mouth as then. Can the infection still be active, and maybe even progressing? I do a salt-water swish which stops it, but it comes back.

Is this normal for a large (hopefully) resolving) dental fistula?

Thanks!
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Old 11-30-2020, 09:04 AM #4
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Wondering if anyone still comes around to answer questions?

It will be six days from two full months since my double extraction, which has healed up great. However, usually night or morning, there is still drainage from this formerly huge fistula pre-extraction.

I am far from a dentist and don't have a way there, so I'm hoping someone will let me know if this could be normal in the resolution of a huge fistula or if infection remains and it may be eating into the bone.

Every few weeks I take a little amoxicillin to help the natural healing process. Although it has shrunk a lot and there's no pain or discomfort, this does seem to be a very long time (the outside time was shown at a single month) and now it's become concerning.

Any information at all will help - Thanks!
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Old 11-30-2020, 01:20 PM #5
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When you say you take a little amoxicillan, what does that mean? One needs to take a full course, usually 7 days or so every day to rid any infection. Now and then is not the way to dose. One thing I've heard over years is take full course that is prescribed.
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Old 11-30-2020, 02:57 PM #6
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Want to add to my post, about 10 yrs ago I had a molar issue, long story and was given a 7 day course as I recall, 500mg three times per day, as I recall and that took care of my issue.....HOPE I never have to go to amox again, hope my area where molar is stays good...I use Myrrh tincture when I feel a little pain there....drop it on the area.
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Old 12-03-2020, 09:42 PM #7
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Hi Jenseen,

I read through your posts about your fistulas, abscessed teeth, root canals, extractions and attempted dental implants..

An oral fistula, as you have described, is a tract of infection that burrows through the bone and comes through the oral tissue to try and drain. What you see on your gum is only the drainage opening. What you don't see is the tract of diseased bone. Which should be showing up on a dental xray.

The fistula occurs from retained infected teeth. It also commonly occurs with root canaled teeth because that procedure is basically a temporary measure to "retain" unhealthy teeth, it does not cure the infection within the tooth or the jaw bone.

The extractions, based on what you described, were incomplete if any piece of tooth was left in there as that piece is a constant source of irritation and bacteria. The fistula should also have been surgically debrided and all diseased tissue and bone should have been removed. If those steps were not taken, then the area remains infected and is not likely to heal properly.

Dental implants require adequate healthy bone and tissue in order to be successful. They fail if that criteria is not met.

It is never wise to take antibiotics as you have described and here's why.
Antibiotics do not stimulate the body's natural healing mechanisms, they do just the opposite by killing off the natural occurring good bacteria.
It takes an oral antibiotic 24-48 hours to break through the good bacteria in order to get to the bad to reach the infection. That's why antibiotics like amoxicillin need to be taken for certain lengths of time to be effective.
Every time you take amoxicillin for less than 7 days, you disrupt it's ability to
work properly. However, your situation may not be cured by the antibiotic even if you take it as prescribed if the surgery to remove the teeth, and the diseased bone and tissue was incomplete.

Please clarify something ... did you go to a dental clinic or dental school for your dental surgery?

Bryanna


Quote:
Originally Posted by Jenseen View Post
Wondering if anyone still comes around to answer questions?

It will be six days from two full months since my double extraction, which has healed up great. However, usually night or morning, there is still drainage from this formerly huge fistula pre-extraction.

I am far from a dentist and don't have a way there, so I'm hoping someone will let me know if this could be normal in the resolution of a huge fistula or if infection remains and it may be eating into the bone.

Every few weeks I take a little amoxicillin to help the natural healing process. Although it has shrunk a lot and there's no pain or discomfort, this does seem to be a very long time (the outside time was shown at a single month) and now it's become concerning.

Any information at all will help - Thanks!
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 12-28-2020, 10:42 AM #8
Jenseen Jenseen is offline
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"It takes an oral antibiotic 24-48 hours to break through the good bacteria in order to get to the bad to reach the infection. That's why antibiotics like amoxicillin need to be taken for certain lengths of time to be effective. Every time you take amoxicillin for less than 7 days, you disrupt it's ability to work properly."

This is excellent information, and the very first time I've known of it. Looking online it always said only to take an antibiotic if you felt it draining.

There is still drainage/infection going on all this time later and I can't tell if if it's from the the nicely-healed area where the fistula has also healed nicely, or the large tooth below this area that looks pretty good, as far as I can see back there. The dentist noticed last year that it was "mobile"- it's a wisdom tooth that suddenly began growing again, quit, and is now up a good bit higher than the others. There are no other symptoms such as pain or swelling. The drainage will stop for a while then resume, always between evening and early morning hours. Oddly enough, during daytime, when I eat, it seems to stop it.

I went to a dental clinic and the head of the clinic did all the work on me for the past 10 years.
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Old 01-04-2021, 08:49 AM #9
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It now appears the source of drainage is the area between a wisdom tooth that grew large in the past year and the tooth next to it.
There is some purulence, for which I'm using amoxicillin, waiting for Augmentin.

tt began so soon after the extractions and the slowly-resolving fistula that it has taken me from October 6 (the double-extraction date) to now to realize what is actually going on,. even though my previously straight bottom dentition has gone crooked over the years - because the drainage is in the same area but right below it and there are no other symptoms.

All the teeth on the bottom are still in and my own, except for a 1-tooth bridge put in about 3 - 4 years ago.
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