antibiotics after wisdom tooth extraction
 

last wednesday, i had my wisdom teeth removed (they were not impacted but all had cavities) but no infection, fairly easy removal. i feel pretty good overall!

my problem is, after the surgery, i was prescribed antibiotics by the oral surgeon. clindamycin, that i took the day of the surgery and had a horrible upset stomach. i called the office, and the dentist prescribed amoxcillian instead. i took that and whoa, was my anxiety ever so terrible. i literally was shaking, and crying and felt horrible overall.

under the direction of the dentist (not the oral surgeon), i was advised to stop the antibiotics on friday. today i went in, and the dentist said everything looks okay, no infection, and i feel good, etc.

my question is, am i still really at risk for getting an infection by not taking the antibiotics? i'm doing the salt water rinses and using the prescription mouthwash. i really want to take them, but i just have severe anxiety about it. am i less likely to get an infection since i had an easy extraction?

i know antibiotics aren't always prescribed after wisdom teeth extractions...but should i ask to try something else? i haven't taken antibiotics since i was a kid (now i'm 30), besides a z-pack a few years ago, which i don't remember having any bad reaction to. is it worth it at this point (5 days post extraction)

any support/advice is appreciated...

Hi jayp,

Antibiotics can affect people in different ways. So if you don't have to take them, then don't. If you feel well and your dentist said everything looks good clinically.... then just continue with the warm salt water rinses until the holes close completely. Do not use any over the counter mouthwash that contains alcohol, chemicals, dyes or preservatives in it. Brush thoroughly and floss as well as you can to keep the plaque down. Stick with a soft food diet for another week or so to avoid moving your jaw too much.

A note about antibiotics causing stomach problems at the onset of using them ..... this can indicate that your intestinal flora (bacteria) are out of balance to begin with. You could benefit from taking a daily probiotic to restore the good bacteria in your gut. For optimal health, most people require a probiotic supplement because their diet is lacking in good bacteria which disrupts the balance leading to digestive, intestinal and candida problems.

I hope this information is helpful to you.
Bryanna

thanks so much bryanna! i will look into probiotics. my dentist also felt it was not necessary to try a different antibiotic - however:

what are some concerning signs of possible infection if i were to get it?

am i "out of the woods" of getting an infection once the holes heal over?

i'm paranoid about osteomyletis too.

the one thing i notice is that my voicebox seems sore, like i coudln't sing or make high pitches if i wanted to. i'm assuming this is normal?

Hi jayp,

FYI Re probiotics..... a good one to try is called Culturelle. It can found at many food stores and drug stores.

There are many signs of oral infection... some are swelling, hot or throbbing feeling in the area that is infected, fever, fatigue, foul breath odor, etc.

Some oral infections do not have symptoms at the onset. So it's always best to to be real careful to take really good care of the wounds and follow the post operative protocol until the sites have closed.

Osteomyelitis can occur after the holes have closed if there is bacteria residing in the bone. However, this is not something you need to focus on as the chances of that occurring are very low especially in a case such as yours.

It is a bit odd that your voice box would be sore or that you would be unable to make high pitch noises since the surgery. Even if you had IV sedation, there is usually no need to intubate the patient unless there are some extenuating circumstances. Did you have IV sedation?

If you have not done anything to cause this soreness, you might want to see your physician if it gets worse or does not improve in a day or two.

Bryanna

thanks bryanna. i think my voice is okay i feel it better today.

a new problem though, i have a small red spot on my cheek outside of where my lower wisdom tooth was taken out. i'm assuming this is some sort of bruising, but not sure why it would happen nearly a week later. :confused:

does this happen so long after - i know it's still healing, and this is the side that has caused me a little more pain. should i be worried about infection?

Hi jayp,

If the spot is on the outside of your face then it is most likely a bruise. If it is on the inside of your cheek it can be a bruise or a canker sore. Just be sure to keep the areas clean and keep rinsing well with warm salt water.

Bryanna

sorry to keep bothering you, but is it safe for me (almost 1 week after extraction) to use the irrigation thing? my instructions said i could use it after 3 days, but i' haven't been using it out of fear of dry socket.

i did use it a little today, but that thing squirts out really fast! it was hard to do it "gently" no matter how hard i tried. so i got scared and now afraid to use it because of dry socket.

i haven't even really eaten anything that would get really stuck in my sites anyways, pretty much i've been living off ensure shakes, yogurt, oatmeal, and ice cream. =/

jayp,

It is not necessary to use the irrigation syringe unless you feel you have something caught in one of the sockets. If you are healing well.... then I would continue with soft foods and warm salt water rinses.

You really should be eating more nutritious foods. FYI... Ensure is not nutritious as it contains nothing but chemicals. Some soft food ideas are eggs, boiled chicken (in soup), cooked beans, hummus, avocados, mashed sweet potatoes, well cooked veggies, baked fish, home made fruit smoothies .... just do not use a straw.

Bryanna

i have a couple more questions - i am now 11 days post op, and feeling better although i have a stitch still in the lower socket that is bothering me. i'm worried it won't dissolve or fall out - is this a legitimate concern? that the socket will heal with the stitch still in there?

also, i keep reading conflicting things - some things that says food that gets stuck in the socket can become infected if/when the gum grows over it. other things i read said gums form from the bottom-up, so if there is food in there, it won't impact the healing process and fall out on its own. what is it!?

i'm soo looking forward to eating a normal diet again.

i still have holes in the extraction sites, and anxious when they're gonna fill so i can stop panicking about an infection!

Hi jayp,

The stitch will come out on it's own. If it is still there 2 weeks post op then have the dentist remove it. A stitch that is embedded in the tissue can cause unnecessary inflammation.... so after 2 full weeks it's usually okay to remove it.

Food that gets embedded in a open socket can lead to an infection. In most cases the tissue inside of the socket closes in from the sides and up from the bottom. This is the body's way of keeping the site closed off before the top closes over. If you were to keep disturbing the tissue from forming by vigorous rinsing with a syringe then the hole will stay open longer.

Best to eat carefully until the top portion of the socket is closed over.

Bryanna

thanks bryanna, all my stitches dissolved. at my 2 week post op, i was told that i can start brushing over the extraction site too. is this okay? i was never told that before.

also, i still have a little jaw discomfort/tenderness around the bottom of my jaw, and i really can't open my mouth 'WIDE" so it's sometimes hard to see if i do have anything stuck in the sockets.

how long does this last for? at what point should i be concerned if the jaw discomfort doesn't go away? it's been 16 days. i think some of it might be my fault for trying to iopen my mouth wide to look at the sockets all the time...

Hi jayp,

Okay good that the stitches dissolved.

I would not brush over the extraction sites until the gum tissue is closed over. I don't know why you were told to do that. Just be sure to brush and floss all of your teeth thoroughly to keep the plaque to a minimum.

A little jaw pain/tenderness for several weeks would be normal. Do not force your jaw to open wide. If you can eat carefully and are comfortable eating some chewy foods then you can start to do that. I would not suggest to bite into a sandwich where you have to pull the sandwich with your front teeth as that puts a lot of pressure on the jaw joints. Also if your jaw aches upon chewing or you have pain, then back off of chewy foods and try them again in a few days... and so on.

The jaw muscles need time to calm down and over working them just adds to the problem.

Glad to hear that you are doing okay... keep rinsing with the warm salt water and be sure to be thorough with your oral hygiene :)

Bryanna

i hate to be a pest, but i'm assuming ear pain is normal too? it's not constant, just random twinges of pain/pressure in my ear and nose. every now and then, i'll get a pain in my forehead or top back of my head that lasts for a couple seconds.

i'm guessing this is all part of the healing process and things settling back into place after a few weeks :confused:

i'm hoping that in another week or so (i.e. 1 month post surgery) these random annoyances will go away. i am seeing the new tissue in the bottom sockets, so i'm hoping it will fill in soon!

Hi jayp,

Random pressure and ear pain, forehead and other head pain are all indicative of the TMJ joint. Not always the case but fairly typical for someone with wisdom tooth removal. Ideally all of these issues will resolve a little bit with each day so long as you are not doing anything to irritate the TMJ joint.

The pain in your nose could be referred pain or could be inflammation in the sinus. Can you describe that in more detail.... how intense is it... when do you notice it.... is it relieved by blowing your nose... do have sinus congestion or nasal discharge .......does it coincide with the ear or other pain.... do you feel it only when you eat or yawn or put your head down say to tie your shoes .....???

Think of the TMJ areas as hinges and the hinges are surrounded by tightly woven muscles and ligaments that connect to other muscles and nerves in your face, head, neck, etc. These muscles are flexible to a point as they hold your upper and lower jaw in a very specific position so as to allow you to eat, speak, yawn, etc without pain. But imagine those ligaments being stretched beyond the comfortable position for an extended amount of time ...... the muscles are going to spasm which in turn sends signals to other connecting muscles and nerves. As the spasms subside so will the pain.
Does that help you to be less confused about the duration of the discomfort that you are feeling?

Bryanna

thanks bryanna, i understand tmj and its affect now. the nose pressure just feels like a weight on my nose that comes and goes - could just be sitting doing nothing - but it doens't hurt - just an annoyance and i don't have any drainage.

now i'm getting a weird feeling with my ear - like the feeling of wearing a really heavy earring is the best way to describe it (i don't wear earings, but it just feels "heavy") it's not swollen, and it's not pain IN the ear, but outside of it. i'm guessing this is still tmj related, and not something more serious. :(

Hi jayp,

The "weight" that you describe feeling on your nose sounds to me like inflammation or pockets of congestion. Our sinuses inflame and become congested for a variety of reasons... could be allergies.... infection .... a polyp .... dry nasal passage... etc. You can have congestion without a runny nose or drainage. Here is a link that explains some of that.
http://www.livestrong.com/article/25...nd-congestion/

Do you have allergies? Are you prone to inflammation in your sinuses from time to time? Have you recently had a cold or upper respiratory infection?

You could try using a saline nasal solution to irrigate and moisture your nasal passages..... no chemicals or preservatives... just plain saline. You can mix it yourself by putting a handful of warm water in your cupped palm, add a pinch of salt and sniff up each nostril. Or you can just purchase saline nasal solution at the store.

The "heavy earring" feeling .... ha ha!!.. good description but funny. Anyway, I don't know what that is! Does the ear feel hot or do you notice if you get hives on your ear?? A feeling of heaviness associated with the ear could indicate inflammation and I suppose it could be referred from the inner ear.

If you feel that you are having a chronic sinus issue.... see your physician for a quick look see in the nose and ear.

Bryanna

i dont think it's a sinus inflammation, no allergies or real sinus problems ever besides an occasional cold, but i haven't had that recently either.

the heavy ear may be more of a tingling or something. i'm wondering if the joint/muscle healing from the extraction is somehow affecting a nerve on the left. it's really strange. and it just started a week ago, not since the beginning. i did see my general physician for other reasons, and she didn't see any sign of infection in the ear.

my lower left jaw is still REALLY tender, it's not painful unless if i press on it, doh! but it almost feels bruised (There is no visible bruise, but has that sort of feeling).the jaw bone is not visibly swollen, but doesn't feel as "smooth" as the right side. the left extractions were a bit more difficult than the right side, (seemed like more effort needed to get them out) but i would expect it to feel okay by now.

i can eat normally no problems but sockets are still open. still doing rinses and using the syringe as needed. can't open my mouth 100% yet either without pain. and no pain in the extraction sites either. but i have noticed a change in my bite which is annoying.

i'm thinking another follow up might be in order. i hate being a baby about this. the oral surgeon said that usually after 6 weeks you're "in the clear" from infection (thought i think he meant socket infections, not bone). but i don't think these sockets are going to close up by then.

also, i should note that i do have a mouth guard to wear at night because of possible grinding/tmj issues from along time ago because i used to get headaches. i have not been using it because a)i always take it out subconciously in the middle of the night, and i have not had any issues prior to extraction) and 2). it's pretty dusty/dirty and probably infested with germs, and i'm scared to put it in my mouth. what is the best way to disinfect? i might want to wear it again.

jayp,

So the problems still seem to be on the left side which means all of your symptoms are probably associated with the healing of that side. Everyone heals at a different rate. Some people take a few months before they feel better.

Since you state that you have had a TMJ problem in the past possibly due to grinding your teeth then it makes sense that your TMJ was giving you some problems after the extraction. Your mouth was stretched open very wide and the lower jaw was force-ably manipulated by the surgeon to gain access to the wisdom teeth.... all of which can play havoc on the TMJ area.

Regarding the cleanliness of your night guard...... you can clean it with a homemade paste of water, baking soda and a touch of peroxide. Saturate a stiff toothbrush (not to be used on your teeth!) and clean the guard. Make sure to rinse it off extremely well before putting it in your mouth. Next time you go to the dentist bring you guard and they can clean it in the ultrasonic cleaner which will remove any buildup that you cannot get off with the brush.

Regarding wearing your night guard.... if you think it would be helpful to wear it and it fits, wear it. If it doe not fit then make an appointment with the dentist to see if he can adjust it.

Regarding eating a normal diet.... if you have any discomfort associated with your TMJ or soreness in your jaw then try to avoid eating foods that require a lot of chewing. The only way to get the muscles and ligaments to relax is to not expect them to work too hard.

Bryanna

hi bryanna - a few more questions - sorry i've been having bad anxiety issues since taking my teeth out and need some re-assurance!

1-i did have my regular dentist look for TMJ issues and she figured it was the same problem that i had before and since i stopped wearing my nightguard, i caused the problem to "act up". i want to get a new nightguard anyways, so my question is - is it "safe" for me to get new imprints of my teeth made with my sockets still being open? or should i wait until they have healed up more? i forgot to ask that of the dentist....hmmm...she also didn't seem to have any interset in looking at my wisdom teeth since i did not go to her for that...

2. when i floss my teeth i cause the gum to bleed - which has pretty much always been my case. is this going to affect the wisdom teeth sockets somehow? like i don't want to be bleeding a lot and risk infection of the socket (though i know NOT flossing could lead to complications too). just want to make sure i'm not hurting anything with the healing process by bleeding on my gums.

3. i also am in desperate need for my routine teeth cleaning/checkup, especially after i think the peridex stained my teeth. should i wait until sockets are fully healed before i schedule?

Three of the sockets are almost closed (1 month post extraction) but the lower left one (which is where i've been having the most trouble) seems to still have a ways to go... it looks ilke the gum is filling in differently than the others. that's why i've been so concerned. it also appears to have more redness around it too.

Hi jayp,

I will repost your questions and answer in bold type.

<<<<1-i did have my regular dentist look for TMJ issues and she figured it was the same problem that i had before and since i stopped wearing my nightguard, i caused the problem to "act up".>>>

THAT IS VERY POSSIBLE.

<<< i want to get a new nightguard anyways, so my question is - is it "safe" for me to get new imprints of my teeth made with my sockets still being open? or should i wait until they have healed up more?>>>

IT IS SAFE SO LONG AS THE HOLES HAVE CLOSED OVER WELL ENOUGH TO TAKE AN IMPRESSION COMFORTABLY. THE IMPRESSION MATERIAL IS NOT GOING TO GET STUCK IN THE HOLES IF THAT IS WHAT YOU ARE CONCERNED ABOUT.

<<< i forgot to ask that of the dentist....hmmm...she also didn't seem to have any interset in looking at my wisdom teeth since i did not go to her for that...>>>

YEA, DENTISTS TEND TO OVERLOOK WORK THAT HAS BEEN DONE BY ANOTHER DENTIST... ESPECIALLY IF IT HAS TO DO WITH ORAL SURGERY. IT'S LIKE THAT'S NOT MY TURF... FOLLOW IT UP WITH THE ORAL SURGEON.

<<<<2. when i floss my teeth i cause the gum to bleed - which has pretty much always been my case. is this going to affect the wisdom teeth sockets somehow? >>>

DO YOUR GUMS BLEED IN JUST ONE AREA OR ALL OVER IN GENERAL?

<<<like i don't want to be bleeding a lot and risk infection of the socket (though i know NOT flossing could lead to complications too). just want to make sure i'm not hurting anything with the healing process by bleeding on my gums. >>>

HEALTHY GUMS DO NOT BLEED UNLESS YOU HAVE SOMETHING WEDGED UNDERNEATH THEM. GENERALLY GUMS BLEED DUE TO THE BUILD UP OF PLAQUE WHICH CAN RESULT IN INFECTION ELSEWHERE IN THE MOUTH. SO IT IS IMPERATIVE TO BRUSH AND FLOSS ALL OF YOUR TEETH THOROUGHLY EVERY DAY. THE BLEEDING WILL STOP ONCE THE GUMS ARE NO LONGER INFLAMED FROM THE PLAQUE. SOME MEDICATIONS, MALNUTRITION AND IMBALANCED HORMONES CAN ALSO CAUSE THE GUMS TO BLEED.

<<<3. i also am in desperate need for my routine teeth cleaning/checkup, especially after i think the peridex stained my teeth. should i wait until sockets are fully healed before i schedule?>>>

SO LONG AS THE WISDOM TOOTH SITES ARE PARTIALLY CLOSED OVER AND ARE NOT SORE AND YOU CAN COMFORTABLY OPEN YOUR MOUTH, IT IS FINE TO HAVE YOUR TEETH CLEANED. THE ONE THING THAT WOULD CONCERN ME ABOUT YOU HAVING YOUR TEETH CLEANED AT THIS TIME IS THE PAIN THAT YOU ARE HAVING WITH YOUR TMJ. IS THAT STILL ACTING UP?

<<<Three of the sockets are almost closed (1 month post extraction) but the lower left one (which is where i've been having the most trouble) seems to still have a ways to go... it looks ilke the gum is filling in differently than the others. that's why i've been so concerned. it also appears to have more redness around it too.>>>

THE REDNESS COULD BE DUE TO BACTERIA BUILT UP. GENTLY CLEAN THE GUM AREA OVER THE SOCKET WITH A Q-TIP DIPPED IN DILUTED PEROXIDE SOLUTION AND THEN RINSE THAT OUT WITH WARM SALT WATER. DO THIS EVERY TIME YOU BRUSH FOR A FEW DAYS AND SEE IF THAT HELPS. DO NOT BECOME OBSESSIVE WITH IT... ONLY WHEN YOU BRUSH.

hi bryanna -

the gums don't bleed horribly or anything - and lately when flossing, i haven't had really that much bleeding. sometimes, i think because my teeth are so tight that i might be "cutting" the gum.

anyways - i'm 5 weeks post extraction and just found out that i might have mitral valve prolapse. which isn't official, but i have been having some symptoms of having mvp.

1. i should be in the clear from endocarditis from this extraction, correct? even if i had/have a heart valve problem- since it's been 5 weeks and i have not had any symptoms of infection? when i mentioned to my doctors they said i should be okay from that...

2. is it possible i could have had a sinus perforation? i feel like ever since the surgery, i felt a weird pressure on my nose. i have a little "post nasal drip" - mucus seems to be going down my throat. it was never mentioned though that my roots were deep and penetrated my sinus. or maybe it's just from the healing of the upper wisdom teeth?

also i think i might be using too much salt in my rinses, since my gums feel dried out. should i just continue to drink water to soothe the irritated gums?

when i saw that you had anxiety I was happy because I thought I was the only one. When I took my antibiotics I had a feeling of impending doom severe anxiety and I cried for about a week for absolutely no reason. I was shaking and I didn't know what to do. I do not have any mental illness in my immediate family nor do I have mental illness LOL but this was absolutely insane; I took the antibiotics and within two hours I was in the worst feeling in my entire life and it lasted for about 8 hours after taking one pill. suffice to say I didn't take another pill that week. about 10 months later I was prescribed antibiotics is a precautionary after surgery and guess what? The same exact reaction occurred again. The first time I was given Levaquin and the second time I was given amoxicillin and the same exact reaction occurred in both antibiotics but this time on top of the feeling of impending doom and anxiety I also had a severe stomach upset and I felt like the creature from the movie Alien was going to rip out of my stomach. me and antibiotics and do not mix!