Infection after molar extraction
 

Background:
About a year and a half ago I developed a hole in my 1st upper molar. It was at the center and went thru the filling. I didn't think anything of it and I'd just floss food out after eating. A few months later I started to get pain. At one point it got bad but it eventually went down and just stayed at a level one could deal with. I remembered stories about tooth pain being the cause for many people's health problems, but I thought this little hole and mediocre pain was nothing to worry about.
The more I read and talked to people, the more I realized that there were many complications that could follow, including the abscess going into the brain. So I went to the dentist the first time about four months ago. He told me to get a root canal, or he could pull it, and put me on amoxicillin 500 mg, 3 times a day, for 5 or 7 days. After I finished the antibiotics, I went back to not doing anything about the tooth. Couple of months later, while flossing, a part of the tooth broke off. I start to get headaches, fatigued and dizziness the moment I wake up. I got to more reading and find out that the infection comes back if the root of it is still there, which is the tooth. Now, I start to get pain behind the eye and my ear. I decide back to the dentist, and he gives me the same story and puts me on amoxicillin 500mg again. 4 times a day, for 10 days. I finished those three weeks ago. Two weeks later, this past Monday, I got the tooth pulled by an oral surgeon. The next day, even though the numbness went down and the aftereffects of the surgery were staring to kick in, I felt ok for the first time in a long time.

Current situation:
The second day after the extraction I developed the kind of pain that I've only had once while the tooth was still in. This was much worse because that level of pain was there 24/7. Two days later I went back to the oral surgeon and he tells me that there is no dry socket, but that there might be an infection. So he puts me on amoxicillin 500mg, 3 times a day, for 7 days. After I asked, he tells me that the sores that I showed him are just canker sores that can be caused by anything. There were only a couple at the time.
As of now, it's been 6 days since the extraction and I'm on my fourth day of the antibiotics. The pain subsides at times but eventually gets back, sometimes to the level of the worst pain I've had there. I have two fistulas above my canine, which is three teeth down from the extraction site. I have one right above my 1st premolar. There is swelling around my 2nd premolar. When I bite down, there is still pressure pain at the teeth surrounding the extraction site. The sores inside of my mouth, across the gums with the fistulas, are spreading. My headache, ear and eye pain, are back, but on the other side this time. The lymph nodes under on the side of the extraction, under the jaw are painful to the touch.

What's my next step?

Am I right to think that the amoxicillin don't work for this infection anymore?

Before I pulled the tooth, I never had any fistulas, swelling, or persistent sores there. At the time, having read people dealing with puss, drainage, and swelling, it was just another reason I didn't think just my pain was urgent.
Having read some stuff on this site recently, I understand a few things weren't done right post surgery. There was no debridement done afterwards; I was given aftercare instructions and my tooth I asked for. Also, I wasn't put on antibiotics immediately after, even though the tooth was abscessed.
At this point, having read the helpful information here and looking at my nasty looking, decayed tooth, I understand that the bacteria is destroying the bone in my gums. Also, that it could be spreading to other parts of the body.

What should I ask of the dentist next time I see him?

Welcome 1stmolar. :Wave-Hello:

Someone will be along to help.

Thank you. Thought I'd mention that I put clove oil on the infected gums for pain management. It could be why the pain subsides only to come back after the oil wears off. Also, the infected gums are staring to bleed slightly, and ironically, now there is white puss peeling off from the fistulas above my canine. There is also a newly formed big fistula above my 2nd incisor.

Welcome to the NeuroTalk Support Groups.

1stmolar, yikes, it all sounds very painful, but look I'm no dentist and I'd hate to give you incorrect advise :o , but in the meantime you could rinse your mouth out a few times a day with warm salty water. That's what I would do in same situation.

Hopefully Bryanna will see your post soon and you'll get some advice.

Thanks for the info. I've been rinsing with warm saltwater for the past 5 days. Though it helps, it's temporary relief at best. The pain though is not so much of a concern at this point as the obvious spread of the bacteria suggested by the return of previous, and new, symptoms.

Istmolar,

If you have fistulas above the canine and 1st pre molar, then you have 2 abscessed teeth. The decay in your first molar was noticed over a year ago so that means the decay had started sometime before that. When infectious bacteria from a decayed tooth spreads in the bone it can infect other teeth, spread to the sinus and into the lymphatic system. Antibiotics cannot cure infected teeth irrelevant of how many times you take them. Your dentist should not keep prescribing antibiotics for you as they are not touching these infections and they are destroying the health of your intestinal tract.

If you have not done so already, please go to a dentist for a complete full mouth series of xrays and a comprehensive examination. It is not wise to keep taking antibiotics when they are not of any value for the infections that you may have.

Bryanna

Thank you for that. I have never had any issues with the canine or 1st premolar, or gums surrounding them, or any part of my gums for that matter, until now. And there were no fistulas, sores, or any kind of white spots until after the 1st molar was pulled out this week. I've even had two of my bottom 1st molars pulled out when I was a kid.
I have had three sets of X-rays done of the area where the 1st molar was, two by two different general dentists and one most recently by the oral surgeon. The oral surgeon also took a full mouth. There was no mention of surrounding teeth being infected. The 2nd general dentist did say that one of my teeth next to the 1st molar has cavities. I had to go with a oral surgeon who works at a school of dentistry since I can't afford a practicing one. So maybe him being in residence may have something to do with not seeing other problems.
May seem like I know what I'm talking about, but that's only because lately I've been reading here extensively to find out what's going. Dental problems are relatively new to me. Especially of this severity. My health has been deteriorating for the past few months, as mentioned above, and that's why I decided to pull the 1st molar out. Things were good one day before they got progressively worse than before.
As far as the antibiotics, during the second visit in regards to the increasing pain, I told the oral surgeon I was on amoxicillin twice before, but he insisted on it. Then the pharmacist told me it may be now that the tooth is out, the amoxicillin may actually work. Made sense at the time. I just wanted to find out how I can get better.
With that said, what is my prognosis at this point, with my overall health and my teeth/gum health? Also, what is the best treatment at this point?

I attached a picture showing the redness caused by the infection. The redness above the 2nd incisor and the canine is where the fistulas used to be. Seems that the clove oil peels off the white part and leaves behind a wound that bleeds a little. I also attached a picture showing the unaffected side for comparison.

Here are the pictures

ist molar,

When you say fistulas, what exactly do you mean? A fistula is not a canker sore. It resembles a pimple as that is what is looks like and it can have pus coming out of it. Fistulas do not disappear as they are directly the result of a brewing infection.

The gum tissue in the photo looks very angry, there are some aphthous ulcers and some sloughing off of gum tissue. Stop using the clove oil as I think it has irritated the gum tissue. What are you rinsing and brushing your teeth with? Any mouthwash? Do you have chronic digestive or intestinal problems or something like GERD/heartburn?

I can see by the photo that you have some interproximal (in between) cavities that appear as very dark areas indicating they may be fairly deep. You also have a badly broken tooth. All tooth decay is infection and it can make someone ill as it wears down the immune system. I assume you avoid the dentist due to finances and perhaps fear or... ?

I am not not a big fan of the dental work that is done in dental schools. I know they need practice but the work is generally not that good. If that is all you can afford then that is what you have to do. But keep in mind that these students are very inexperienced.

Bryanna

Maybe I don't know what an actually fistula is, but what I have is a white patch that develops where the redness is in that first picture. It shows redness there only because the clove oil peels it off, and the area returns to white as the oil wears off. You did put it the best way in saying there's soughing. Of all the things I'm doing to deal with this issue, from taking antibiotics to brushing my teeth, clove oil is the only thing that seems to have any effect on the pain. Otherwise the pain stays at a very high level, seeming all day long.
I'm brushing my teeth with a standard toothpaste that says sensitive, and I'm rinsing with warm salt water about 4-5 times a day. I do have GERD and heartburn. The dark part you were referring to in my teeth may be fillings; and yes the tips of my teeth have a tendency to break off easily. I avoid the dentist for the same reason I went with the school of dentistry, and that's finances. But that's just one reason why I'm here.
At this point, I keep taking the antibiotics because I think it's keeping the infection from spreading to other parts of my body. I will stop if there is no merit to that.
The return of symptoms I've had pre-extraction tells me the infection is back. The fact that those symptoms are worse and that I now have additional ones tells me it's worse this time. My teeth are not in the best of shape, but I've never had gum issues and the only tooth that has given me problems in a long time is the 1st molar that is out now. I had the thing pulled out because to my understanding it was the root cause of the abscess, and that the abscess remains in the tooth nerves because the antibiotics can't access that area. The cause of the infection being gone, the antibiotics seemingly having no effect, and the infection getting worse and spreading, knowing what the correct thing to do would be very helpful at this point.
Also, the gum area that is infected is also starting to get sensitive to cold and hot like the tooth was. To me, that says it's the same bacteria that decayed the tooth. Looing at the tooth makes me think the same thing is happening to the bone of my gums. The tooth having broken off at one point because of the decay leads me to believe the same thing will happen to the bone if I don't do something constructive about it.

The pain is slowly leveling off where one can deal with it. The other symptoms are too. Based on experience with the tooth, while it was still in place, it doesn't mean the infection is gone. Even though the tooth rarely hurt the last couple of months, at the crown, it looks like a fossil. I guess the question I'm trying to pose is how to prevent this bacteria from spreading.

Seems the amoxicillin got rid of the post-surgery infection. The pain is almost gone. My gums are slowly getting back to normal. The other symptoms are almost gone too.

In reference to what the dentist said. I was seen by a different oral surgeon. He explained to me that what may have caused the high level of pain is actually dry socket. He wasn't sure because I saw him more than a week after the extraction. Based on what I had read about dry socket, before and after his conclusion, I believe he is right.
At the same time, I'm also convinced I also had an infection in and around the site. I had gooey nasty looking stuff coming out of the socket. Also, this white stuff, that looked like some kind of residual, on the roof of my mouth, above the gums. Either way, as bad as I think things were before and after the extraction, I know things would have got worse if I waited longer to pull the tooth. I'm sure someone can learn from this.

Miss Bryanna, the ulcers you mentioned, the oral surgeon said are caused by the body's reaction to the extraction. I tend to believe him because it was a difficult one that lasted a while and involved a lot of tugging, wiggling, and overall movement of the tooth. Also, the sloughing off of the gum you mentioned was probably due to the clove oil I was using on them, which you correctly advised me to stop doing. If I had to deal with this again, I would probably put the clove oil cotton balls in the socket instead of the gums.
Having dealt with all this because of neglect over one tooth, making sure it doesn't happen again is imperative to me at this point. That said, the main incisor next to the broken tooth you mentioned is more broken. I also have other teeth in my mouth that are chipped and broken at the tip. In reference to the main incisor above, it's the only one that emits a foul odor when I floss it. Because all of them are teeth that can be easily seem, pulling them is not the first option, so what else is left?

I've got lots of bumps and knobs in my mouth. but it doesn't stop me from posting! i'll always be there for a voice in the "crowd"! You are in my prAYERS. When I was struck by the rim of a basketball hoop two years ago while setting it up all alone be cause ,my wife refused to help (i'll get into that lator) anywho, I thought I had new teeth growing (at my age???) how will i alert the social media??? i found an excel lent doctor who gave me some great advice and he said lay off the sigar cubes because you are not a pony, but a man a man that has been threw so much. after the rim of the basketball hoop hit me straight in the noggin, i felt a tightening in my gums and well, i've never wisdom teeth out (yes, i'm still wqise) but my excellent doctor re assured me that everything would be just FINE. and well, it was for a qhile until my second TBI...i was walking to the bathroom and tripoded over a baby swing, of course i love the baby but her things are always in the way! anywho? i ended up falling face first into the coffee table. it hurt very badly but i managed to gather myself and touched the back of my head and felt blood, just a trickle, but it was still......there.:grouphug:

Maxpower,

So glad to hear that you have survived some major mishaps!! Perhaps your wife is wise not to "help" you with certain things... ?? :)

Thanks for posting!

Bryanna