irrigating after infection
 

Hi All, how exactly do you do this?

My lower left extraction site has been oozing brown fluid for days and I finally got in today to get some antibiotics, and was told to irrigate the site after every meal. The Dr flushed it twice and a LOT of fluid came out and it felt great. I tried to do it myself recently and dont know if I'm doing it properly as it stung but nothing came out. Do you go at it from the side of the site or do you plug the syringe straight in from the top? thats where mine is leaking from.

Doc didn't say anything about my other extractions (had all 4 removed). Should I be irrigating the other lower site as well? There's no leakage at that site at all but I'm still generally tender in both sites equally.

Thanks!

Hi dydx1,

You will not necessarily get anything to come out of the socket each time you irrigate it. Frequently irrigating the socket will irritate it and slow down the healing. Also, if you do not eat on that side of your mouth, then it is not necessary to irrigate the site after every meal. You should however be rinsing 3-4 times a day with warm salt water until the surgical wounds close over with gum tissue.

Why did he prescribe an antibiotic? Did he say you have an infection? If you are not clear on that, please call his office and ask specifically if he thinks you have an infection. Do not let the reception nonchalantly tell you that it's okay to take the antibiotic... or since he prescribed the meds that it is to assume that you have an infection. You want that receptionist to ask the doctor very specifically if he thinks you have an infection.

Antibiotics are horribly over prescribed and should only be prescribed for infection. Many people assume that antibiotics are a benign medication, meaning no harm can come from taking them. The truth is that antibiotics can cause intestinal problems to occur that are not only uncomfortable but can lead to further intestinal problems that can be difficult to eradicate.

I cannot tell you if you need the antibiotic or not.... only the oral surgeon can as he evaluated you clinically.

I hope this information is helpful.
Bryanna

Thank you Bryanna.

I'm sorry that I wasn't super clear. I had my surgery last Wednesday and this is the worst day that I've had thus far, with headaches and extremely low levels of energy. ALl I've been eating is yogurt and mashed potatoes and am unsure when to start progressing. It's hard to bite because my left cheek (same side as oozing) is swollen and felt like it had a hard lump in my cheek.

The doctor (I think oral surgeon resident) saw me on an emergency basis today and told me it looked like a "little infection". He looked around and I told him my symptoms (almost constant brown and terribly smelling/tasting liquid oozing from the socket). He flushed it twice and told me to do this many times and that the more I did it the better. He gave me amoxicillin and metronidazole to take for the week. I'm not used to taking pills and two at a time is a lot for me. I stopped taking the ibuprofen that I was prescribed because I didn't want to be managing 3 kinds. I feel as though, like I said, that the pain I'm getting is fairly equal between the bottom two sites even though one is causing me a lot more trouble ooze wise than the other. Maybe I need to keep taking the ibuprofen.

Thank you for your wise insight. My biggest goal is to get some energy back and to start trying new food. That constant gross taste in my mouth has made these last 6 days especially difficult. I hope that things start to turn around quickly.

Sorry to double post. I noticed also when he flushed me that I can see a white spot in the hole (bone?) should I let the stuff ooze out or should I be trying to bite tea bags and form a clot?

dydx,

There are many things you can eat that are soft as limiting your diet to a couple of foods is not nourishing and that is one reason why you have no energy :/ You get nutrients from the foods that you eat... the less variety of whole foods that you eat the worse you are going to feel.

Google soft food diet and you will come up with lots of healthy choices. Eggs, apple sauce, sauted or boiled vegetables, any fruit (no seeds), oatmeal, hummus, baked chicken or fish, sweet potatoes, soups, stews, smoothies, shakes, soft cheeses, etc.,

You need to be seen by an oral surgeon for a proper evaluation. Did you have the extractions done at a dental school by a student?

Your description may indicate a dry socket which needs to be treated by the oral surgeon. He will pack the site with a clove smelling medication that will need to be changed every couple of days by him until the site starts to heal on it's own. Irrigating it at home will not heal that condition and can cause the socket to become even more dry which can result in an incomplete healing of the bone. I'm sorry but the "dentist" that you saw today was not correct in his suggestion about the irrigation.

The pain meds are not going to cure the problem either. They will reduce the inflammation temporarily but the best remedy is to have the socket treated by the dentist. He should also check the other lower socket also to make sure it too is not a (milder) dry socket.

Don't be afraid to expect to see the oral surgeon. You need to get the proper treatment and should not have to suffer like this. Remember, the squeaky wheel always gets the oil!

Bryanna

dydx,

That white spot could be the bone.... indicating a dry socket that needs to be treated by the oral surgeon. This indicates that the clot either did not form properly at the onset or it was disturbed early on.

You are not going to form a clot because the stuff oozing out is blood filled with bacteria. The site needs to be treated as I mentioned. He may need to debride the socket and get some blood flowing in there to deliberately form a new clot. That is not something you can achieve yourself at home.

Please go back and see the oral surgeon.
Bryanna

Thank you so much Bryanna.

I had all 4 extracted at the hospital by a qualified oral surgeon. HOwever from here on out if I have difficulty the person who sees me is a oral surgeon resident (student?) as he takes all the emergency appointments or fit in appointments I guess. I called the nurse this morning and she told me my surgeon wasn't in today and didn't tell me when he would be in. I asked if I could have a follow up and that was her response. I think she's getting annoyed. I think he only works once a week so maybe tomorrow he would be in. Should I wait until then to go down?

Since he irrigated that problem socket I no longer have pain and the oozing is very minimal. I haven't been irrigating it myself because I have no confidence in doing so. I try to spray some salt warm water on it but am not confident digging into the wound that isn't healed.

Now, the problem is my OTHER lower socket (seems strange that this would happen since yesterday when I saw the resident) is oozing the way my left one was and I can feel some pressure/ mild pain but nothing that has required ibuprofen overnight.

Do I just let it ooze out? Do I go back down and see the resident today (nurse said he will just flush that one) or take my chances and wait until tomorrow and HOPEFULLY (but still maybe not) catch my actual surgeon.

I'm very panicky about this because I'm going home for the holidays in under a week. And am confused because my gut feeling was that the irrigating was going to leave me with more problems (that lower left socket seems to be "sunk" down a lot now compared to the one on the right that's oozing) which you also think too.

And thank you for the food suggestions. I guess I have somewhat been starving myself because I'm so paranoid about getting food in the infected wounds (and that I have braces and chewing is generally difficult anyway) but I need to take more chances.

Hi dydx,

Extraction sites will generally ooze for the first 24-48 hours after the extraction. If the sites are still oozing a week later, that is not normal. I can only share with you what I know from my extensive dental experience as a chair side assistant and tell you what I would do if this were me. I would make it very clear, irrelevant of how annoyed someone gets, that I want to be evaluated by the oral surgeon who did the surgery. It is a good sign that the original site is improving, but not normal for the other side to start oozing at this point.

Common sense should tell any dentist that the average patient is not going to be comfortable or confident in irrigating an extraction site that is painful. So it is not your fault that you feel this way and should not be made to feel that way.

When you rinse with the warm salt water. rinse aggressively so as to be thorough and productive with the rinsing. The motion of rinsing can dislodge most debris that is caught in the wounds. If the wound is infected at the bone level, then all the rinsing in the world is not going to reach that area.

Your new symptoms on the one side are not normal for this time of healing. You should have all 4 sites evaluated by the original oral surgeon.

Braces and extractions and eating ..... oye. It is so imperative that you keep your mouth as clean as possible with brushing, flossing and tongue scraping. i know it's hard to clean your teeth with the braces on but spend the time using every gadget that you have to clean your teeth. It will be so worth it in the long run. Also, put some more effort into what you can eat that is soft and nutritious. Veggies, fruits, smoothies..... lean protein are your best options. I know this is difficult but please don't give up and crawl under a rock hoping this will all go away. You want to heal properly so that you do not end up with any additional problems down the road.

If you end up seeing the resident, I would suggest that you make it perfectly clear that you know your symptoms are not typical and would have appreciated if the oral surgeon had followed up when problems occurred and you want him to know that this is how you feel. This does not have to be done in a mean or suspicious manner... just being deliberate and matter of fact will get your point across. Believe me, you have every right to feel this way.

Make sure all 4 sites are checked especially since you plan on traveling soon.

Please check back when you can...
Bryanna

Hi Bryanna,

I took your advice and got in to see someone today. They told me my oral surgeon would "pop in" but he didn't. I got a different oral surgeon resident. He gave me a more thorough run down than the previous resident did, and told me that I wasn't infected but that I had food stuck in the site that recently started oozing. He felt my gumline and jaw and said that I was recovering. Said my top ones were doing great.

Told me to continue to take the antibiotics still. I''m on 500mg of amox and 500mg flagyl and wondering if I can take flagyl once a day instead of twice or if this will harm me in the long run if I do this. It gives me headaches and makes me not want to do much of anything. Honestly by the time I get in to see someone it's bene hours and I'm in a state of confusion and drowsiness so I forget to ask some of these questions that I wish I had asked.

Other than that I haven't had any pain in the extraction sites last evening, overnight, or yet today. I guess I have to keep irrigating the sites which I'm still not comfortable doing but since food got stuck in one I guess I have to kep doing it. He said that they appeared to be clotting underneath, when he flushed the left one all that came out was pure fresh blood.

But I still have small holes and he said to continue with a soft diet but didn't say for how much longer. How will I know when I'm good?

Thank you for following me on tihs Bryanna. I can't wait to get off these pills and to have those holes on the bottom filled in so I know I won't have to deal with dry socket on top of all of this i nthe coming days for christmas.

Hi dydx,

Stay on a soft food diet until the holes are completely closed.

Irrigate gently with the syringe and then rinse aggressively to be thorough in flushing out food debris.

I cannot comment on the dosage of the flagyl. I suggest you call the pharmacist, tell him how it makes you feel and ask for his opinion. I do think that your diet is playing a key role in how you are feeling. You have not had much nutrition since the extractions and your immune system is becoming weak. Add the stress of all this and the antibiotics to the mix and I can see how you would feel so lousy.

Please make an effort to eat better and more often. Make sure to drink lots of filtered water throughout the day as this will help to flush the toxins out of your system. You will know that you are drinking enough when you have to pee more frequently :) and stick with it.

Avoid sugar and all soda, even diet soda as these things are toxic to the immune system. Eat whole fresh foods.... fruits, veggies, eggs, etc.

Keep us posted...
Bryanna

Thank you again Bryanna, it is so useful to hear from you on here. I just had a good breakfast with my Flagyl and am feeling not as impacted by it.

Do sandwiches count as soft food? I don't want to push it too much because my gums are a little red/inflamed along the side of my teeth from the left side but they do appear to be improving. A lot of that white sloughing skin around too (which I hear is a good thing).

Also when I syringe I'm not getting much food but there seems to be a lot of brown stuff. Looks like old blood. Should I let this stuff stay in there to help it heal or get it all out of there?

Is it bad to use listerine strips that dissolve on my tongue? What about mints? My breath is horrid.

Hi dydx,

A sandwhich is not considered soft food because they require you to open your mouth wide, require you to pull with your lower jaw to bite off a piece of the sandwich and require a lot of chewing.

Soft foods are the consistency of eggs, cooked or stir fried vegetables, soft meat like stew meat or baked chicken, fish, potatoes, yogurt, fruit.....

That brown stuff coming out of the socket still concerns me especially if it is a lot, as you say it is. Because the sites seem to be improving, I would say to keep irrigating as you are and lets see if that stuff decreases over the next couple of days.

The white sloughing skin should also be diminishing. Do not overuse the salt. You only need a pinch in a bathroom size cup of water to rinse with.

DO NOT use any mouthwash (never anything listerine) because the harsh ingredients are very irritating to the gum tissue and can dry out the socket. Listerine and products like it, mouthwash or other, never have any positive therapeutic benefit whatsoever. They kill ALL of the bacteria, both good and bad which predisposes the user to gum problems and tooth decay.

If you want to freshen your breath, buy some peppermint oil and put it in your salt water rinse. Sucking on mints, which contain sugar or a sugar substitute along with other ingredients are not advisable as they too will be irritating to the gum tissue and can dry out the sockets. They also predispose the user to tooth decay.

If you brush and floss your teeth thoroughly and scrape your tongue once or twice a day, your breath will improve.

Bryanna

Okok, I guess I was just HOPING that I could eat a sandwich!

My gums appear to be improving. The bitter tasting fluid is not constantly oozing, it appears to be getting less and my breath appears to be improved even since yesterday, since I really tried to irrigate that socket, but there is still the taste.

However... if I really want to make it ooze I can do so. I've found that if I irrigate the holes, the fluid comes out a little bit. It seems to pool in my back molar when this happens. So then I irrigate again and more comes out, and then stops. But I can't keep doing this because I did make the gum bleed also at one point on the outside near the molar.

I can keep irrigating and get it all out but at what point does that start to damage the healing process also? I mean my left lower socket looked good and empty but if I irrigate it a couple of times I can get the brown stuff to come out of there also and pool in my back molar.

Sorry Bryanna, I will try to post less frequently after this one, I am hogging you here. You have been a tremendous support though as I feel that the nurse and surgeons hope to never hear from me again. I am flying home for the holidays shortly, and I run out of my antibiotics on Sunday. Hoping to get it under control before then, or realize that this is "somewhat normal" but doesn' tsound to be despite the two residents not being concerned.

Hi dydx,

I am concerned about the constant oozing from the socket. There should not be much if anything really oozing out of there. It sounds like the one socket that fills up is still not healing. If this oozing does not stop by monday, I would get it checked again. If you still have the problem when you get home... perhaps a visit to an oral surgeon who is in private practice would be a good idea.

You can post as often as you like.... I try to check in at least once a day.

Bryanna

Hi Bryanna, your help as always is much appreciated.

I would say that at this point it is not oozing, the taste is still diminishing, but when I irrigate I can get that discharge to come out. It's not a whole lot but again I'm careful and not sure how much to be picking at it. Like I mentioned I can keep irrigating it but I don't know how to balance the line between getting stuff out and causing more damage by irrigating the holes 2-3 times with a full syringe in a short span of time. I'm trying to avoid giving myself dry socket at the same time as trying to figure out this liquidy stuff.

Apart from irrigating the holes themselves look fairly normal ( I would think), I don't experience pain just the general tenderness when I speak or smile too big sometimes. They don't look bright red or anything like that. The holes were cut in such a way that it's quite hard for me to see in there.

However I am pretty nervous. I don't like wondering whehther they are healing or not and want to enjoy my time home. Do you thikn that this would warrant an emergency call to the OS resident on call? I would hate to do that. Both times I saw them I got that vibe that I was overrreacting. My other option (I leave tomorrow AM) is to see my general dentist at home over the holidays. Believe it or not where I come from we do not have an oral surgeon, you have to fly out of province (to where I live year round).

Hi dydx,

I do think you should see the dentist when you get back home. Another set of eyes is usually a good thing :)

Regarding the irrigating, just irrigate after you have eaten a meal. One syringe full should be good. If you feel like you have something caught in there, then irrigate it again. But honestly, at this point most people are not still having to irrigate the sockets. So I don't want you to over do it and disturb the healing.

The fact that they are not oozing and you have no real pain are good signs.

I don't want you to feel like you are being unreasonable about this going on for so long. I think you have had legitimate reasons to be concerned and need to monitor this very carefully.

Have a great time with your family and hopefully you will not have any further problems!

Bryanna






QUOTE=dydx1;1114053]Hi Bryanna, your help as always is much appreciated.

I would say that at this point it is not oozing, the taste is still diminishing, but when I irrigate I can get that discharge to come out. It's not a whole lot but again I'm careful and not sure how much to be picking at it. Like I mentioned I can keep irrigating it but I don't know how to balance the line between getting stuff out and causing more damage by irrigating the holes 2-3 times with a full syringe in a short span of time. I'm trying to avoid giving myself dry socket at the same time as trying to figure out this liquidy stuff.

Apart from irrigating the holes themselves look fairly normal ( I would think), I don't experience pain just the general tenderness when I speak or smile too big sometimes. They don't look bright red or anything like that. The holes were cut in such a way that it's quite hard for me to see in there.

However I am pretty nervous. I don't like wondering whehther they are healing or not and want to enjoy my time home. Do you thikn that this would warrant an emergency call to the OS resident on call? I would hate to do that. Both times I saw them I got that vibe that I was overrreacting. My other option (I leave tomorrow AM) is to see my general dentist at home over the holidays. Believe it or not where I come from we do not have an oral surgeon, you have to fly out of province (to where I live year round).[/QUOTE]

The bottom two sites are doing well, I haven't had any oozing and it doesn't seem like there is much food getting stuck in there. The sites have shown some noticeable closure but there are still smallish holes and a large indent. No oozing since my last post.

I do have a little bit of redness of the gum in between my last two molars on both bottom sides. is this still normal at this stage? I haven't been flossing between there. It seems like sometimes some food gets stuck in there so I've been using the syringe to wash it out.

So I have been doing pretty well. However the last few days one of my upper extraction sites feels almost swollen-like. There isnt any pain but it feels different than the other sites in my mouth. For that extraction the tooth was coming down straight but hadn't yet erupted the gums, I think it was just above the gum line. My molar that is next to the extraction site has a filling, I'm not sure if this is relevant or not. Actually the molar in front of that one has one too.

I notice when I talk or smile certain ways that there seems to be some kind of suction going on between my cheek and that area and it brings a weird sensitive sensation that is quite sensitive and bothersome. This just started happening the last few days. Again, it's not paining but there is a general swollen or discomforting feeling back there and that suction or part where my cheek pushes against it when my face moves certain ways makes the area really sensitive. It's hard to describe the feeling. When I rinse sometimes it feels better but sometimes it feels tender when swishing in my mouth. I'd say the discomfort has been happening more often than not. Not discomfort as in pain but in tenderness/swollenness or something.

I can't really see back there, if I stretch my cheek as far as I can and try to see it from the side I just notice white stuff back there and white stuff on the other upper extraction site. They look the same from what I can see, but I can't get a good angle at all.

What could this be?

dydx,

The redness between the molars is probably plaque. Please try to floss in there or buy some interdental floss picks.

I don't really know what that suction feeling could be. However, the white covering on the both upper extraction sites is either plaque, a sloughing off of tissue or a little fungus growing. Take a clean q tip and gently see if the white comes off easily. If it does then it's plaque or sloughing tissue.

Are you rinsing with anything other than salt water?

Bryanna