Dry socket causing lump on jaw?
 

I had all 3 of my existing wisdom teeth removed 2/24/16. One lower and both upper. The lower developed dry socket. I have been treating for a week with the clove gel product Sockit, though I ran out this morning. The dry socket is improving, but still bothersome. Especially the cavernous hole. I haven't eaten solid food in nearly two weeks. The dry socket apparently has a gravitational pull. I tried to eat a steamed carrot one night and got a ginormous carrot piece stuck in there for a day. I haven't tried to eat again.

My questsions are:

It's been a week since I saw the surgeon for dry socket, how much longer will this hole of doom last? Do I need more Sockit? The pain has not "peaked" in two days.

There is a very painful and tender lump on my jaw line just below the dry socket. It feels hard and is very painful to touch. Is this just normal swelling or should I be concerned that I have yet another complication? I really might cry.

Thanks in advance!

Hi snowclover,

Lower wisdom teeth extraction sites can take several weeks to heal closed. However, the tender lump on your jaw line is concerning. What did the oral surgeon say about this lump? Has the surgeon taken an xray since this tooth was removed?

Bryanna

I haven't talked to the oral surgeon since he diagnosed my dry socket a week ago. Since that appointment, the swelling has gone down and the pain deep in the socket has diminished enough that I just noticed the painful lump. That's why I was wondering if it was the result of the dry socket or if I should go in again. I'll call in.

I saw the oral surgeon. After her determined that there were no signs of infection he didn't think that X-rays were necessary and that it felt like scar tissue to him, and that it would become less sensitive and maybe go away in time.

I have fever and discharge at the incision site now, so definitely infection. I'm heading back in tomorrow. Updating for future googles.

snowclover,

Please tell the oral surgeon to take an xray of that area.
Keep us posted.

Bryanna

He insisted there was no infection and what I was seeing was secondary healing. He assures me that everything looks great, the giant painful lump is scar tissue that I need to massage away and all of my pain is from the trauma of the extraction. No X-rays. It's been 31 days since my extraction, I am still using Sockit, heating pads and Ibuprofen to function. I feel like I'm being dismissed while simultaneously assured to call if I have any concerns. I do have concerns! I have been seen four times post op for pain, told everything looks fabulous and tut tut go home now. I am at a complete loss. Will this pain ever go away?

Snowclover,

Unless the oral surgeon has xray vision allowing him to see into places that are not visible to the eye... he cannot say for certain that there is no problems occurring in the bone or the socket.

You need an xray.

Bryanna

Bryanna,

Thank you for your encouragement. I returned to the oral surgeon again. My face had swollen so huge and was hot to the touch that the infection was pretty evident. He did finally do X-rays where it was determined that I did indeed have a very large and very infected abscess. Emergency incision and drainage was performed yesterday and aside from healing an incision and stitches again I feel so, so much better.

I'm not mad at the surgeon, I think he truly believed I was not infected, but I did learn I should have trusted my instincts and advocated for myself more. I knew it was an abscess for weeks before it was treated.

Thanks again Bryanna.

Snowclover,

To be honest, I would be upset with the oral surgeon if I were his patient and he didn't xray the area when the lump was first discovered. There really was no excuse for him not to take that xray at that time. He could not rule out infection just by taking a clinical look at it and he knows that.

I'm glad you have finally gotten some relief.... but the I&D is no picnic and now you have additional healing to do. I hope it goes well for you.

Yes, please in the future trust your instincts and don't hesitate to make your concerns clear especially when there are obvious signs that something is not healing normally.

Hope your healing is uneventful from this point forward.

Bryanna

I've done a bit of research and learned the risks of untreated abscesses which were not explained to me and I am a bit freaked out.

I'm hoping for an eventless recovery from here as well though I'm terrified of the abscess returning because it was not packed or a drain was not placed. I've lost quite a bit of weight this month being unable to eat and the fear of something going wrong again is terrible.

The stitches from the I&D are very painful and I sleep more than I'm awake to minimize any risk of the abscess returning. I still have referred pain to the ear nearest the abscess and the stiches are so painful I dream that I'm chewing on broken glass most nights. How long is an average I&D recovery? My follow up is in 5 more days and I'm long since out of sick leave so I'll be at work like this all week.

My advice to anyone who discovers a painful lump; demand an X-ray!! It was so much smaller and less painful when I first noticed it. This has been very painful and frightening.

Thank you Bryanna for taking the time to help me and others. I'm afraid to think what would have happened if you hadn't encouraged me to demand an X-ray. :hug:

snowclover,

It's best that you don't research about jaw abscesses because every case is a bit different and is treated accordingly. So what you may be reading may not fit your situation at all.

I did not discuss abscesses with you because it may not have been an abscess at the onset and I did not want to alarm you unnecessarily. That is why I kept stressing to have the xray done.

The area will be sore from the incision and the sutures. Keep in mind that there is an infection which causes a great deal of inflammation. So the area is "heated up" to begin with. Making an incision in a hot inflamed area is going to result in soreness :(

You need to keep the area clean. Did the os recommend salt water rinsing? If the salt stings, then just use warm water to rinse with. NO mouthwash.

You can also apply moist heat (comfortably warm) to the outside of your face over this area a few times a day. The moist heat draws the blood to flow into the area which can reduce pain and swelling and speed up the healing.

You need to watch for swelling, fever, or an increase rather then decrease of pain within the next 2-3 days. If any of those develop, do not hesitate to get back to the oral surgeon. Just a note ... if this os is making you feel put off or that he's not concerned about this infection, please consider consulting with a different oral surgeon. You would need pre and post op xrays to see a new surgeon.

Bryanna

I didn't mean to imply any kind short coming with your advice, you probably saved me! I'll stop googling because it is scary!

I am doing salt water rinses and will watch for this things. Thank you again!

snowclover,

I didn't take anything that you wrote to me as offensive in any way. Because I cannot communicate on anyone elses behalf, I try to provide enough information for someone to act as their own advocate. Your dental situation is not uncommon to anyone in the dental profession and each time I see this happen I feel badly because someone (respectfully) puts more trust in their dentist than they do their own instinct.

How are you today? Do feel things are staying status quo or improving?

Bryanna

Bryanna,

I'm honestly not sure if things are improving. Today is 6 days post i&d so maybe it's still early. I have a follow up Friday morning and I have a few issues I want to mention to the surgeon, but I am concerned that they will again be attributed to the "trauma of surgery" and told to give it more time.

I've stopped taking any pain medications because I have been feeling very faint and weak. I feel generally unwell so I cut the oxycodone because I was afraid it may be contributing in some way. I am on day 7 of Amoxicillin 2x a day, but do still have a low grade fever some nights.

The area where the abscess was is not painless. Maybe it's too soon to expect that. There is a small, hard pea sized lump that is very, very tender to the touch and still throbs in pain sometimes with little shocks of pain down my throat and into my ear. The pain behind my ear is fairly constant and distracting. I don't know if it's from a tight ligament, or referred pain, or if I should mention it to the surgeon at all. Any thoughts?

The last thing that I'm experiencing is pain where the stitches pierced my gums and extreme temperature sensitivity in the nearby teeth. The oddest part is that I have the same issues on top of my mouth at one of the other extraction sites that I have not had much time to focus on since the dry socket and infection. (The one directly above the problem extraction) It feels like there are stitches left in my upper gum sticking out and the holes there and below from the i&d are incredibly sensitive and painful. Maybe they just need more time to heal too. I've never had stitches outside of this and had no idea they would be so painful!

I would be happy to hear that all of this just needs more time. I plan to see a general practitioner if the faintness doesn't improve because I've struggled to work and take care of my kids this week! Hoping an end is in sight. Thanks again Bryanna, I wish I could send you some chocolate or something. :hug:

Heather

As an additional update: the incision reopened a little somehow (I think it was completely closed) and a lot of blood and pus came out so I guess it's still infected which may explain the pain. I've cleaned with salt water rinses until nothing continued to leak out. I have an appointment with my GP in the morning and the oral surgeon Friday morning so hopefully this isn't a setback in healing.

snowclover,

The incision opened most likely from the pressure caused by the inflammation and infection. Obviously you still have an infection. Releasing the blood and pus will bring some relief. But it may only be temporary. The infection that developed in the jaw bone after the extraction, which could be correlated with the original infection from the tooth... had time to advance because it was not treated early on after the extraction. So the infection may be fairly deep which means you may get some noticeable filling up and draining several times. The problem with a draining oral infection is that as long as there is an opening it will tend to drain more than you are even aware of. This means that you are digesting the bacteria... so that could be one reason why you are feeling so poorly. However, to close up a draining infection could result in more severe problems. So that would not wise to do if in fact it is still draining.

Also, the antibiotic may not be the proper one for this infection. The only way to have known which specific antibiotic to prescribe would have been for the oral surgeon to take a swab of the pus at the time of the I&D and have it cultured. Once on the antibiotic, the culture may be a bit skewed.

It is good that you see your physician so that he has this on record for you, However, he is not going to know how to treat you for this oral infection. He is not educated in dental issues at all. Even those infections that have become a systemic problem. The oral surgeon needs to take this infection seriously and explain to you what is going on and how he plans on taking care of it. Tell him how awful you have been feeling. Leave out NO details.

Keep rinsing with the warm salt water. Also apply moist heat to the outside of your face a few times a day to get the blood flowing in that area.

Please let us know how things go tomorrow.
Bryanna

I am back with the first happy update since February! The oral surgeon gave me a final 10 course of antibiotics as well as a surgical grade mouth wash. The pain is almost gone, it still can get sore if I move my mouth in a way that's uncomfortable for the considerable scar tissue. The ear and jaw pain is gone. My energy is back to normal, and now that I'm here it's easier to see just how very sick I was. I could barely get to work. Pictures of me since February look pale, sunken and very ill. I'm so grateful to have this behind me (knocks on wood).

Bryanna- Thanks for all of your encouragement and advice!! ((Hugs))

Lessons learned:
TRUST YOUR INSTINCTS!! IF you feel really sick, you probably are! Demand tests, labs and X-rays before you allow someone to dismiss your concerns!

Thank you again!