Infection after extraction 3 weeks ago
 

Hello, I'm Nikki and new here so please forgive me if I post in the wrong place etc. :)

I had a bottom molar extracted just over 3 weeks ago which was a tough cookie to get out. I was left in a lot of pain, 3 return visits, a bit of tooth left behind and I finally though last week was the tipping point and things were healing nicely. I noticed a few days ago the gum area over the extraction site seems 'high'; this then developed into a fleshy lump which was higher than its neighbouring teeth. I started to feel a throbbing and mild stabbing pain in my cheekbone today so I got an appointment at my dentist who diagnosed an infection and put me on a course of antibiotics for 5 days. There is pus in the lump which can be manipulated out which he did but now it seems full again.

I am a little concerned as I have had teeth out previously (2 for a brace as a teenager and one upper wisdom) with no trouble at all. I would like to know why it has become infected? Is it normal for the gum or tissue to appear to have grown over the extraction site so quickly as only 11 days ago I had a the last irrigation and packing. Will the antibiotics work or do you think there is something underlying that needs to be addressed? I had an xray a week after extraction which revealed the tooth fragment but nothing else. I will be honest in saying I have not really brushed the extraction area as it was so tender; could this have caused the infection. I also stopped rinsing after things felt better around 11 days ago.

Thanks in advance for your help :)

Also, I have a partially erupted, compacted and decayed wisdom tooth which is behind the extraction site and due to be extracted by an oral surgeon at the end of May; could this be the cause of the infection? Thanks again!

Hi boogagirl,

I am in the dental field and can offer you some information here.

Based on your description, the dentist did not complete the extraction as he left a piece of the tooth in the socket and that is what is most likely causing the infection. Antibiotics cannot cure this infection because the piece of tooth is covered in bacteria and it is keeping the infection alive.

The decayed partially impacted wisdom tooth is also contributing to the infection. It is a shame that both teeth were not removed at the same time by the oral surgeon, not the general dentist, as that would have been more sterile and thorough resulting in a less troublesome post op. Now you have to endure another surgery. Why was it done this way?

It is important to keep ALL of your teeth clean so that plaque does not accumulate on them as the build up of plaque will lead to further infection. Do not brush the extraction site itself, just all of your other teeth. Rinse 3-4 times a day with warm salt water to help flush the debris from the wound. Do not use mouthwash as the chemicals are not therapeutic and will irritate the oral tissue.

It would be wise to see if the oral surgeon can get you in sooner while you are taking the antibiotics as they would help with the surgery and post op healing.

I hope this information is helpful to you.
Bryanna

Thanks for replying Bryanna. I don't think I made my situation that clear so I'll try to clear up a few things here:

Mid April, tooth was extracted

2 days later return to same dentist, irrigated and packed

2 days later return again, told had dry socket, bone scraped and hole packed

3 days later, in agony went to different dentist as mine was closed, they did xray and saw piece of tooth left and suctioned it out, irrigated and dressed wound.

Week later, returned to new dentist, he confirmed no infection, put bit more antiseptic in and advised to leave alone to heal.

10 days later, fleshy lump and throbbing appear. Go to old dentist as new one is on holiday and he confirms infection. Gives me 5 day course of 500mg amoxicillin. I am on day 2 of the course now.

I don't know why the two teeth weren't arranged for extraction at the same time by the oral surgeon who is due to attend to the wisdom tooth at the end of May. I think he wanted to fill the now extracted tooth but it was too deeply decayed. He struggled with the extraction.

The extraction site is fully healed over as in there is no visible hole just a spongy area that is swollen and pus filled. I have put photos for you to see. It seemed to heal over the top of the hole within 5-7 days of the last visit to the new dentist, is this too quick? I am wondering if it over healed and some food etc was left in the hole causing my new infection?

Am I likely to get another infection when this clears as there may be food etc inside? Should the lump be lanced? Also the wisdom tooth won't be out for some weeks. I don't think I can get in any sooner but am going to try!

I am brushing my teeth twice a day and have started rinsing again with salt water. I have recently started gently brushing around the extraction site and over the bump, should I stop this?

My main concern is a recurring infection and if this is dangerous? I am otherwise in good health, don't drink very often and don't smoke.

I do need 2 fillings on the opposite side of the mouth which are booked in, I would have had them sooner but my mouth has been through a lot :(

Still have niggling pain at the moment, no temp or other swelling and the pus lump has reduced slightly in size and redness. I do feel rather tired and my arms are aching.

Thanks for you advice in advance.

Nikki,

Thank you for posting the photos.
You explained it fine in your original post but thanks for sharing more information.

There should be NO pus and it should not look like raw meat. That lump is a concern and not normal healing.

Everything you describe is evident that the original dentist did a poor job at extracting that tooth. For another dentist to find a piece of tooth in the socket after the site was scraped at least twice by the original dentist after the extraction ..... says a lot about the dentistry being done by the original dentist. Please find a new dentist!

Please stop brushing the wound and that lump. There is a bad infection there and brushing it will transfer the bacteria elsewhere. If you can please do everything you can to get in to see the oral surgeon asap. This should not wait. Do you live in the UK? If you can get in earlier, is there any way you could go to a private practice oral surgeon and pay out of pocket? You really do have a serious infection that should not be put off and it needs to be treated by an oral surgeon not a general dentist or a clinic of inexperienced dentists.

The pus is now draining which is keeping the pain down and the exterior face from swelling. However, the area where the pus is draining from can close off from the inflammation and then you will have pain and swelling.

If this were me, I would call a private oral surgeon practice and tell them you have a severe infection as a complication of a recent molar extraction in the area of a partially impacted wisdom tooth. They do not need a history of what took place, only that there is pus oozing from the site and a huge lump. It is important for you to know that the antibiotics cannot cure this problem. The meds can only temporarily subside some of the inflammation but that will return with a vengeance. Please get in to see the oral surgeon.

Bryanna

[QUOTE=Bryanna;1141089]Nikki,

Thank you for posting the photos.
You explained it fine in your original post but thanks for sharing more information.

There should be NO pus and it should not look like raw meat. That lump is a concern and not normal healing.

Everything you describe is evident that the original dentist did a poor job at extracting that tooth. For another dentist to find a piece of tooth in the socket after the site was scraped at least twice by the original dentist after the extraction ..... says a lot about the dentistry being done by the original dentist. Please find a new dentist!

Please stop brushing the wound and that lump. There is a bad infection there and brushing it will transfer the bacteria elsewhere. If you can please do everything you can to get in to see the oral surgeon asap. This should not wait. Do you live in the UK? If you can get in earlier, is there any way you could go to a private practice oral surgeon and pay out of pocket? You really do have a serious infection that should not be put off and it needs to be treated by an oral surgeon not a general dentist or a clinic of inexperienced dentists.

The pus is now draining which is keeping the pain down and the exterior face from swelling. However, the area where the pus is draining from can close off from the inflammation and then you will have pain and swelling.

If this were me, I would call a private oral surgeon practice and tell them you have a severe infection as a complication of a recent molar extraction in the area of a partially impacted wisdom tooth. They do not need a history of what took place, only that there is pus oozing from the site and a huge lump. It is important for you to know that the antibiotics cannot cure this problem. The meds can only temporarily subside some of the inflammation but that will return with a vengeance. Please get in to see the oral surgeon.

Thanks Bryanna.

So what is causing the infection 2 weeks after the tooth that was left behind has been sucked out? How will an oral surgeon treat this differently to a general denist? What else will they do other than offer me antibiotics if there is nothing else left in the hole? Sorry for so many questions but I am worried now.

Nikki,

The original dentist may not have cleaned out the socket adequately and/or the infection was more extensive than he diagnosed. I think the partially impacted wisdom tooth is also partly to blame as it too may be infected as bacteria and food debris has been seeping in and living underneath that flap of tissue covering part of the wisdom tooth for months or even years. The depth of that bacteria has not be determined but that tooth could actually be locking in the infection. Also with the extraction of the molar and then each scraping of that area more bacteria has been getting stirred up. That is why I asked you why both teeth were not removed at the same time as that may have avoided this problem. But because the general dentist is not trained to remove the wisdom tooth he just took out the molar and had a hard time doing that.

A general dentist is not trained to remove partially impacted wisdom teeth especially those that are infected. They don't have the experience or proper instruments to handle this type of extraction. An oral surgeon is extensively trained and experienced with these extractions and the infection that is brewing there.

There are other risk issues associated with this type and location of infection of which I am not going to get too deeply into here. But the longer you wait the more likely may need an incision and drainage prior to the removal of the wisdom tooth if the infection and swelling gets much worse.

I hope I have explained the problem clearly. If not, let me know.

Bryanna




Thanks Bryanna.

So what is causing the infection 2 weeks after the tooth that was left behind has been sucked out? How will an oral surgeon treat this differently to a general denist? What else will they do other than offer me antibiotics if there is nothing else left in the hole? Sorry for so many questions but I am worried now.[/QUOTE]