Delayed Wisdom Tooth Infection
 

I had all 4 of my wisdom teeth removed in November 2014 and that went as well as expected. I made a full recovery in about 2-3 weeks. In the beginning of January 2015, I noticed pain and swelling in the area where my bottom right wisdom tooth was removed. I though maybe I had some food or something stuck back there so I tried rinsing with mouthwash a couple times a day for a few days. Swelling and pain didn't improve so I made an appointment with my Oral Surgeon. I went in yesterday and he said that I had a little pus. He said it was infected. He gave me a little novocain and re-cut open the area and scraped all of the infection out(most painful thing I have ever experienced in my life) and rinsed the area with saline. I was in tears throughout the entire procedure and was in excruciating pain for the next 4 hours-constant tears. Luckily, I had some leftover pain meds from my wisdom tooth extraction. I almost ended up in the ER. Also- My cheek is SOOO swollen and bruised today. It looks like I have half of a tennis ball sticking out of my jaw. My question is: Should've my doctor given me a little anesthesia or laughing gas? Like I said, he did give me 2 shots of novocain, but they didn't do much for me. Also, do doctors normally prescribe pain medicine after a procedure like this? Is the amount of swelling I have normal?

Hi rmlballer,

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

The actual physical oral recovery from wisdom tooth removal is longer than 2-3 weeks. The gum tissue may appear to close over sooner than that but there is usually a small opening, like a slit, for several weeks where food can get trapped in. Food impaction and plaque accumulation can contribute to an infection. Careful eating and regular salt water rinsing until the surgical wounds have closed completely can prevent food impaction. As I said, it can be deceiving if the gum tissue looks like it's closed all the way when it's really not. So maybe that is what happened in your case.

Just a word about using mouthwash. Products with ingredients similar to Listerine actually contribute to oral health problems. The chemicals reduce the flow of saliva and they kill both good and bad bacteria. All of which are irritating to the oral tissue and throat, can also lead to mouth sores, infections, gum disease and tooth decay. It is best to not use these types of mouthwash at all, especially when you have surgical wounds in your mouth. The most therapeutic mouthwash is good ole warm salt water of which you could add a pinch of peppermint oil.

The reason the local anesthetic was not very effective for this procedure is because infectious bacteria is acidic, whereas the anesthetic ingredients are alkaline. So the acidity in the bacteria overrides the alkaline. He basically gave you the anesthetic to numb the top of the gum tissue to make the incision and also used it as a neutral disinfecting solution while debriding the socket. The saline rinse afterwards is used to flush the debrided socket clean.

Post op bruising from this procedure can occur. Some swelling is expected however it should not be real significant other than when you wake up in the morning for the following day or two. This swelling is because you've had your head down all night. Try sleeping on an extra pillow and see if that helps. If you feel unwell, develop significant inside of your mouth or a lot of swelling during the day, develop a fever or intense pain, see the oral surgeon.

Some dentists prescribe pain meds or antibiotics after this procedure, others do not. Generally the patient feels significantly better by the 3rd day after this procedure. So if you have concerns that something is not right, don't hesitate to call the oral surgeon.

Bryanna