white stuff coming out of gums after bone graft surgery
 

Hi,

I was told I had to have a bone graft done on my lower left jawbone (#18) due to an extraction of a wisdom tooth I had done over 10 years ago. Why didn't they catch this sooner, I don't know. I have been asking that from my regular dentist and perio specialist before I made the decision to have the surgery. I felt like they did not want to point fingers at one another for an oversight. I did not have any pain at all before they told me this news. After the dentist cleaned the area and injected some clear liquid into the pocket my gums had formed and after the perio specialist poked around the area, an infection formed which forced me to have an emergency surgery.

After the first month, I noticed some white stuff coming out between my gums and tooth. It was soft, not hard like the bone graft material. Yes, I had some bone graft material come out but was told this was normal. OK, so I did not worry until this white soft stuff came out. I went to the perio specialist who did the surgery and was told it was scare tissue and removed it. Was told not to worry. I asked if I could brush on the site with an electric toothbrush and was told at this point I could do anything, eat on that side, brush, floss, just go back to my regular activities. I was also told to push down on the gums with a toothbrush he gave me. When he did this to my gums it bleed and hurt. I was told to do this and eventually the bleeding will stop. I did what was instructed.

I thought I have seen the last of the white stuff but no. It continually comes every now and then. I simply remove it with the toothbrush he gave me. I am in no pain but wonder if this is normal.

I'm I losing the bone graft material he put in there?
Is this white stuff suppose to keep coming out like this?

I hope this bone graft is successful because I had to pay all of this out of pocket ($ 2,000). I don't know what I will do if I had to have another one. I may not have it done due to the fact I barely could afford this one.

Has anyone had a similar experience? Any advice or suggestions would be greatly appreciated.

-P

Hi,

I'm wondering if the white stuff coming out of the gums in that area is pus. Do you have a bad taste at all?

Bryanna

No, I don't have a bad taste in my mouth. The white stuff looks like soggy bits of rice. I smash it with my fingers and there is no odor from it. It appears every now and then. I am wondering if this is the bone graft material that turned from being a hard grainy type substance to this soggy like material. Is this normal? I have more check ups with the perio specialist who did the surgery, but I feel as if he is not concerned about it enough. I don't want to go through this again, in say 3 or 4 months down the road. I'm not in any pain physically just financially. This surgery was a surprise and unexpected. I still cannot believe I had to get it. I only had one cavity in my life.

Any suggestions or advice is greatly appreciated.

Hi p_v13,

Bone graft material is generally hard and does not resemble anything soft or soggy. Also, it is not very common to have bone graft material seep out of a surgical site a month or so post op. So I'm not sure what this is. Sometimes the dentist will put a collagen plug in the site on top of the bone graft... this acts sort of like a blanket to protect the graft and keep it in place during the initial healing phase. This plug is white and spongy.. but the plug actually becomes one with the initial blood clot that forms immediately after the surgery. So I would be surprised if that's what you were seeing.

If it is pus and there is an infection there... you don't have to have pain or swelling because the bacteria has found an opening to seep out. If it is infection and that area closes off, then you would get pain and swelling. However, I am not sure what you have.

By any chance.... could it be plaque? Are you brushing thoroughly in that area?

Bryanna

Hmmmm...interesting. the white spongy plug that you described seems to fit what i am seeing from time to time but then again i am unsure. it's not a large amount that come out but it's enough to alarm me. Also, why does he have me push on the gum lines with a tooth brush? is this suppose to help get the blood to circulate or what? in some areas it is still tender and i do not push hard on the gum lines like he showed me.

Yes, i have been doing my best to keep the area clean. i floss, brush with an electric tooth brush, and rinse with warm salt water. also i clean the area again with chlorohexidine he gave me. I do all of this 3x a day and whenever i eat something. should i be doing more? Any suggestions?

Oh, i wanted to know if part of your gums are suppose to feel numb. when i floss i cannot feel my gums in a certain area. i believe this is the part where he put the stitches in order to hold the flap of gum over the bone graft. will the numbness go away or is this permanent? Should I be alarmed?

Thank you for answering my questions. i greatly appreciate them.
P

Hi p_v13,

The collagen plus that I mentioned is one piece. It does not separate from itself and it becomes engorged with blood from the initial clot. So I'm thinking it's probably not that.

Did your dentist tell you it's ok to use your electric toothbrush? Some dentists suggest not to use it for the first 6-8 weeks post op. Gentle flossing is needed, but don't use the floss too aggessively. Gentle, "thorough" tooth brushing with a very soft bristle toothbrush twice a day, floss once a day unless food debris gets stuck in between the teeth someplace, and salt water rinsing 2-3 times a day. That is really all that is necessary for post op care after your type of surgery.

Every time you brush along the gumline in both the front and back of your teeth, you should have the bristles of the toothbrush at a 90 degree angle along the gumline. Use gentle circular motions around the front and back of every tooth as this mechanical action will remove plaque and massage the gum tissue. Then use the brush in a back and forth horizontal motion along the biting surfaces to clean them.

I think the white stuff is either a little bit of pus or plaque....... that's my guess based on your description of things. When do you go back to see the dentist?

Bryanna

Thank you for your suggestions. I thought that using an electric toothbrush was too soon but asked him more than once if it was ok. I was told yes I could do anything. He didn't seem too worried about the white stuff when he looked at it and gave me the impression that I was worrying for nothing.

I have a 2 month check up with him Dec. 9. I will mention again that I still see the white stuff every now and then. I will also ask if it is plaque or pus. Hopefully he can give me an explaination as to why this is happening. I do not want to go through this ordeal again. I have never had any problems with my teeth before and this one threw me.

If it is plaque or pus, will he just give me more antibiotics and clean the area? Will that get rid of the white stuff? Again, I am not hurting but I do not want to wait til I get to that point and suffer major pains and problems.

Thanks again for your advice. I will let you know what he said.
-P

Hi p_v13,

If it is plaque, he will instruct you on how to clean the area more thoroughly. If it is pus, then he will have to determine why it is infected and prescribe treatment and/or antibiotics accordingly.

Hopefully it is something that is easily remedied. I know this whole thing has been an ordeal for you especially since it was so unexpected! Try not to worry about it.... just keep the area very clean without over cleaning =)

Please let us know what he says on the 9th!

Bryanna

I had my appointment today and thought I share what the Doc had to say. I mentioned all of my concerns especially the white stuff coming out of my gums. He said not to worry about it. I am doing exactly what I am suppose to be doing. As long as I do not have any pains that is keeping me up at night then all of the things happening are normal. He examined me and gave me another "special toothbrush" to continue cleaning the area with. He is satisfied with the progress and will see me in 3 months. By then he will x-ray to see the progress of the bone graft.

It appears I am on the right track with my oral health. Thanks for your replies and suggestions. You have been very helpful.
-P

Hi p-v13,

Well that's great news!! Just curious, did he say what the white stuff was?

Bryanna