Abscess after extraction
 

Hello...I chose to have an extraction rather then root canal on a back molar with infected roots. About 2 weeks before the extraction, I noticed a painless white pimple on the gum below the tooth. I was put on antibiotics for 7 days and a week later, had the extraction. It was not an easy extraction, it took a long time, with lots of cutting of the tooth and whatnot. I felt no pain during the recovery period, only the unnerving feeling that something, like cotton, was stuck between my lip and my gum. I went back to the dentist after two weeks and she informed me that there was a pocket of abscess in the gum. I was put on antibiotics for 10 days, it's day 3 and I just noticed a white pimple on the gum between where my tooth used to be and the tooth beside it. Am I to worry about this?

Thank you

Hi Lori,

It sounds like you had a severe infection with that tooth that had spread to the jaw bone. The original "pimple" is called a fistula. This is when the bacteria becomes so virulent that it looks for a place to drain into or through. The oral fistula is a tract of infection that burrows a hole through the bone and out the gum tissue. This fistula acts as a drain, but does not cure the infection.

That feeling of cotton between your cheek and gum was infection coming from the bone, not just the gum tissue.

The new fistula indicates that there is still an infection in the bone and it's trying to drain. This certainly needs to be clinically evaluated and may need some additional intervention.

Was the dentist who extracted the tooth an oral surgeon? If not, then it would behoove you to not go back to her, but to make an appointment with an oral surgeon for the proper evaluation and treatment of this infection. Antibiotics are usually not capable of handling this type of infection and it is not wise to assume they will. The original infection may have spread to the adjacent tooth, thus the location of the new fistula. So a new xray of that entire quadrant of your mouth should be done.

It would be wise to seek the consult with the oral surgeon as soon as possible.

Hope this information is helpful.

Bryanna

Thank you for your advice. I have an appointment with the surgeon on Monday morning.

Lori,

In the meantime, do not rinse with any mouthwash, like Listerine. The chemicals in mouthwash do not distinguish between the good and bad bacteria, they kill ALL bacteria which makes the problem worse. The chemicals are also very irritating and drying to the oral tissue pre disposing the user to further bacterial problems.

The most helpful and non irritating rinse would be home made warm salt water. A 1/4 teaspoon of salt to 3 ounces of warm water, 3 times a day would be beneficial. Make sure to brush and floss all of your teeth to keep the bacteria down in the rest of your mouth.

If you develop a fever or swelling, call the surgeon and get in to see him sooner.

Bryanna