Post-extraction complications

I had a bottom molar extracted on Tuesday May 9th. I was still in a lot of pain by the weekend so on Monday 15th I got an emergency appointment with my dentist, who diagnosed a dry socket. He irrigated and dressed it, and prescribed antibiotics (metronidazole, and I've just now taken the last one).

I found a couple of websites which said the dressing needs to be changed every 24 to 48 hours, but when I rang the dentist again on Wednesday the receptionist said I should just keep the original one in as long as possible, and call again if I was still worried by the end of the week. I noticed that the websites I'd seen were private dentists, whereas I get free treatment from the NHS in the UK. Although most people have to pay for NHS dentistry, it still runs at a big loss and they're under budget pressures, so I feel I'm seeing what I'd expect from one dentist who has incentive to do as much treatment as possible vs one who would want to avoid treatment .

On Wednesday evening the pain seemed a lot better, and I woke up on Thursday with the dressing nearly all gone, and it felt like the wound had significantly closed over, so I avoided the stress of calling/visiting the dentist this morning (Friday). But the pain came back, especially in the evening, and I've been feeling run down all day with a sore throat. I have Chronic Fatigue SYndrome, so it's probably just that flaring up again, not surprising after the last few weeks (the tooth was painful before the extraction), but I can't help worrying that I've still got an infection deep in the socket/bone.

Another big problem is that no matter how carefully I eat, food always gets stuck in it. I'm not sure whether it's better to leave it and hope it works its way out before long (this does seem to happen) or try to get it out and risk doing more damage. I doubt I'd easily be able to buy an irrigation syringe at the weekend. I used the end of a small zip tie earlier, that was quite successful. What would you recommend?

I was also wondering whether it would be a good idea to try stuffing some Iglu gel in it, at least before eating. It isn't something I'd like to try without the recommendation of a dentist or someone who's found it helps.

That's tough. I would just leave it. Warm salt water rinses and be gentle. I'm not a dentist but I would not irrigate it or anything.
Hope you're feeling better soon.

Today it feels like the hole has closed over a bit more, but it's still quite painful. Is it normal for the pain to continue for a while when a dry socket is healing, or does it suggest there's still an infection underneath?

Dry socket pain can last for several weeks. I'd avoid packing it with anything yourself as that could keep it from healing effectively. An infection is unlikely, especially if you just finished a course of antibiotics. It likely just needs some more time to heal.

drm said:

Dry socket pain can last for several weeks. I'd avoid packing it with anything yourself as that could keep it from healing effectively. An infection is unlikely, especially if you just finished a course of antibiotics. It likely just needs some more time to heal.

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I've also been feeling a bit feverish (but TBH it's difficult to tell the difference between that and a CFS flare up and lack of sleep etc) with tender/swollen neck glands on that side. The wound site is definitely improving, but the deep-feeling pain isn't. I called the NHS 111 service over the weekend and they said it isn't rare for infections to linger in the bone and need more than one course of antibiotics (and that was the case with my previous dry socket), and advised I should see a dentist again ASAP, but the only weekend emergency service in the city was overwhelmingly busy, and I was too anxious cope with their stuffy waiting room for 3+ hours. A dentist from my usual practice can see me a bit later today though.

I am in the US and see a pretty decent private dentist. I have a dry socket. He packed it and gave me antibiotics. He said if it falls out even the next day that's ok. He said I should feel better in a couple days. Hope that helps you. If the pain is returning I would call back. Good luck.

Apart from the pain I felt better by Monday, but saw my usual dentist's colleague who irrigated and dressed it again. The dressing seemed to make a massive improvement, but it only stayed in for a few hours (I think the more it's healed, the less well it can hold a dressing) and the pain came back. I can feel the wound itself gradually improving, but the pain keeps coming back, and today it's worse than ever if anything, not responding to painkillers.

I saw my usual dentist today (I had originally made this appointment for a check-up several months ago; I would have postponed it until this is fully healed, but the dentist on Monday advised me to keep it so my regular dentist could have another check). This time he said it looks like it's healing well and he didn't irrigate or dress it.

Both said my glands aren't swollen and that there are no other signs of infection. How can it still be so painful? Does it often take a few weeks for enough tissue to form to cover the bone adequately or something?

The pain is a little better today, but not much. I've got a theory about what could have made it worse. It feels like there's a sharp bony ridge along the edge nearest my tongue, and perhaps I've entered a phase of healing where the soft tissue is being stretched over it. Does that sound plausible? Possibly my tongue keeps putting pressure on it too, especially when I'm all tense.

Keeping/getting bits of food out is still a problem. Last night it suddenly occurred to me to see if I could get an irrigation syringe from Amazon, and I was just in time for next day delivery, so that should arrive in the next few hours and hopefully help with that. But at the moment the warm salty rinses also seem to make the pain worse.