Chronic long time infection

[Jwwood88]

A little over a year ago, I had my top two wisdom teeth and a right molar removed due to impaction and infection. Due to financial constraints, I was only able to get those 3 removed at that time. Also still, I have an upper left molar that is decayed, broken and black ish, on that same side I have the lower wisdom tooth that has been chronically infected, it is partially covered with gum near the back. it isn't red or swollen, only mildly painful, but it does ooze pus if you apply pressure to the gums around it with a qtip. The pus is really liquidy near the gum flap but on the sides it's more of a thicker near solid pus. In front of that wisdom tooth, I have two molars that were drilled and filled about six months ago, frequently, there will be pus from them as well. Anyways, my worry is that the infection will spread (if it hasn't already) to elsewhere in my body and cause severe problems. I mean I keep reading articles where people have died from a tooth infection that spread in short amounts of time, and this one has been infected for over a year or more. That's scary. But I mean, are these fears unfounded? Should I be terribly worried? I've already got heart problems as is. I have an appointment with the oral surgeon to remove them in two weeks. I'm having them removed awake, I have a severe fear of death with being put to sleep. And a severe fear of death from dental complications in general. I'm going to an appointment literally right now to see if my regular dentist will give me some antibiotics to try to clear up the infection before the extraction because I fear that if they extract it while it is infected it could instantly enter my bloodstream and spread. I mean seriously, should I worry? Im so bad that even during extractions, I change my blood pressure medicine for a few days to one that doesn't interact with lidocaine, because my normal med does, I take some klonopin before the procedure, and then I have my oral surgeon monitor blood pressure and heart. Please help with some advice or reassurance or something. Thank you.

 

[leasierra]

Well, there is risks in having an active infection in the mouth. There are some bacteriae that can cause endocarditis having a door in tooth infection.
With that said, you are doing everything ok. I really think that prophilaxys with antibiotics should dismiss the actual risk of spreading infection to a bare minimum (the same that all of us can have in any surgery)
You should be extra carefull in regard to your base heart condition, but you're doing it!

I think you'll be just fine. Just stay calm and keep doing things the right way. You're being incredible good with the procedures so take it easy.

Hope you get better soon, and i really would like to know more about your situation.

Blessings.

PS: I'm not a dentist, i'm a med student. My words are by no mean from a especialized point of view.

 

[Jwood]

Well, there is risks in having an active infection in the mouth. There are some bacteriae that can cause endocarditis having a door in tooth infection.
With that said, you are doing everything ok. I really think that prophilaxys with antibiotics should dismiss the actual risk of spreading infection to a bare minimum (the same that all of us can have in any surgery)
You should be extra carefull in regard to your base heart condition, but you're doing it!

I think you'll be just fine. Just stay calm and keep doing things the right way. You're being incredible good with the procedures so take it easy.

Hope you get better soon, and i really would like to know more about your situation.

Blessings.

PS: I'm not a dentist, i'm a med student. My words are by no mean from a especialized point of view.

Thank you for your response. I did visit my regular dentist this morning. She cleaned around the wisdom tooth with a weird pick thing, and ended up giving me a prescription for keflex. She didn't seem to concerned about the infection, seemed to think it was more the gums than the tooth. However I still have a severe fear of the infection spreading from the tooth area to elsewhere. I fear fatal complications. And the cleaning of the gums she did there hurt terribly.

 

[leasierra]

I know it can be very stresfull. But you should trust in your dentist treatment and judgment. Can i suggest you some time out? When is your next appt? Identify when you think heavily in regard to the infection and try to do something else. Read a book, play a musical instrument, or just watch a movie.

You'll be just fine. No dentist (or health related proffesion) will send you home with a serious treat to your health without taking precautions.

As for the pain in the cleaning of the gums, could you ask him/her some anesthetic? Topical or local at least. You should be able to comunicate freely and tell when you're in pain! Don't be afraid as im sure they would take care of you.

Hope to hear from you soon and with goods news!

 

[Jwwood88]

I know it can be very stresfull. But you should trust in your dentist treatment and judgment. Can i suggest you some time out? When is your next appt? Identify when you think heavily in regard to the infection and try to do something else. Read a book, play a musical instrument, or just watch a movie.

You'll be just fine. No dentist (or health related proffesion) will send you home with a serious treat to your health without taking precautions.

As for the pain in the cleaning of the gums, could you ask him/her some anesthetic? Topical or local at least. You should be able to comunicate freely and tell when you're in pain! Don't be afraid as im sure they would take care of you.

Hope to hear from you soon and with goods news!

My next appointment is February 15th with the oral surgeon. And yeah, I try to distract myself, it can be hard though, I've got bad anxiety, panic, health anxiety and highly ocd thinking. I worry about a health issue and then obsess over it and then panic, which creates a new "symptom" then the process repeats. I don't have them numb me up unless I'm getting a full procedure done, because my blood pressure medication interacts with the lidocaine/epinephrine mix. And I don't get numb enough with the local anesthetic that is epinephrine free. So I usually have to switch to a different blood pressure med for a few days before and after the procedure. I also have a severe fear of being put to sleep and not waking up, so I do all procedures awake as well. On the 15th, they are taking my lower left wisdom and a broken decayed tooth. I find it very easy to worry for sure.

 

[leasierra]

My next appointment is February 15th with the oral surgeon. And yeah, I try to distract myself, it can be hard though, I've got bad anxiety, panic, health anxiety and highly ocd thinking. I worry about a health issue and then obsess over it and then panic, which creates a new "symptom" then the process repeats. I don't have them numb me up unless I'm getting a full procedure done, because my blood pressure medication interacts with the lidocaine/epinephrine mix. And I don't get numb enough with the local anesthetic that is epinephrine free. So I usually have to switch to a different blood pressure med for a few days before and after the procedure. I also have a severe fear of being put to sleep and not waking up, so I do all procedures awake as well. On the 15th, they are taking my lower left wisdom and a broken decayed tooth. I find it very easy to worry for sure.

I understand. I can tell you that you're pretty much in the safe zone about the infection. I cannot give you a final answer about this, as i'm not a Dentist. But i do know a few things about infections and how they spread as i recently finished my course on Infectology in Medicine.
You'll have plenty of time to react to a possible systemic infection in the remote possibility that you get one.

I'm open to any questions or talking you need over the course of this 13 days you got to wait. So fell free to PM me, or keep writing in here as long as you need or want.

Blessings.

 

[Jwwood88]

I understand. I can tell you that you're pretty much in the safe zone about the infection. I cannot give you a final answer about this, as i'm not a Dentist. But i do know a few things about infections and how they spread as i recently finished my course on Infectology in Medicine.
You'll have plenty of time to react to a possible systemic infection in the remote possibility that you get one.

I'm open to any questions or talking you need over the course of this 13 days you got to wait. So fell free to PM me, or keep writing in here as long as you need or want.

Blessings.

Thank you very much for the continued responses. Not sure how to send a PM on here, but I associate the continued feedback. I also appreciate the patience with my anxiety and over thinking. In the days since I started the antibiotic, there hasn't been too much improvement. The tooth area is still a bit painful, but also, the gums in that area are mildly inflamed, but my nostril on that side is mildly sore as well and all around my nose is kind of red, and my cheek on that side is mildly poofier than the other side. So now I'm severely worried. I mean how would I really know If the infection is spreading? And what do I do if it is? It's kind of scary to be honest.

 

[leasierra]

Sorry for the long wait!
Was out of the city for 3 days.

The symptoms you are describing are usual in a tooth infection. Don't know how many days did you take the antibiotic, but you should wait at least 48/72hs to see improvement. Hope you're already improving.

You should contact inmediatly (as in that day, or the next one if it's already late to call) if you have a serious inflammation in your check, like visible augment of volume, a tennis ball in your mouth size.

You should also be aware of your body temperature. As a general rule (at least from my texts) if you have a 38.0c temp (100.4 F) you should monitor two or three more times in 1 hour intervales. Call your GP or dentist if it doesn't go down. You should always contact a GP or dentist if you have a fever 38.5c (101.3F) or higher, some say 39c (102.2F) or higher.

This are general recomendations that could not apply to dentistry, so it would be good to be reassured by an expert.

Other "worrying" symptoms could be: Confussion, extreme chills and shaking, severe "asthenia" (sleepiness, lack of energy), chest pain.

This are all symptoms that could be associated to a "sepsis" but they're not always present, and if they're presents they could mean another thing. So by any means take this as a engraved rule. It's just some information.

Hoping to hear from you soon.
Blessings!

 

[Jwood]

Sorry for the long wait!
Was out of the city for 3 days.

The symptoms you are describing are usual in a tooth infection. Don't know how many days did you take the antibiotic, but you should wait at least 48/72hs to see improvement. Hope you're already improving.

You should contact inmediatly (as in that day, or the next one if it's already late to call) if you have a serious inflammation in your check, like visible augment of volume, a tennis ball in your mouth size.

You should also be aware of your body temperature. As a general rule (at least from my texts) if you have a 38.0c temp (100.4 F) you should monitor two or three more times in 1 hour intervales. Call your GP or dentist if it doesn't go down. You should always contact a GP or dentist if you have a fever 38.5c (101.3F) or higher, some say 39c (102.2F) or higher.

This are general recomendations that could not apply to dentistry, so it would be good to be reassured by an expert.

Other "worrying" symptoms could be: Confussion, extreme chills and shaking, severe "asthenia" (sleepiness, lack of energy), chest pain.

This are all symptoms that could be associated to a "sepsis" but they're not always present, and if they're presents they could mean another thing. So by any means take this as a engraved rule. It's just some information.

Hoping to hear from you soon.
Blessings!

Thank you for the continued response, I really do appreciate it. My anxiety level has been really high all week long. And the extraction is still 5 days away. I'm going to have them treat this one the same as the last extraction I had a few years ago, I plan to switch from my propranolol (Beta blocker for my blood pressure) to metoprolol for 3 days before the procedure, because the propranolol interacts with the epinephrine in the local anesthetic, and I can't get the local workout epinephrine because then I don't get numb. Then during the procedure, I will have my blood pressure monitored, as well as my heart, they use this weird wrist ekg type machine to monitor it. I hope it goes well. I have been talking cephalexin for the past 8 or 9 days, but the infection doesn't seem to have gone away, the tooth is still oozing a bit of pus from time to time. So I'm afraid that when the oral surgeon removes it, the infection is going to spread into the socket, I called the oral surgeons office to ask about it, and they said that they don't think it will be a problem. So now I'm worried about that as well. I already have a fear of having a reaction to the local and having a heart attack. Now fear of infection again. This is driving me crazy.

 

[leasierra]

The switch in the betablocker is okey.
The monitoring with the EKG is great.
Sound like they have the bases covered. You're going to be ok.

Don't mind the infection in the tooth. It's possible that the causal agent it's some sort of anaerobic bacteria encapsulated in there so it could be resisting the antibiotic because the lack of blood irrigation in the zone. Sometimes systemic antibiotics don't do so well treating local infections that are well encapsulated.
You know what they do in this situations? They open the site! By creating a way to the exterior this anaerobic agents die and the wound heal in no time. Of course they will probably give you another course of ATB to be covered in all sides but i'm sure it will get better with the extraction.

The extraction is the solution, not the risk. So hang in there for the 5 days remaining and it will be good the day after it. Believe me!

Blessings, and comeback with news as soon as you can!

 

[Jwood]

The switch in the betablocker is okey.
The monitoring with the EKG is great.
Sound like they have the bases covered. You're going to be ok.

Don't mind the infection in the tooth. It's possible that the causal agent it's some sort of anaerobic bacteria encapsulated in there so it could be resisting the antibiotic because the lack of blood irrigation in the zone. Sometimes systemic antibiotics don't do so well treating local infections that are well encapsulated.
You know what they do in this situations? They open the site! By creating a way to the exterior this anaerobic agents die and the wound heal in no time. Of course they will probably give you another course of ATB to be covered in all sides but i'm sure it will get better with the extraction.

The extraction is the solution, not the risk. So hang in there for the 5 days remaining and it will be good the day after it. Believe me!

Blessings, and comeback with news as soon as you can!

Thank you again for the continued response. I truly hope you are online this evening. I have my extractions first thing in the morning and I am beyond terrified. I have switched beta blockers as I had said, but I still fear some kind of reaction to the epinephrine in the local anesthetic, I fear a severe heart related incident. And I fear that the infection in my tooth is going to get into. My blood stream as soon as he pulls that tooth out. I'm scared I'm going to die tomorrow. Please please ease my mind or something. I don't know.

 

[Sevena]

As they will be monitoring your heart rate, you really have nothing to fear. They are licensed medical professionals who will have treated people with heart problems before, and they would definitely know what to do on the (very slim) off-chance something went wrong.

I promise you, you won't die tomorrow! You'll be back here letting everyone know how it went.

They will also know the symptoms of spreading infection, which is so incredibly, hugely rare that you really shouldn't be worrying about it. I know you will anyway, but you have to put your trust in the professionals treating you. This is their job and livelihood, they wouldn't risk your life!

I know how you feel to a degree at least. I've had some heart problems, and when I had to go under general anasthetic for full extractions I was half-sure I was going to die! But the staff there reassured me at least enough for me to let them put me under, and the relief when I woke up and it was all over was something else!

So good luck, but I know you won't need it. Let us know how you are afterwards.

 

[Jwwood88]

The switch in the betablocker is okey.
The monitoring with the EKG is great.
Sound like they have the bases covered. You're going to be ok.

Don't mind the infection in the tooth. It's possible that the causal agent it's some sort of anaerobic bacteria encapsulated in there so it could be resisting the antibiotic because the lack of blood irrigation in the zone. Sometimes systemic antibiotics don't do so well treating local infections that are well encapsulated.
You know what they do in this situations? They open the site! By creating a way to the exterior this anaerobic agents die and the wound heal in no time. Of course they will probably give you another course of ATB to be covered in all sides but i'm sure it will get better with the extraction.

The extraction is the solution, not the risk. So hang in there for the 5 days remaining and it will be good the day after it. Believe me!

Blessings, and comeback with news as soon as you can!

I sincerely appreciate you helping me through this. I had the extraction done, and the only I guess, complication was a spike in blood pressure and heart rate upon administration of the lidocaine, but that went away shortly thereafter, this was 8 hours ago. I am now home and enlarging, however I still have a small bit of bleeding, minimal from the upper socket. I am now scared that maybe I will bleed to death from it. And I have no idea how to tell if that is happening.

 

[Jwwood88]

As they will be monitoring your heart rate, you really have nothing to fear. They are licensed medical professionals who will have treated people with heart problems before, and they would definitely know what to do on the (very slim) off-chance something went wrong.

I promise you, you won't die tomorrow! You'll be back here letting everyone know how it went.

They will also know the symptoms of spreading infection, which is so incredibly, hugely rare that you really shouldn't be worrying about it. I know you will anyway, but you have to put your trust in the professionals treating you. This is their job and livelihood, they wouldn't risk your life!

I know how you feel to a degree at least. I've had some heart problems, and when I had to go under general anasthetic for full extractions I was half-sure I was going to die! But the staff there reassured me at least enough for me to let them put me under, and the relief when I woke up and it was all over was something else!

So good luck, but I know you won't need it. Let us know how you are afterwards.

Thank you for your kind words. I did survive, however the fear of infection is still there. And now a fear of bleeding to death.

 

[leasierra]

I'm really, really, really happy about the outcome of your intervention.
You're not going to bleed to death for the gums! I can assure you, it would be the first case in history haha.
I know you're probably not bleeding anymore, but if you do you can bite a gauze humidified really gentle for about 30min. If the bleeding is notable. Try to avoid it if you're just sipping a little bit of blood taste. It's normal to experience a little bit of bleeding for the first 24hs aprox.
I can assure you now it's going to go everything uphill. Just take the precautions they gave you, don't use straws, don't smoke, don't bite, don't rinse hard for the first 24 hs, don't brush for the first 24 hs. Take the medication they gave you, probably ATBs and painkillers. Eat soft meals, preferable with no seeds or little bits that can get into the socket. ICE CREAM! It's like the best to eat, the cold helps to vasoconstrict vessels (diminish bleeding) and also it takes down the inflammation, so less pain and less discomfort.

Please come back with more news! I'm hoping for a quick healing. And we will be very happy for you!
Blessings.

 

[Jwood]

I'm really, really, really happy about the outcome of your intervention.
You're not going to bleed to death for the gums! I can assure you, it would be the first case in history haha.
I know you're probably not bleeding anymore, but if you do you can bite a gauze humidified really gentle for about 30min. If the bleeding is notable. Try to avoid it if you're just sipping a little bit of blood taste. It's normal to experience a little bit of bleeding for the first 24hs aprox.
I can assure you now it's going to go everything uphill. Just take the precautions they gave you, don't use straws, don't smoke, don't bite, don't rinse hard for the first 24 hs, don't brush for the first 24 hs. Take the medication they gave you, probably ATBs and painkillers. Eat soft meals, preferable with no seeds or little bits that can get into the socket. ICE CREAM! It's like the best to eat, the cold helps to vasoconstrict vessels (diminish bleeding) and also it takes down the inflammation, so less pain and less discomfort.

Please come back with more news! I'm hoping for a quick healing. And we will be very happy for you!
Blessings.

Been taking antibiotics since about two weeks beforehand, however the Oral surgeon claimed he saw no signs of infection despite me being able to squeeze it from around the tooth before the extraction. It hurts like crazy this morning. An intense ache, I looked at it and part of the clot has a weird almost greenish color or maybe I'm imagining it I don't know. I hope it isn't infected.

 

[leasierra]

You have very good information in this forums about post extraction steps and evolution. Use the search feature if you want to read, but keep in mind everybody is different and there is no equal procceses. So dont get alarm on a few differences here and there.
Did the bleeding stop?

Did the dentist give you more antibiotics?
Did he or she gave you some kind of rinse?

For the color you describe you could probably benefit from a rinse with hidrogen peroxide (oxigenated water) you can dilute it 50/50 or use it pure.

Two or three times a day, one or two days its enough. You also could rinse with salt water luckwarm. Just do this rinses very gentle like only letting the water pass over the site, fill your mouth and do gentle "No" gestures.

Come back with news or questions as soon as you want! Blessings

 

[Jwood]

You have very good information in this forums about post extraction steps and evolution. Use the search feature if you want to read, but keep in mind everybody is different and there is no equal procceses. So dont get alarm on a few differences here and there.
Did the bleeding stop?

Did the dentist give you more antibiotics?
Did he or she gave you some kind of rinse?

For the color you describe you could probably benefit from a rinse with hidrogen peroxide (oxigenated water) you can dilute it 50/50 or use it pure.

Two or three times a day, one or two days its enough. You also could rinse with salt water luckwarm. Just do this rinses very gentle like only letting the water pass over the site, fill your mouth and do gentle "No" gestures.

Come back with news or questions as soon as you want! Blessings

Good morning, and thank you. The bleeding did stop. I had to go back to the Oral surgeon yesterday, because I was finding some green ooze on the extraction sites, however, he did not seem concerned at all, said that he didn't see anything (even though when it was oozing pre extraction, he also said he saw nothing). So he "to ease my mind" switched my antibiotic form cephalexin to amoxicillin. He then rinsed it with water and sent me away. However upon waking up this morning there was mild ooze again, looked kind of green. And even though today is day three, it still hurts a whole lot more than I'd expect. I don't remember having this much pain the last time I had teeth removed. So I'm really not sure what to do. I don't know if I just wait it out and see what happens, I bother to make another appointment with the oral surgeon, or I make one with my regular dentist. I really don't want to end up with an infection that spreads in my body. Also, when I was younger, I had a mrsa infection in my arm, I am curious if that could still be in my body years later.

 

[leasierra]

Pain can be different per extraction for a variety of reasons. Size and form of the roots, tecnics used in the extraction, etc. So don't panic if it hurts. The pain should get lesser and lesser as day goes trough tho. You should contact your dentist if the pain gets substantially worse.

About the green ooze it's not good but it's not terrible either. Don't panic about it. You are taking the Amoxi for the mild infection, as i said to you in previous posts now that the tooth is out it should be fairly easy for the ATB to act in place and therefore it should get a lot better soon.
Please remember the warning signs that i gave you. High fever, really big inflammation on the site (the whole cheek). If any of this happen please contact your dentist asap.

About the MRSA: the Staphylococcus Aureus it's present in about 40% of the humanity. If you had an active infection it's possible you're colonized by it, but this is true for 4/10 patients who had the same intervention as you. The % of Methicillin resistent strains is about 2%. I don't know what it's the rate of MRSA infections on tooth extractions, but i would say it's waaaay low to worry about, at least i'm sure it's not 2 out of 100 patients and that 2 are for sure colonized by MRSA, so we can assume that being colonized by MRSA it's not a sentence to have an infection (i promise to search trough some repositories for statistic studies about it tho).
Can i ask you if you talk about it with your dentist?

You're doing great Jwood, and you'll be in perfect shape in a few days, just hang in there and don't fall back. I trust you and your strenght! You were very brave and you're being brave now.

 

[Jwood]

Pain can be different per extraction for a variety of reasons. Size and form of the roots, tecnics used in the extraction, etc. So don't panic if it hurts. The pain should get lesser and lesser as day goes trough tho. You should contact your dentist if the pain gets substantially worse.

About the green ooze it's not good but it's not terrible either. Don't panic about it. You are taking the Amoxi for the mild infection, as i said to you in previous posts now that the tooth is out it should be fairly easy for the ATB to act in place and therefore it should get a lot better soon.
Please remember the warning signs that i gave you. High fever, really big inflammation on the site (the whole cheek). If any of this happen please contact your dentist asap.

About the MRSA: the Staphylococcus Aureus it's present in about 40% of the humanity. If you had an active infection it's possible you're colonized by it, but this is true for 4/10 patients who had the same intervention as you. The % of Methicillin resistent strains is about 2%. I don't know what it's the rate of MRSA infections on tooth extractions, but i would say it's waaaay low to worry about, at least i'm sure it's not 2 out of 100 patients and that 2 are for sure colonized by MRSA, so we can assume that being colonized by MRSA it's not a sentence to have an infection (i promise to search trough some repositories for statistic studies about it tho).
Can i ask you if you talk about it with your dentist?

You're doing great Jwood, and you'll be in perfect shape in a few days, just hang in there and don't fall back. I trust you and your strenght! You were very brave and you're being brave now.

I can't thank you enough for the continued support and response. The green ooze is still semi present, but only mildly. I have been talking the amoxicillin for a few days now, but I still see ooze from time to time, I have pain in the sockets, mostly first thing in the morning, somewhat during the day, hoping it isn't dry socket. The blood clot is still all the way there in the top. However the lower wisdom socket, the clot is half the size that it was. I've felt bad like I had a fever, but I don't have a fever. I have been mildly nauseous, but I don't know if that could be due to potential infection or due to 4 days of yogurt, spaghettios, pudding and soup. I've felt really tired. Also, because I normally have high blood pressure in normally in propranolol, for the procedure I switched to metoprolol, I haven't switched back yet, still taking the metoprolol, but for whatever reason, my blood pressure is unusually low. I don't know if that is related. I know I worry too much, so I thank you for indulging my slightly neurotic nature.