How to know if I should take antibiotics my dentist prescribed?

[applefairy]

Hey guys, the reason I'm here for this questions is because I'm on immunosuppresive meditation for rheumatoid arthritis, so I'm wary about any infection and have to be careful.

Before Christmas I had a gum abscess appear above my very back left molar (the one in front of the wisdom tooth). It was relatively painless, only a little tender. The first dentist I saw just gave me antibiotics and took an xray, didn't see anything wrong. Those pretty much did nothing, so I went to a different dentist.

This dentist looked at some xrays in up close detail and said there was an infection underneath an old filling I got as a kid. I couldn't afford root canal, so we decided to extract the tooth instead.

She gave me a course of antibiotics first, which made the abscess go down a little but it started to grow back once they were done. I went on a second course, but the same result, so we just decided to take the tooth out.

I had the tooth removed on Sunday afternoon, so it's about 45 hours since the it was taken out and so far it's been good. Today the site is a little more tender, but I think that's because things are shifting around a bit up there, the pain is in no way a problem. It only hurts a little with movement like when I smile, I imagine because everything is bruised. There is a very very dull pain in the area, but I think that would be normal after extraction.

She prescribed me another course of antibiotics, but told me not to take them right away as she didn't want me on yet another course unless absolutely necessary. She told me to give it 3/4 days and if I felt I needed them, then to go ahead and start them. She felt that the infection should clear up now that the tooth is gone.

So I haven't been keeping too close an eye on the extraction area, but today I took a look and saw that it's covered over white a whitish-yellowish and one area grayish stuff. There seemed to be some bubbles, but I guess that could just have been saliva. I know not to touch it, so I haven't been poking at it! I did some gentle salt rinses from 24 hours after the extraction, and brushed the rest of my teeth lightly.

My question is, does this whitish stuff mean that I have an infection still and if so should I start the antibiotics? There is no bad smell (as far as I can tell), and pain is minimal. I don't actually know if this is normal or if it needs antibiotics. My dentist didn't give me any signs to look out for, so I realised I actually just don't know if I need them or now.

 

[carole]

Hi the white stuff is normal and you want it, it means that you are healing. I think it is called granulation tissue, here is an explanation:
Granulation tissue is new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process.Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size.

It sounds to me like you don't need the antibiotics. I am not a dentist but if you have no pain apart from a bit of aching that is normal and no bad taste you are doing okay.

If you are worried then do contact your dentist and let them have a look.

 

[applefairy]

Thanks for your reply Carole, it sounds like everything is as it should be then. I was worried that the white stuff was pus from infection. The area does feel more tender today than the last few days, but it's totally manageable and from reading about it apparently it's kind of normal for pain or swelling to peak around 2/3 days.

I used to have really bad trouble with anxiety, but I did a lot of work through therapy and it's no longer as bad anymore. However, this issue I was obsessing about and so nervous about things going wrong. It's made me realise that I still have some way to go on dealing with my health anxiety.

Thanks again for your help. I think you're right, I just need to be more patient with it and if necessary go back to the dentist in a few days time.

 

[applefairy]

I just googled images of granulation tissue! 1) it's totally gross lol and 2) I'm pretty sure this is exactly what's happening with my gum.

Thanks so much Carole!

 

[carole]

It certainly sounds like it is to me. I also suffer from anxiety and as I am sure you will know we can drive ourselves mad with worry.

I find a good guide to knowing if it is a real problem or not is to try to distract my mind by doing something and if I forget about the symptoms then all is good. I have worried myself up some really painful tooth aches but when distracted they have gone. Also if you can sleep okay that is also a good sign, usually a pain that keeps you awake is not good and needs attention.

As I mentioned if you are really worried than the best person is your dentist. I think you are doing okay and cleaning carefully around the extraction site which is the right thing to be doing.

All the best to you

 

[applefairy]

That's actually a pretty good guide. If distraction works, and things aren't getting worse, then there's absolutely no need for worrying