Lower molar extraction

[amanda1252]

I am day 4 since having my lower molar extracted. I was in quite a lot if pain day 2/3 (was sure I had dry socket) but last night/today the pain has decreased significantly and I only need minimal Ibuprofen. I have suffered with dry socket on all previous extractions (day 2/3) and I am really anxious that it will happen again this time. I know from experience that decreasing pain today is a good sign and I can still see some blood clot (no granulation though) as well as significant closure of the extraction site. I assume this is normal? When can I stop worrying about getting dry socket? Pictures are from extraction on Monday and today.

 

[Gordon]

If you've not got one by now, you're not going to get one, relax and enjoy your weekend.

 

[amanda1252]

Thanks Gordon, so I got through the weekend without any pain killers and today I am 8 days since extraction. yesterday I started to get referred pain around my wisdom tooth and jaw/ear. I have noticed a small hole on the inside of my gum which I think may be a bone spicule. I saw a dentist and she said I have no infection and the bone spicule could be the cause of the new pain so I could either watch and wait or, she could numb me up and reopen the extraction site to clean it, remove any bits of bone and scrape it to start a new blood clot. Needless to say, I am so scared of the dentist and it has been an anxious enough week already I opted to leave it be. I have posted a picture from today, you can see the small hole near my tongue which has been like that for 5 days now. What are your thoughts, should I have gone through the procedure?

 

[Gordon]

Definitely looks like a sharp bit of bone.

It'll be perfectly OK if you leave it be, (getting it removed would deal with it quicker and is much easier than the extraction was so you can certainly handle it).

 

[amanda1252]

Hi Gordon, if they reopen the extraction site to clean it out and restart a new bloodclot will I be at risk of dry socket again? At the moment the only pain I have is around the gum when I touch it and a sore tongue. I am quite sore on a morning and need some ibuprofen but think this is caused by gum swelling from laying flat. I go on holiday in 9 days and don't want to be worrying about dry socket or infections, but also dont want to be in pain with damaged tongue. I am still doing the salt water rinses 3/4 times a day. Is there anything else I can do?

 

[Gordon]

There's not much risk of dry socket, since they shouldn't be opening up the socket enough to cause an issue. It's really just the edges of the hole you'd need to work on. I'd be tempted to just numb the area around that wee sharp bit and smooth it off with some tweezers if I was doing it.

You could try some Difflam oral rinse instead of the salt water, it's a mild antiseptic with some numbing action too, might help a bit (it also tastes pretty nice!).

 

[amanda1252]

Thanks Gordon, I am just so scared of the injection as I don't numb and it takes lots of attempts and a long time before it takes effect. Also the thought of the injection next to the gum (near the cheek) puts me off because it is already very painful and sore in that area and has been since the initial extraction. I just noticed today a small pink lump appearing on that side near to my cheek, is this another bone spicule working its way out on that side as well now?
The hole on the inside near my tongue is sore but I cannot yet feel anything protruding from it, although my tongue is sore (not yet ulcerated) so I guess it is mostly from the inflamed gum at the moment.
On the positive side, if I dont eat or talk I have little pain and it does not wake me at night.
I only got the tooth out because I have had sensitivity for years and the dentist told me when it got bad there was mo option but to have it removed. Sensodyne stoped it but recently It was starting to mildly bother me most days so I opted to have it removed so I didnt get bad toothache when I went on holiday.
Not sure now if I made the best choice but I suppose constant toothache would be worse.

 

[amanda1252]

Hi Gordon, so I went back to the dentist as I was concerned the lump may be an abscess and if it was then I needed it sorting before my holiday.
Anyway, I agreed to let him give the socket a clean and then he put some dressing in, without numbing and it was fine. The socket does not hurt, it is the surrounding gum especially on the cheek side. The worse part was the suction pipe touching my gum while he was rinsing the socket .
He said it looks to be healing ok, just slowly and that there is no sign of infection and if there was it was very low lying.
Do you think I must have a slow healing response considering I have had 4 teeth removed over the years and each time has been problematic.
Hopefully all will be fine now, although the taste and smell of the dressing is disgusting. I am off to the theatre tonight, I am sure the people sat next to me will be questioning the awful smell

 

[Gordon]

I suppose everyone heals at different rates, so yeah, you could have a slower response.

Well done on going back to get it looked at though, it should improve a bit quicker now.

 

[amanda1252]

Hi Gordon, so the swelling continued to slowly increase over the weekend so I had to visit the dentist again today.

So they did an xray and it was clear. They decided it was best to go back into the socket and physically look. I was very reluctant but felt like I had no other option as I was not getting better.

I was told that there was no shards of bone or signs of infection but the socket was very jagged and digging/irritating the gum. They filed down the boney socket, gave it a good clean out and put in some alveogyl. He said the socket itself was healing well.

Will this resolve the issue? I go on holiday in 4 days to Switzerland (dont need the expense of seeing a dentist there although I would assume my travel insurance would cover it)

I can cope with the slow healing and swelling/ pain upon touch especially now that I have been xray and the inside of the socket has been physically checked.

I am just worried about infection, dry socket, Am I now at risk of these again?

By the way, you were right, going back in was not as bad as the extraction itself. The numbness is now starting to wear off and I feel tender (especially where he injected me into an already very sore inflamed gum) but hopefully will not get any referred pain.

I am 2 weeks today since extraction, and the anxiety levels are quickly increasing day by day.

 

[Gordon]

No, you’re not really at any risk of getting a dry socket. Alvogyl is good stuff, apart from the taste!
Getting things cleared out should get the healing going properly now.
Enjoy Switzerland. It’s lovely.