Retained root (abscessed) emergency removal...

[Caraleisa2]

Hi,

This is my first post, so I hope I'm doing it correctly! I have had pain in an area in my mouth (tooth 19) that no longer has a tooth. The tooth was removed about 20 yrs ago, and though I never got a 'replacement' I wear an appliance at night which kept the adjoining teeth from moving.

There was no pain at all for all these years, then a few weeks ago it began to get tender... the pain continued to increase slowly, but today I woke up with some stabbing pains in the empty space. I was brushing and flossing in the hope that would fix it but ... it's time to face the facts.

I've had several bad experiences with dentists, so I do avoid going, but I knew I had to deal with it.

Turns out the tiny rootlet at the bottom, WAY down in the bone, is infected and the entire area is abscessed. My dentist put me on Keflex right away, and had me schedule oral surgery asap - which amazingly is set for tomorrow at 2 pm.

My question - what can I anticipate for this?

It would help me tremendously to have a general description of what the event will be like.

Is it as difficult as a tooth removal, is it worse? Do they put you to sleep? Do I need a driver? They did not tell me to have someone drive me. Will it be painful? How do they cut into me to get it, from the top, the side, etc? Stitches? The area of abscess is pretty large, it fills the entire space above and beside the piece of root. Will that need to be drained, or packed, or what? How long does it take to heal (average, of course).

Sorry for all these questions... and thank you so much for any info you can provide. This is a GREAT service for those of us who hate going to the dentist!

 

[Gordon]

Kind of hard to say without seeing the x-rays, I'll try to answer but may not be 100%

1) Easier than normal removal, bit more fiddly for the dentist but probably less traumatic for the patient
2) Don't know, if you haven't been told to bring a driver then that would rule out GA or IV sedation
3) Usually access from as near to the root as possible
4) Usually needs stitches
5) No special drainage required, just remove the root and let the body deal with things
6) Can't say about healing without seeing first, probably about a week

 

[Caraleisa2]

Hi Gordon,

Thanks for your reply. I had already left for the surgery so didn't see it until I returned.

So, I will tell you all about the experience for your own interest...

Firt - the root tip was very large and completely encased in bone, and it turned out to have been a more difficult than usual extraction. That said... wow, this surgeon was incredible!!

When I arrived, the doctor first saw me in a consult room, went over the xray and then explained what he'd be doing in detail, answering any questions I had and making sure I understood what was going on.

Then, I went into the surgery room, where I had an anesthetic gel swabbed in the area. After five minutes or so, the dr came in and gave me shots of anesthetic. That first shot in the back curve area has always been extremely painful for me. This hurt, but substantially less than before, which was encouraging. He allowed ten-15 mins for the novocaine(?) to 'take'... then gave me a couple more shots which he said were also a test - and I could not feel a thing.

I did ask for nitrous to help me relax. I was in a lot of pain due to the abscess. He got in there, and was very calming, explaining to me what was going on. I had a couple questions and he actually fully understood what I was saying!!

Even though I had no pain when he released the largest cyst, I felt the pressure go away. There were several pockets of infection, and he had to drain each and remove whatever... then he went after the root tip. He had to go deeper into my bone, twice. I had NO pain, and was actually pretty comfortable.

Eventually he was able to get the tip out, and stitched me up. The incision was, I discovered later, really long, and even went around the tooth in front of the abscessed area, because the abscess was right up against it.

I didn't have much pain, though he gave me both pain medication and 600 mg ibuprofen. I was already on Keflex.

The area oozed blood for hours, in fact, I kept a gauze in my mouth overnight, but this am it is no longer bleeding. he did tell me it may bleed slightly for that long, so I wasn't worried.

Now I am astounded but have almost zero pain. I am to rinse with salt water 4-5 times a day for a week, also eat only soft foods for days, and then really keep it light for 2-3 weeks to let the gum completely heal.

I had an amazingly good experience. I would recommend this surgeon to anyone!!

James Gustainis, MD, in West Chester, PA.

I hope this account helps -- it was not a bad experience at all. And I HATE going to the dentist.

 

[Deb89]

Glad everything worked out! If you need any help with choosing soft foods to eat, let me know. I had two impacted wisdom teeth removed this past summer so that was pretty much my diet for about two weeks.

 

[Caraleisa2]

Thanks, Deb.

I should be ok. I'll be having my Valentine's dinner of Fettucine Alfredo. Soft and delicious! MMMMM!

I've been eating yohgurt, oatmeal, soft bread pb&j. Some ideas for protein that is soft would be helpful if you can think of any. Probably I can do bean soup, or beans and rice by tomorrow.

I remain astounded that I have so little pain. I am certainly being very careful, but still!!

Thanks and Happy Valentine's Day.

Carol

 

[Deb89]

Peanut butter suprisingly as protein in it, so I'd stick with that! (I'm a vegetarian so don't get protein from things like chicken).