Hi, I'll try to answer your question!
Some surgical wisdom tooth extractions can be rough and I'm sorry you're having some trouble post-operatively...
Firstly, I would ask you if you've returned to the surgeon's office to have them inspect the extraction sites...if not, this would definitely be appropriate for them to do
After a tooth is extracted, the socket bleeds and that blood forms a blood clot to fill the socket. This blood clot is what gradually reorganizes as healing progresses to form the new bone and gum tissue to close up the space where the tooth root used to be. So, it is very important that immediately after the extractions, the patient do everything possible to avoid inadvertantly dislodging that blood clot. I'm sure the Surgeon and/or his/her Assistant/Nurse went over post-operative instructions with you and/or whomever may have escorted you to the surgery. To a large extent, that's what these postop instructions are for: to prevent loss of the all-important blood clot. However, despite everyone's best efforts, sometimes the blood clot, or part of it, is dislodged and lost. When this happens, it leaves the empty bony socket open and somewhat exposed.
The empty socket is then prone to filling with food, saliva...all carrying bacteria that are normally present in the mouth and an infection is likely to start...I think that's what you have going on
This is commonly known as a "dry socket"
the normal procedure when the patient returns with a dry socket is to gently irrigate as much of the accumulated debris as possible from the socket, perhaps with hydrogen peroxide or with chlorhexidine solution, a disinfectant
then the surgeon gently packs the socket with a medicinal braided cloth tape, called "iodoform gauze". This gauze tape is v. often coated with a rather vile-tasting, but VERY effective ointment called, appropriately, "Dry Socket Paste"
Yes I've been back , and that's when he prescribed the Amox. he also irrigated the socket and pressed (hard) on my cheek to get the pus out. I've been back twice post op. I'm just worried that the infection is not going away--and that is the hard lumps in my jaw
Hi,...are you aware of whether he placed that packing material into the socket?
yes he did.
you really could not have missed it if he did...that paste smells like creosote and I'm told tastes awful
ok, good: he should have had you come back in no longer that 2 days after placing that packing to remove it and replace it...did he?
yes, yesterday and he replaced it. I go tomorrow again
the amoxicillin is definitely the correct antibiotic for you to be taking and the dosage is appropriate
great! He's right on the ball...
great. Do you know what the hard knot is?
let me ask you if it feels at all as if the swelling is getting worse or seems to be progressing down your neck?
the knot is likely just the infection localizing and consolidating...part of the healing process
also a good bit of swelling which is part of the inflammation that is secondary to the trauma of the extraction
my neck has been tender (this is my biggest worry) but it has not gotten any worse, nor is it swollen
yes, I would expect some tenderness of the neck might be perfectly normal... the surgeon may have had to exert quite a bit of pressure on your lower jaw while it was numb in order to perform the extraction
your jaw muscles might also feel sore and stretched out
are you still using ice packs over the area?
I like the fact that you're taking the Advil with the vicodin...it will really help with the inflammation
you should be able to gradually start tapering off the vicodin and maybe double up on the Advil if your stomach can tolerate it
warm to hot salt-water rinsing in the area maybe 4-5 times/day would help at this stage
a nice tablespoon of salt in maybe 1/2 a teacup of hot tap water
all the other areas feel OK?
sorry reply button was not working
He just doesn't seemed too concerned about the lumps--while I've been making myself crazy thinking about the infection closing my throat (angina something-or-other) or traveling to my heart.
and I've been doing rinses, and tapering off vicodin-I haven't had any today
well, I understand your concern and you're justified in being concerned, but it doesn't sound to me like that is occuring
sometimes those surgical extractions can really be a rough road - especially when you're not 18 or 20!
I know, my darn cheap parents!! lol
but it sounds like you're doing everything just right and the healing process is going along fine
yes, of course....the parents...
but it's great that you went through with it on your own now and you'll be way more comfortable in the long run
lol! really! Well thanks for helping I just needed reassuring I guess
once you can just suffer through the healing process
yes, I'm v. glad to help...you're going to be fine, it sounds like to me.
Feel free to hit the "Accept" button if there's nothing more I can help you with tonight and also you can leave postive feedback if you'd like
Thanks so much.
Your'e entirely welcome