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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 2035
Experience:  Dentist and Anesthesiologist for 34 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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Exposed bone on the side of wisdom tooth extraction site

Resolved Question:

I recently had a wisdom tooth on the bottom pulled two weeks ago. There's now a bit of bone exposed near the socket wound (on the side near the tongue, not the cheek, and slightly behind the socket wound of the extraction site). The exposed bone hurts whenever my tongue scrapes it, so I'm still having trouble chewing solid food, even if I only use the other side of the mouth. The socket wound itself seems okay right now. The socket wound was hurting a lot about a week after the extraction (probably infection), and the dentist cleaned the wound and packed some kind of clove-tasting power with cotton inside the wound, and that stopped the pain. I then went back a couple of times to have that clove-tasting powder/cotton dressing replaced with fresh ones. Now it's about two weeks since extraction, and the socket wound isn't hurting anymore, but the exposed bone on the side of the socket wound is bothering me. So my question is, will the exposed bone area heal by itself (will the gum automatically grow over the exposed bone and cover it up again)? How long would it take? What can I do to help the gum grow over the exposed bone again? Do I need additional surgery, such as cutting the gum open and then file/clip the exposed bone area and then stitch the gum up over it?

Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Katz replied 1 year ago.
Welcome .I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.The area that you are referring to,is a common area where necrotic bone will slough off and because the tongue is constantly rubbing against this bony area,it takes a long time to heal.In addition,the tissue on the tongue side of the jaw bone is extremely thin allowing any slightly rough bone in this area to become exposed.These areas seldom heal on their own without treatment.You really can do nothing to rectify the situation but you are correct in your treatment plan.You need to return to the surgeon so that they can trim back the jagged bone so that the gum tissue on either side of the tear can join without being obstructed by the sharp edge of bone.Sometimes we need to place a suture or two in this area but it must be done carefully because the tissue here is so fragile.I place patients on antibiotics at this point because of the possibility of the necrotic bone becomming infected.It only takes about 20 minutes to get this trimmed back but you will feel almost immediate relief and your tongue will thank you for it.Most patients with this problem come in with a sore tongue in addition to the sore jaw.If you have any further questions please ask.
Customer: replied 1 year ago.

Thank you for the reply, Dr. Katz. I have two follow up questions:


 


1) Is it possible that the gum will grow and cover up the exposed bone on its own without having to file down/clip off the exposed bone area? If so, how long would it take? The two dentists I've gone to (I'm in Fuzhou, China, at the moment) both say that there is a chance the gum might grow and cover up the exposed bone without further treatment, though they can't be be certain, and the only way to find out is to wait and see. But they don't tell me how long I need to wait before it's obvious that the gum is not going to grow and cover up the exposed bone. I mean, I could be waiting for weeks and months, and that's a long time of being really uncomfortable and not being able to eat normally. It also lengthen the time I might be exposed to infections since I can't be on antibiotics for a long stretch of time--that's bad for my body, right?


 


2) And if I do go and have surgery done (cut the gum open, file down/clip off the exposed bone, stitch up the gum), how long would it take for me to heal to the point of no more pain and be able to eat normally? I'm about to go on a trip and I hate the idea of not being able to eat normally while traveling.

Expert:  Dr. Katz replied 1 year ago.
As long as your tongue continues to rub against this area,it will remove the healing cells that are trying to form.You cannot remove your tongue,so it is like a large splinter in your finger that will continue to hurt and be inflammed until it is removed.This procedure to repair this area is not a major event.Any good oral surgeon or dentist with some ecperience can nip this bone smooth so that the edges are covered by soft tissue and you will begin to heal.Once this area is trimmed back,within a week you will feel fine.The dentists that you are going to do not have experience..or else they would have treated you right away.Once the bone is showing and is exposed..it needs to be trimmed back so that a fresh surface of blood and tissue can start to reconnect at the site.It is bad for your body to leave the situation as it is.You need to go to a dentist who knows what he is doing.The two that you have seen don't have the experience to treat you.
Customer: replied 1 year ago.

Thank you. In two days, I'll be going to Taiwan, and I'll try and go see a dentist there, since Taiwan is much more advanced than China in general. Is it okay for me to wait a few days (will it cause bad complications if I wait a few days) and do the treatment in Taiwan (where they will likely have better dentists), or it's not soon enough and I need to do it in China with the local dentist right away (tomorrow)?


 


 


The two dentists I went to locally are practicing dentists for many years locally in the city of Fuzhou, each with decades of experience (and one of them is the head of the oral department of the a big hospital). I think it's just that medically, their knowledge is behind dentists of developed/advanced countries. They also tend to have terrible bedside manners (China being what it is). Too bad I won't be back home in the States until late November. Dentists in the States are far better for sure.

Expert:  Dr. Katz replied 1 year ago.
You are not in grave danger if you wait a couple of days..but the pain and irritation will most likely continue.Any dentist with any surgical experience should know how to correct this problem.This is an oral surgical problem and if these dentists are just filling teeth,they will not be exposed to the surgical side.This is not a medical problem.You need to see an oral surgeon.Most general dentists do not know how to deal with this dilemma.
Customer: replied 1 year ago.

Thank you. I guess if I'm not in grave danger of irreversible damage or bad infection, then I should probably try the dentists in Taiwan. At the very least their bedside manners should be a lot better overall, and have better equipment. I just don't trust the dentists here anymore--not after what's happened already.


 


Before I end this Q&A and give you a rating (a good one :-) ), are there things I should watch out for and keep in mind for the upcoming surgery? Any possible complications I should be aware of?

Expert:  Dr. Katz replied 1 year ago.
This is a minor procedure.They will numb the area and use a clipping device that will create a smooth fresh area so that the gum can granulate and heal over the area where the bone is protruding.That is all there is to it.I would take an antibiotic like penicillin vk 500 mg every 6 hours for 6 days after it is trimmed.There really should be no other major concerns.
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 2035
Experience: Dentist and Anesthesiologist for 34 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
Dr. Katz and other Dental Specialists are ready to help you
Customer: replied 1 year ago.

Thank you, XXXXX XXXXX!

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