Dentistry/leaking graft particles / bitter taste 8 weeks post-operatively
Dr. Teig, I just read and found helpful your response to the woman who had bone graft particles leaking out and a bad taste rather shortly following her sinus bone graft procedure. I was heartened to hear that oral bacteria in an unfinished wound healing does not necessarily signify infection. I had an extraction / socket bone graft [of particulate human tissue] of tooth #14 on January 4—almost 8 weeks ago. I have experienced leakage of particles over the weeks, including 5 particles just last week one night that I put in a baggie, and I perpetually have some awareness of a bad taste. It becomes a bitter, metallic bad taste if I don’t brush my teeth for a few hours after a meal. Is this still possibly within the bounds of normality for 8 weeks out post-operatively? The wound site, I’m told by my dentist, looks great—pink, not swollen, not sore, and I have no fever. I do notice that my cheekbone on that side is noticeably more prominent than it ever was, but friends tell me well, you’ve lost weight in this ordeal, and no one is perfectly symmetrical. I have no soreness or pain. I called the periodontist who did the extraction and graft, who last saw me 4 weeks ago when he removed the stitches, and I reported the ongoing bad taste and particles. His office told me that he would defer to my new prosthodontist for evaluating this site until my next scheduled follow-up in May. Any insight you can offer would be most welcome. Sincerely, Cheryl
Cheryl - I am a little disturbed that the periodontist who placed the graft is not following you closely. With the repeated loss of particles, infection or not, the periodontist should be examining you closely. That is one of the main problems with periodontists, they are not surgeons and are not familiar or trained with the repeated and close examination necessary to insure proper healing.
Look, the are might be healing, but not having been examined for a while by the doctor who did the surgery is all wrong and unprofessional. Do not take no appointment now. You need to be followed closer; that is normal and professionally correct.
So call the periodontist and have yourself evaluated. The prosthodontist has no surgical knowledge and should not be the one to evaluate the graft site. So if the periodontist does not see you, have yourself evaluated by an oral and maxillofacial surgeon. I hope the proper doctors evaluate you soon to insure that proper healing is occurring. Normally, during the healing period, the patient should be rinsing with warm salt water for a few times a day for
1-2 minutes. That will help the healing. I wish you well and hope the periodontist learns the appropriate follow-up occurs.
If you have additional questions feel free to contact me. I wish you well and hope it all heals.