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Dentistry/Pain 10 days after lower molar extraction


QUESTION: I had to have a molar extracted from lower jaw 10 days ago, due to a failed root canal. There was a granuloma on one of the roots that we could see after the extraction. Healing was going fine, besides the odd bit of discomfort when food got stuck in socket. Yesterday I started experiencing pain deep in the socket, particularly when swallowing. Can you develop a dry socket so long after tooth extraction? I have been rinsing with salt water 4times a day, since day 2. I was also on an antibiotic for 1st 5 days.

ANSWER: Sue - a dry socket does not usually begin later than five days after extractions.  Of course, I cannot fully determine the cause of your pain, but the presence of an infection is probably the probable cause of the pain.  Of course there are other potential causes, but it is most important that you get back to the doctor's office to evaluate you.  If that doctor cannot find a cause, he should then refer you to an oral and maxillofacial surgeon.  

So contact the office and be evaluated as soon as possible.  I wish you well and hope the problem resolves.  If you have additional questions, feel free to contact me again.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your response. I went back to the dentist and he said that he doubts there is an infection as the gum is not inflamed and all is looking good. He suggested that perhaps I had traumatised the site with chewing etc and to carry on with salt water for a few days. It has improved over the last day but has not gone away completely. It only seems to be sore now when swallowing liquid. He did give me a script for an antibiotic if it got worse. I am now not sure whether I should just take the antibiotic, or give it a few more days. What do you suggest?

Sue - you have nothing to lose by taking the antibiotic at this time.  If there is an underlying problem, the antibiotic should help.  In addition, you need to immediately begin warm salt water rinses, but increase the rinsing to 4-5 times a day for a full 3-4 minutes.  The increase of the warm salt water will increase the blood flow to the region and help to promote healing.  


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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