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QUESTION: Hi there,

I had an apicoectomy on 3/28/14 (6 days ago) on tooth #8 and am still experiencing significant swelling and pain in my gums. I am also noticing slight yellow/reddish drainage coming from one of my sutures right at the tip of where my gum meets my tooth. Is this normal or is it a sign of infection?

I've been rinsing my mouth with warm salt water after every meal, so I will be surprised if this is in fact an infection. My endodontist isn't available to see me until Monday. Please let me know - thank you!

ANSWER: Anna -  It is not totally unusual to have some slight swelling and soreness, but drainage six days after the apicoectomy is not appropriate.  The warm salt water rinses you are doing is totally correct.  The doctor should have prescribed an antibiotic to be taken after the apicoectomy and you didn't mention that.  

I am not comfortable with any drainage still present six days after the surgery.  The endodontist needs to arrange to have you seen now and not wait until Monday.  If he is not available, he should refer you to a different specialist to properly examine you.  So contact his office and ask for them to arrange to have a different doctor examine you.  It might be nothing, but it should be examined if you are having drainage.

If you have additional questions, feel free to contact me again.

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

QUESTION: Thank you so much for answering my question last time. I am now 3 weeks post apoicoectomy and the pain I was experiencing prior to the procedure has returned. Does this mean the apico has failed or is it still too soon to tell?

If it has failed and I need to extract the tooth, what are the chances that the pain will return? I am getting very frustrated with this tooth and am seeking a permanent solution. Any advice will help.

Thanks again

Answer
Anna - if the cause of the pain is actually the tooth, then an extraction should eliminate all pain within a few days of the extraction.  Like I stated previously having a different doctor examine you and if the tooth needs an extraction then that will perform the extraction. For that reason, the doctor who glucosamine and determine the need for an extraction should be a board certified oral and maxillofacial surgeon.

I wish you well and hope you feel better soon.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

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.

Experience

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

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

Education/Credentials
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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