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Dentistry/Premolar extraction


Four weeks ago I had both of my maxillary first premolars removed for braces. The problem is that after the surgery my sockets did not bleed, so the dentist applied some kind of paste (I think Alvogyl) for prevention.
After 5 days I started to feel a little pain and bad breath coming from one of the extractions. The dentist assured me it was curing allright and washed the socket with peroxide (but without removing the paste!).
Two more weeks passed without pain, the socket closed up but 3 days ago I felt the last bit of paste coming out, smelling horrible. After that incident I have been experiencing constant pain for 4 days and I woke up this morning with a swollen cheek. Is it possible to get an infection or a dry socket after 4 weeks from the extraction? Can the dry socket paste left too long be the cause of it? Thanks in advance!

Alina - It is definitely possible to develop infection after that paste was gone.  Bacteria from the mouth accumulated in the area and has now developed an infection.  You need to immediately begin warm salt water rinses for 3-5 minutes, at least 5 times a day.  You need to contact the dentist and he needs to prescribe an antibiotic.  If that does not stop the problem, you should see an oral and maxillofacial surgeon to evaluate the infection.

I hope you feel better soon.  If you have additional questions, feel free to contact me again.


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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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