AboutJoel S. Teig, DMD, FABOMS Expertise I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.
Organizations American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons
Expert: Joel S. Teig, DMD, FABOMS Date: 5/20/2008 Subject: Nearly 3 weeks post op oral surgery and having some problems
Question QUESTION: I am a 36 y o female with a past medical history of Parkinson's disease, melanoma R thigh, dermoid tumor on my spine, several basal cell carcinoma's removed, pre cancer cells on cervix and have had a TVH. Now to my mouth, I recently had a wisdom tooth impaction removed due to a possible cyst that had ruptured prior leaving a hole so deep that the oral surgeon said he had never seen one that deep before. He did tell me about the risks of my jaw braking and/or losing the sensation in my face due to the nerve that was like a band wrapped around the bottom of the tooth. He also did a bone graft because the wisdom tooth was sitting on my jaw bone and therefore had made my jaw very weak. The surgery was scheduled for 45 minutes, but it took 2 and half hours. I did have some pain afterwards but on my last visit (which was 2 weeks ago) he said things seem to be healing well. The hole was not competely closed and I have been rinsing with warm salty water daily, 2-3 times or more. I also took two rounds of antibiotics and I am brushing and flossing as well as rinsing after each meal or snack. I do still have partial numbness in my jaw and lips. Over the weekend I have had a low grade fever and had a really bad taste in my mouth. I had diarrhea one day for 12 hours straight and I have been very nauseated and had tramendous gas ever since. My tooth feels as if there is pressure and when I try to look at it, there is a hole behind my second molar and it almost looks as if there is a space under that tooth as well. I am also getting some yellow drainage occasionally but I am still continuing to do warm salt rinses. This moring I woke up feeling like my head is full of cold. I just didn't know if this could be related and this tooth my be infected. The tissue surrounding the second molar is very tender and sore and my gums are swollen around that area. I just thought I would ask for your opinion and advice before Monday and I call the office. I just can't seem to shake this yucky feeling and nausea. Any advice would be greatly appreciated.
Thank you and God Bless!!
ANSWER: Candy - Sorry for getting back to you now, I was ill. It sounds like you might have an infection or just an inflammatory reaction of the bone lining the socket. The surgeon should probably put you back on an antibiotic and if resolution of the problem does not occur quickly, it might be best that he explore the area.
Without actually looking at the area it is a little difficult to be totally correct, but with your symptoms for so long exploration may be best. If you have additional questions, feel free to contact me again.
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QUESTION: Thanks so much for your reply. Today there is a space under my second molar that has white stuff in it. I have rinsed my mouth and flossed and gotten some of it out, but I am not sure what exactly it is. It does have a foul smell but it doesn't look like pus. I called my oral surgeon today and they suggested I call my dentist because it could possibly be tooth decay from how deep my wisdom tooth was and how infected it was initially. To me it seems like it some of the bone coming out, if that makes any sense at all.
I do hope you are feeling better. My husband is very ill with a virus and it has been a long 3-4 day recovery. Thank you so much for your advice.
God Bless You,
Candy
Answer Candy - From what you describe, it does not sounds like decay of the adjacent tooth, but rather it does sound more like bone. Of course I cannot be sure, but just to take precaution that it is bone, you need to begin a regimen of warm salt water rinses for about 5 minutes 4-5 times a day. The water will reduce the inflammation and can often allow the body to just discard the piece.
