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Oral Surgery/reoccuring infections after wisdom teeth extraction

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Question
Four months ago, my teen, had 4 impacted wisdom teeth extracted by a recommended Oral Surgeon.  5 or 6 weeks after, one lower socket began hurting and then became swollen. The Oral Surgeon said it was infected, drained puss, and treated with antibiotic.  It seemed to respond, and felt better. The Oral Surgeon seem to feel it was due to insufficient cleaning and care after surgery by my teen, thus food particles got inside causing infection. About two weeks later, the other lower side became infected; same treatment, same antibiotic, same outcome. Then the process repeated, and both lower sockets alternately infected again and were prescribed the same treatment. But one of the infected lower sockets didn't ever feel all better, and just as the other lower side began to bother her again, the Oral Surgeon recommended a second surgery. So a surgery to reopen and clean out the sockets was performed.  After, we heard there was a lot of puss, and gunk in there, assumed to be food particles. Now it is totally clean and sewn up very tightly in hopes of nothing getting in. That surgery was 4 weeks ago, this morning one lower jar area of my teen is swollen and appears to be reinfected. After calling this morning, we have an appointment this afternoon with our Oral Surgeon. The long duration of continued infections is disconcerting.  Are there any other possible reasons for these repeated infections? Do you feel we should continue our current course or seek a second opinion?

Answer
Mom - Of course, without examining your child I cannot be completely sure, but the repeated infections and obviously poor healing tends to indicate that the infection has spread and your child might have osteomyelitis.  This is a more aggressive infection of the bone and can be difficult to eliminate.  Antibiotics can help to contain, but once stopped the infection can reoccur, if it is osteomyelitis.  

I too am not comfortable with what has happened and the doctor seemingly unable to gain control over the infection.  Getting a second opinion from a board certified oral and maxillofacial surgeon is important.  It is not a slap in the face of the surgeon, but it is appropriate in this type of situation.

So look for a board certified oral and maxillofacial surgeon to examine your child.  If you need assistance in finding one, get back to me, tell me where you live and I will send you names of appropriate doctors near you.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired

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

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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