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Oral Surgery/Post Apicoectomy


QUESTION: Due to trauma to my jaw several years ago I required 2 root canals & subsequently 2 apicoectomy's to my two front bottom teeth (I believe # 10 & 11?).  
I am 15 days post surgery & I am due for another followup in 7 days.  Everything has been healing well.  Swelling & Pain subsided within a week.  It has gradually been getting better.
Today I noticed a pus filled pocket where a suture had been.  I popped this and allowed it to drain until there was only blood.  The area is dark red but otherwise no sign of additional pus.

I am generally concerned.  Is this something normal post surgery?  Could something have gotten into my gums during the healing process or is this something serious?  I am concerned about additional infection and what that could mean (i.e. additional procedures)?

ANSWER: Rob - After surgery, internal bleeding under the sutured gum tissue can continue and produce a situation called a hematoma.  Usually these are not a problem, but occasionally it can become infected.  To help, you immediately need to begin warm salt water rinses in the area for about 2-3 minutes, 4-5 times a day.  If you were not placed on an antibiotic, that would now be important.  

So do the warm salt water rinses and that will often promote complete drainage.  If you are not on antibiotics, have the doctor prescribe you one.  If the problem continues, the doctor definitely needs to consider the cause of continued problems.  Usually it will get better with the antibiotics and the rinsing, if the apicoectomies was done correctly.

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

QUESTION: As a follow up to my question and Dr. Tieg's response...

I hope this helps anyone looking for answers who has had a similar situation as I have...

I saw my oral surgeon today regarding my apico.  First, it is very important to see the oral surgeon who performed the surgery if you have any issues.
Upon examining my gums and teeth he immediately remarked that everything looked great and was healing well.  

I have a light yellowish liquid draining from my gum at the site of the suture.  He said this was normal given the nature of the trauma to my jaw.
***(I thought this was continued infection)***
He advised that I continue to massage the area to encourage drainage and to rinse 4-5 times a day with salt water to draw out anything in there.  He did not prescribe meds and I have a follow up appointment in 2 weeks.

Rob - I am a "belt and suspender" surgeon.  If you are still getting drainage of liquid, beside the continuation of the warm salt water and antibiotic can help prevent the area of drainage to have infection.  The chances are not high, but there is a chance.  So as the type of surgeon I am, antibiotics are important still, in my perspective.  Continue to heal well.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


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.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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