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Oral Surgery/Tooth Extraction - Had low sinuses


QUESTION: I had upper tooth #4 extracted yesterday and seems to be healing ok today on day #2 of recovery.  However, I am feeling some pressure in my right nostrel, right ear, and have small headaches.  Is this normal healing pains after tooth extraction surgery, or could this be early signs of a sinus puncture?  The surgeon i used seemed very good and reputable, and did not mention anything in the post op room other than the surgery went really well.  I am to see him again in 2 weeks.

Also, my extraction site has turned white.  Is this normal on healing, or is this indicative of infection?  They told me it was normal when I called this morning.


ANSWER: Stephen - first of all, the white area to the extraction site is not abnormal.  It is actually an accumulation of oral bacteria.  For that reason it is important that you begin warm salt water rinses for a couple of minute, 4-5 times a day.  

As far as the headaches, pressure in the ear and nostril, that is not totally abnormal.  Most  likely, you are having spasms of the jaw muscles.  This is not unusual after extraction, but it is another reason that warm salt water rinses are important after extractions.

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

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

QUESTION: Thank you. I am now on my third day of recovery since I had the procedure done early Thursday morning(7-8am).  Beyond 24 hours now.

I started the oral rinses yesteray morning and the white is now mostly gone. It looks like old gum that was white is eroding away and the gum is looking pink and healthy below with some stiches across it to hold it shut? Do oral surgeons typically close with a couple of cross stitches?

The gum inflamation is rapidly going down and the wound is compressing backwards every day.  

The one thing that has me concerned is I don't see any red indicative of a blood clot on the surface.  At least not much.  To the side is a small red spot, but thats it.  Is it possible I won't be able to see the blood clot formed on the surface due to the overlapping pink gum that is stiched up?  I also thought I heard the nurse say he put in a plug?

Thanks for your quick responses,

ANSWER: Steve - The red area indicative of a blood clot found after an extraction should not be present if the closure was done correctly.  The gum flaps closing the area should contain all the blood below the gum flap so that new bone form in that area.  The doctor did the correct approach by placing a "plug".  A watertight closure is important to achieve healing and the seal closes the hole tightly.  

As far as the suturing, cross sutures is one technique and there are others.  The key factor is not the particular type of suturing, but the water tight closure.  

It sounds like you are healing and that is good.  If you have additional questions, feel free to contact me again.

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

QUESTION: I am on my sixth day of recovery now, and the wound seems to be doing well.  Although I am noticing a few droplets of brown sticky residue forming around my plug.  Is this blood and a normal healing response, or does it mean my socket is leaking / have an infection?  Ive been continuing with the salt water rinse, but the brown droplets seem to keep coming back after I eat or rinse.

Steve - The brown droplets could be small areas of blood clot or accumulation of debris.  Without symptoms of pain, swelling or leakage into the sinus, it sounds like you are healing just fine.  Keep up with the warm salt water rinses and the healing should progress.

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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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