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Oral Surgery/postextraction infection

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Question
QUESTION: hello sir,
i am not understanding how it is happening...
in attempt to anesthise tooth (grade 3 mobility) i give many injection in pockets...the patient return with swelling pain and swalloing difficulty....how it can be prevented and where can be fault.....
is it necessary to prescribe antibiotics after extraction.....

ANSWER: Ritu -  if you are unable to anesthetize and you are sure that the injection is done in the correct site and the inferior alveolar nerve has been anesthetized, then only inflammation of the nerve can be the cause.  In that situation you need to attempt to reduce inflammation.  The simplest and very successful technique is to simply have the patient begin warm salt water rinses in the exact area for about 2-3 minutes, 4-5 times a day.  

If the inflammation exists after the extraction, and there is some inflammatory bleeding after the extraction, then antibiotics would be appropriate.

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

QUESTION: I prescribed the antibiotic to that patient...amox,clav combination and serratio, brufen...next day patient come with yeavy pus discharge from socket...does my intraligamentary injection done this!!!

Answer
Ritu -  It is difficult for me to know why, but this to occur the next day should have nothing to do with the antibiotic.  I again suggest that the patient immediately begin warm salt water rinses for 3-5 mintutes, 4-5 times a day.  I cannot tell you if the injection did this, but you may have introduced bacteria into the ligamental attachment with the injection.  Have the patient do the above rinses immediately.

Oral Surgery

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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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