persistant oral infection...please help

[reg_void]

Hey guys,
This is my first post after reading many other users stories. I have had my wisdom teeth (3) removed by a oral and maxifillo surgeon 12 days ago. In the weeks leading up to the surgery I was prescribed 500mg amoxicillin, when that didn't work, 500mg amoxyl with clauvanic acid, when that didn't work 400mg metronidazole. Got my teeth out (out of state) and was prescribed 500mg cephalexim. I developed dry sockets in my 2 lower extraction sites and my local dentist packed them with alvogyl and gave me another script for metronidazole at the same strength (500mg). Last night I was in severe pain and went to the after hours gp, who prescribed me more amoxicillin. This is all within a 4 week period. The infection just isn't clearing up despite following oral hygiene and doctors orders to a tee. I've been told I can still smoke tobacco (due to quitting daily marijuana use 2 weeks ago and caffeine at the same time, to help battle my anxiety). Does anyone have any stories like this and if so does anyone have any advice on what I can suggest to the dentist/gp as they keep putting me on the same meds over and over and I believe I may have built up a resistance. I cannot see my surgeon and the dentists keep saying it will get better....but it's not. Please, any advice would be greatly appreciated

[jotini]

Hey, I'm in training to be an oral surgeon! So, the smoking is going to seriously impair your healing. It's also likely to be the cause of the dry socket too as it reduces blood flow - which you need when you're trying to heal. Whilst I'm not saying give up, just maybe for a few days try really hard just to have a couple less cigarettes; once you have healed a little more then you can resume regular smoking (though I shouldn't advocate smoking at all!).
The dry socket was from losing the protective blood clot when the teeth were extracted; if they're not truly infected then antibiotics will do nothing. It sounds like your surgeon and dentist were giving them out like candy! We don't quite have that approach over here.
To me it sounds like you have delayed healing, primarily from smoking, you may also have other factors in your medical history that compound healing.
Also, If it is getting a little stinky and gross in there I would recommend hot salty mouth rinses, a teaspoon of salt in a small cup of hot water and just bathe the sockets by holding the rinse over them for as long as you can. The salt will kill the bacteria much better than antibiotics.

Jo

[reg_void]

Hey, I'm in training to be an oral surgeon! So, the smoking is going to seriously impair your healing. It's also likely to be the cause of the dry socket too as it reduces blood flow - which you need when you're trying to heal. Whilst I'm not saying give up, just maybe for a few days try really hard just to have a couple less cigarettes; once you have healed a little more then you can resume regular smoking (though I shouldn't advocate smoking at all!).
The dry socket was from losing the protective blood clot when the teeth were extracted; if they're not truly infected then antibiotics will do nothing. It sounds like your surgeon and dentist were giving them out like candy! We don't quite have that approach over here.
To me it sounds like you have delayed healing, primarily from smoking, you may also have other factors in your medical history that compound healing.
Also, If it is getting a little stinky and gross in there I would recommend hot salty mouth rinses, a teaspoon of salt in a small cup of hot water and just bathe the sockets by holding the rinse over them for as long as you can. The salt will kill the bacteria much better than antibiotics.

Jo

Hey Jo,
Thanks for your reply...yeah I have been gently rinsing with saltwater every 3 - 4 hours. I have cut down smoking but I might try stopping altogether for a day or 2. There is Definatley infection as there is swelling and whiteness of the gum around the extraction site. I don't believe dry socket to be an issue anymore as the alvogyl has come out yesterday and swelling has reduced a bit, and with that reduction so has the pain....I'm at my wits end lol.

[reg_void]

Gday Jo,
Just a quick update. I have just seen my dentist again and they have sent me for another OPG to see if anything went wrong during surgery. I will post the results regardless of positive or negative outcome. Thankyou again for your speedy response.
Steve.

[Jess13]

Hi i used to work in the medical field, if the dr didnt know what kind of bacteria was causing an infection that wasnt responding to antibiotics he would take a sample and have it sent to the lab for a culture. Then he would know what meds to prescribe. Diff bacteria respond to diff antibiotics. Maybe suggest that to the oral surgon. Good luck! I hate anything to do with the dentist ��

[reg_void]

Hi i used to work in the medical field, if the dr didnt know what kind of bacteria was causing an infection that wasnt responding to antibiotics he would take a sample and have it sent to the lab for a culture. Then he would know what meds to prescribe. Diff bacteria respond to diff antibiotics. Maybe suggest that to the oral surgon. Good luck! I hate anything to do with the dentist ��

Thanks Jess,
If this new course of amoxicillin dosnt start doing anything by my next dental appointment (Wednesday) then I will definatley suggest that.

[jotini]

Hey,
An OPG sounds good, they can check if you have any flecks of bone that can't get out (totally normal).
Stopping for 2 days would help you out immensely! If you can then do it. You may notice the rest of your gums bleed when brushing them after you stop smoking for a few days - that's just your gums getting their blood supply back! Again, it's normal.

Please do post the outcome, and keep up with the saltwater rinses. I hope you're not in too much pain, dry sockets are really unpleasant - I feel really bad for patients when they come back in pain and look so sad.

[reg_void]

Hey guys, just me again. My opg came back normal so I asked if they would remove the alvogyl from one socket (it has been in there over a week now), clean it out and reapply alvogyl. They just said it will some out on its own. Now I know this, but I have done everything in my power to keep it in....successfully. is it ok to leave this stuff in that long? I fear that there is infection or pus underneath it as its sore and a bit 'squishier' when I touch my cheek than the other side, in which the alvogyl did fall out and I took that opportunity to clean it before they repacked it today. So to clarify, lhs has pain and is squishy...the side that has had one application of alvogyl in it for over a week. Rhs feels good, side that alvogyl came out and allowed me to clean more thoroughly. I know the dentist is a professional but I mean, they can't feel what I can feel.

[jotini]

Hey,
They are probably less inclined to remove it in case they disturb any clotting process underneath. It won't do you any harm to leave it in fortunately.

On a completely non-professional note and on a personal level, I had wisdom teeth and molar teeth out for orthodontics and would very gently swab the socket with a Q tip soaked in salt water. Definitely don't put a dry one in there. You can do that to remove any plaque or general gunk around the socket. The alvogyl may come out but if it comes out then it was ready to come out anyway if that makes sense.

As far as the squishiness goes its just your body increasing the fluid flow to the tissues to promote healing and repair, it'll do the job on its own. If there is pus you should be able to see it. You have had quite a lot of antibiotics though and probably won't need any more unless really necessary.

For pain just continue taking any painkillers given, or take whatever you would take for a headache.

[reg_void]

Thanks for the advice. Definatley provides me a bit of piece of mind, which my dentist struggles to make me feel. They just seem like they rush me in and out as quick as possible and don't answer my questions and concerns, and I am the type of person that likes to have a solid understanding of what is going on. I'll keep this thread updated with any negative or positive outcomes. Once again, thanks a million :-)

[ruhligv]

I am so sorry for your infections that is absolutely the worst pain ever! I had mine out last April, they were infected under my gums and had to be taken out a day after going to the dentist... All 4! I had final exams the following week and had to work the following day! Worst couple weeks of my life, I sat in a ball in the corner at work and cried I was in so much pain! I had dry socket (I don't smoke) and could barely eat! Luckily it only lasted about 9 days and then I was all better, the best thing I did was the oral rinse, that really helped. I couldn't believe how much food and yuck got down into the extraction sites.

Anyway hang in there! Glad you got some piece of mind here! Did they put you under during the surgery at least? They did me, I don't think I'd have survived if they didn't. My surgeon was super hott too, which always sucks when you show up in your pjs and look like a swollen sausage from surgery with drool oozing down your face! (And I was sobbing for fear of throwing up!) he was an awesome surgeon though, very kind and explained what he was going to be doing, showed me the x rays before starting and how he had to be careful around the nerves... and personally called me later that night after I got home to ask how I was doing. I thought that was really, really great! He made me feel very confident in his work and like I could call him if I had any problems or questions.

[reg_void]

Hey guys,
Yeah the infections Definatley are a pain in the...mouth...but hopefully they are calming down. First decent day back at work today and I think it was good to sweat out a few toxins. I've come to accept that I'm gonna have some pain (dentist reckons about 6 weeks worth) but as long as I start to feel healthy, I'll be ok. Definatley can't wait to have a quiet beverage...just quietly lol. It's good to know I'm not the only one suffering or having suffered (not in a way that means I like when ppl suffer but you know what I mean). Let's me feel like I will be ok in the end. Yeah I was put under as it was difficult surgery and high risk of damaging a nerve that one of my teeth were pushing on. That coupled with severe anxiety around it all dosnt help the healing process, I think. Anyway, not too bad today....taking it as it comes. Just trying to keep food out of my sockets is the most difficult thing at the moment as I'm STILL not allowed vigorous rinsing. Anyway, I'll keep all updated and hope everybody is doing well :-D