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Face and Jaw Surgery

Wisdom teeth extraction gone bad?

02/27/2007

Question:

I had 4 wisdom teeth removed 8, days ago by an oral surgeon. I have been in pain since the surgury. I finally insisted that someone see me on the 6th day. (The doctor who did my surgury went out of the country, the day after my surgury.) The doctor I saw said my mouth looked normal, and was healing. He did not shine a light into my mouth. He gave me more pain pills and said to see my doctor next week when he got back to the office. I was very upset and thought I could wait to see the other doctor next week. I could not wait. The pain got even worse. Yesterday, I went back to see him at another of his offices in a town 30 miles away. He was not pleased to see me. I told him I had to have something done. I had to work! He said he would pack the one site and I was to choose which one. I chose the right side because I could see the roots of my other teeth and exposed bone. He finally turned a light on and looked into my mouth again. I told him again to look on the side next to my jaw. He said maybe he could put in a stitch there. After one stitch, he said maybe two stitches. He packed the site with clove tasting material. Told me to see the other doctor on Tuesday (5 days later). My question: Is this normal procedure? I NEED TO KNOW WHAT TO DO NEXT? THANKS FOR YOUR HELP!

Answer:

Pain after wisdom teeth removal is usually significant. This is more common with the bottom wisdom teeth. It is due to the nature of the bone. In addition, accumulation of food debris and tissue debris occurs in the lower jaw due to gravity. This causes significant inflammation and contributes to further pain.

Infection of the extracted surgical site usually does not happen for 4 to 5 days. From the description you have given, it appears you needed better pain management and specific control of inflammation by removal of food and necrotic debris from the surgical sites. The oral surgeon packed the surgical site by dry socket dressing. Dry socket dressing consists of eugenol that is toxic to pain fibers, hence patients get almost immediate pain relief. Unfortunately this may slow down the healing process in some situations.

Dry socket is a painful inflammatory condition of the tooth socket where the clot is lost, leaving exposed bone. This is seen more in bottom jaw and in smokers. This usually does not happen for about 5 days. 

I cannot answer if the management of your situation is right or wrong without appropriate evaluation. I suggest you see the surgeon who treated you again or find an other surgeon for a second opinion especially if you are unhappy with the treatment rendered. 

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Response by:

Likith V Reddy, MD, DDS, FACS Likith V Reddy, MD, DDS, FACS
Formerly:
College of Medicine
University of Cincinnati