I'm 35, and just had the 2 wisdom teeth on the left side of my mouth pulled 4 days ago. (The other 2 wisdom teeth were pulled 12 years ago... one was growing in crooked.) I wasn't having any serious trouble with them... just found I was biting myself more, and thought I'd be proactive and avert any possible trouble down the line.

When I had my extraction 12 years ago, it was with an oral surgeon. I received a local anesthetic and nitrous oxide before they were pulled. I'm not positive, but I seem to recall the gums were stitched afterward. I don't remember suffering much pain afterward. I also don't remember a gross amount of bleeding. It was a pretty smooth experience.

I've sinced moved, and my current dentist performed the task. He's not an oral surgeon, but was very confident he could manage my wisdom teeth. They were not impacted, and my teeth are in great condition. (Never had a cavity.)

He only gave me a local; no nitrous oxide. He had to shoot me up a few times, as I could still feel him when he would attempt the extraction.

Everything seemed okay. He said I was hardly bleeding, advised I remove the gauze when I got home, and didn't think I'd need any more. I asked if he was going to stitch things up, and he said no, shrugging it off as if it wasn't necessary. He just warned me about the blood clot/dry socket phenomenon, not to rinse my mouth with mouthwash for a few days, etc.

Well, when I got home, blood was gushing out. This continued for at least 3 hours. I didn't understand his "hardly bleeding" comment. I did spit the blood out, worried about the dry socket thing all the while. But, surely, I wasn't expected to swallow all of this blood!

That night, I awoke from sleep and felt what seemed like a giant wad of gum (like, at least 5 pieces of gum) in my mouth. It was a giant blood clot! Surely, this wasn't the blood clot that was to form, protecting from dry socket? I mean, it was giant! I'm not squeamish, but this freaked me out. So, I spit, and it slipped right out. (If I hadn't spit, I'd have probably swallowed it. Yuck!)

I went to work the next day. I was a bit tender, but Ibuprofen seemed to help. People commented their surprise that my face did not appear swollen. I thought it was going to be smooth sailing.

Well, the pain only seems to be growing with each passing day, not diminishing. Last night, I had to break into the Vicodin my dentist gave me as a 'just in case' measure. That only numbed me, but didn't dull the pain, so I also took 600 mg ibuprofen. (My dentist said it was okay to take both.)

I know some pain and discomfort is to be expected, but I would think things would start feeling better, not worse. And the fact that I didn't get stitches has me particularly worried. It seems like food could easily slip into one of the holes in my gum line now, even though I'm being careful about what goes in my mouth. And will the gum actually grow from each side of where the tooth was and seal over together smoothly? It wont' just remain as a gaping hole?

Everyone I've asked, and everything I've been reading since, expresses stitches as standard. I've found nothing that DOESN'T mention stitches as part of the procedure.

Is this normal and am I just being a wimp? Has anybody heard of the 'no stitches' thing, and know how the gum manages to grow back together in this case?

Sorry for the long post. I just want to feel better, and avert this pain turning into something worse.

Thanks for reading!

I am sorry to hear that you are having problems. I have had a wisdom tooth out with no stitches and it was fine. Spitting is a HUGE no-no after extractions and increasing pain is a bad sign. Sounds like possible dry socket to me and I would suggest calling your dentist. Do you smoke or take BCPs? If you do either of those things the chances of dry socket are greatly increased.

Call your dentist! If it is dry socket, only your dentist is going to be able to help with the pain. Good luck!

reginar - Is the pain REALLY bad like a deep dull throbbing? Sometimes a dry socket can form in 2-4 days or so when the clot dislodges due to spitting, smoking, carbonated beverages, or for absolutely no reason at all. Without the clot the bone and nerves are exposed and it's very painful like a deep dull throbbing - I've had a number of them and I've taken the Vicoden and Advil combo. Dry sockets prolong the healing and you'll have to have the dentist put some treated dressings in there which will stop the pain in about 10 minutes. You just have to go every couple of days for about a week. One dentist gave me a syringe with some white stuff mixed with clove oil in it so I could just squeeze it into the hole myself at home.

Extractions will hurt for awhile even without dry socket - it's an uncomfortable but tolerable pain.

The area will heal from the inside out, from the bone up, as opposed to the gum area creating a seal over the extraction site. It's not unusual to not have stitches in the wisdom teeth - sometimes I think it's healthier as the area won't be sealed off closing bacteria and toxins in there.

This always happens on a weekend when you can't reach the dentist doesn't it? If he's got a pager or emergency number and you're in alot of pain, don't tough it out - get it looked at treated if it indeed is a dry socket.

After 48 hours it's OK to do gentle salt or plain water rinses - no swishing though! :)

No, you're not a wimp - dental pain is the worst....

cathyk

[This message has been edited by cathyk (edited 05-24-2003).]

Thank you, Shaman and cathyk! Your insightful words helped put my mind at ease about the lack of stitches.

My dentist has been away for the holiday weekend, naturally. Since I've written, I've kept on my cocktail of ibuprofen, and have been able to live with it. It still is hurts, but less than when I posted to the healthboard.

I still plan to follow up with my dentist this week though, just for one last look. I'm not a smoker, nor on any other meds. I do suffer from seasonal allergies, however, and wouldn't be surprised if I sneezed the clot away, creating a dry socket.

Anyway, thanks again. Your reassurance has done wonders to help along my healing process.

I'm sorta of in the same situation as you. I had my upper l. wisdom tooth (which was fully erupted) pulled last week and over the past week I've been feeling this dull numb pain, & it doesn't just hurt after I eat, the pain is always there. I just made an appt. with the oral surgeon for this Thurs. to check it out.

If it is a dry socket, what will be done to get rid of it? I'm clueless as to what a dry socket is - will it ever go away on its own?? BTW I'm on birth control pills

I had a dry socket after wisdom teeth removal. You can either go the the dentist and have them take care of it, or the pain will go away in a few days on its own. I elected to do nothing and it got better.

"A "dry socket" occurs when the blood clot is lost from an extraction site prematurely. Basically, the blood clot in the socket serves the same two functions as a "scab" on a skin surface cut. First, it assists in the cessation of bleeding and second, it protects underlying structures during the healing process. Like the child who "picks at a scab" the area heals in time but is painful for far longer than if the "scab" had been left alone.

When the blood clot is lost before the underlying structres have had time to heal, bone is exposed to the oral environment along with fine nerve endings. This is an exquisitely painful but otherwise relatively harmless situation. There are packing materials which the oral surgeon can place to help ease the discomfort both by physically blocking the wound and by the action of the chemicals in the pack on local nerve endings. Generally, patients return to have the pack changed every day or two and most patients do not require more than 2 or three dressing changes. Some patients require no dressing while others may require 4 or 5 changes of packing. Tincture of time and good oral hygiene usually resolve the situation.

There are some activities which may increase the propensity for dry socket formation...smoking, drinking carbonated beverages in the first 24 hours after surgery, spitting or drinking through a straw in that same time period...but often "dry sockets" occur for no particular reason at all."

Wow thanks so much for that informative explanation - the pain is just horrible with it & its so weird 'cause you keep thinking a tooth is still there with all the pain its causing, & Advil barely works. Hopefully my appt. tomorrow will ease this annoying feeling.

Thanks again