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Old 11-25-2011, 08:00 PM   #1
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Irrigating an abscess properly

I'm 46 yrs old and had all my four wisdom teeth pulled back on Oct 20 (2011). Seven days after the surgery I had my follow-up appt with my dentist and I was in great pain but I guess I expected that considering my age and the surgery involved. A few days later I developed a marble sized abscess on my lower left rear gum, below the last molar. Despite repeated please with my dentists office, the earliest they said they could see me was three weeks later. During those three weeks I visited the ER because I had no other choice considering I was in incredible pain. After 4 ER visits (two were to administer an IV antibiotic) I finally made it to the next appt. He looked at the abscess then opened up a hole in my lower left gum for a drain (he did this with no local anesthetic and the pain was nearly unbearable). He told me to irrigate the drain and gave me another script for Clindamycin.

I irrigated the drain as he said over the upcoming week but the intense pain persisted, so I made another appt where the earliest they could see me was a week later. In the interim I had to visit the ER again because I had slept very very little and only had ibuprofen & tylenol for the pain, which did absolutely nothing for me. The ER doc gave me an injection of Toradol and that gave me tremendous relief, at least enough to go back home to sleep--something I hadn't done in days. Whenever I eat it is "costly" too me for I have to anticipate the pain rising even higher.

Anyway, I saw my dentist for a third visit last Tuesday. He told me I hadn't been irrigating the drain effectively enough and put a syringe in the drain and pressed down HARD--omg, I have never been in such pain in all my life! He repeated this another 2x then said that if I had been doing this all along I wouldn't be in such pain. He then ordered his nurse to call the ER I was going to and to order them not to see me for anything related to dental work. I could tell he was a bit po'ed. I told him that I had been irrigating--vigorously--but not as aggressive as what he had just done. In any regard it's been 4 days now since that visit and I've been following his orders with absolute precision, but this has put me in so much pain that I'm eating and sleeping even less. Sometimes the pain is so acute and sever I nearly faint or think I'm going or have a seizure. Trust me--I'm not exaggerating the pain. I would not wish it even on my worst enemy. It is well beyond pain, it is torture.

That being said I'm still in great pain. The dentist said I would definitely better in 1-2 days and it has been 4 days.

My concern is this: Since I still have an infection, isn't it rather dangerous to aggressively shove water down a tooth drain that is still abscessed? I'm thinking that it's only prolonging and possibly spreading the infection further. I am not getting any better and the pain is causing me to have thoughts I never dreamed possible. I'm really considering seeing another dentist.

Sorry for the long post but I felt I needed to provide detail and context for a better understanding of my dilemma. I feel something is definitely awry and amiss with my dentists treatment (a friend and my father do as well).

 
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Old 11-25-2011, 09:04 PM   #2
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Re: Irrigating an abscess properly

Addendum to my op above:

Before I had my wisdom teeth draw I had no abscesses, infections, or even pain from my teeth (the x-rays showed I had healthy teeth other than the impacts). I had all 4 wisdom teeth removed because all of them had been impacted and one was starting to surface on the right side of my mouth. None of my teeth were infected or exhibited pain or even sensitivity before surgery.

I had the surgery performed because I wanted to avoid problems/complications down the road any impacted teeth. The abscess/infection I have only appeared about a week after surgery and is still present.

 
Old 11-25-2011, 10:09 PM   #3
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Re: Irrigating an abscess properly

I am so so so sorry for the pain that you are in. The way you describe it just makes me want to scream. I would go to another dentist. You really don't want that infection to just be festering in your mouth.

 
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Old 11-26-2011, 04:57 AM   #4
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Re: Irrigating an abscess properly

Hi,
I'm with Armywife. Go to a new dentist and get a second opinion in the very least and please do it now. Explain the amount of pain you are in and that you have needed IV antibiotics.

Clindimycin is a heavy drug. While you are on it, PLEASE do some probiotics. Yogurt with live acidophiles or acidophiles pills will work. It will help keep the bacteria in your intestines in a normal balance. Clindimycin will kill off the good bacteria as well as the bad and your don't want one flourishing more than the other. Yogurt will really help. Any gastrointestinal problems should be reported to your doctor (or dentist) immediately.

I am so sorry you are in this much pain. Words for (and about) your dentist fail me!

GOOD LUCK. Please let us know how you are.
My very best to you,
Gellia

 
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Old 11-26-2011, 04:09 PM   #5
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Re: Irrigating an abscess properly

Thank for your kind and compassionate replies as well as understanding. For the past few days thte pain has been so severe that at times I was crying on the floor in utter agony, holding my head between my hands. I'd be arguing with God pleading with him and why I was going through all the pain. I didn't have such nice words to say for which I'm ashamed for now. I had my pastor send out a prayer request. I felt like I was going to have a nervous breakdown because there was no reprieve, no let up.

Thankfully today my pain has subsided a bit. I'm now able to at least function a bit more normal and get some things done that I had to put on hold for a while.

I bruised very very badly from the surgery. I had two black eyes, badly bruised lower left jaw, and a yellow "trace" going all the way down to my throat. I attribute this perhaps to the statin drug I'm using. Ever since I've been on statins I've bruised or pulled muscles easily (I do weith training 5x/wk + daily walking). I'm on a lower dose now but hopefully the CoQ10 can help.

Finally, whenever I open my jaw it feels like a vein is being "stretched" under my lower left teeth and may snap. Maybe the infection worked it's way to the surrounding muscle, I really don't know (any input would be greatly appreciated . I also have some numbness on the front left part of my chin as well as the upper teeth on both sides and lower left side. When I mentioned this to the dentist, and you're going to find this incredible, he took one of his dental tools that had a hook with a sharp point at the end and flicked it on my chin. He asked me if I felt it and I told him YES, I did--I mean he actually drew blood when the tool hit my chin. He said that it wasn't numb. I told it it was partially numb and he still couldn't accept that. So finally I told him: Let me put it this way: I have lost feeling in those areas and wonder if it will come back. He basically ignored my comment and told me about irrigating the abscess.

I typically eat yogurt on a semi-daily basis but whenever I'm on antibiotics I eat at least one per day.

A poster in another forum said that after he used the vitamin supplement Co-Q10 he healed up much faster. It's actually good to take it if you're on a statin drug (like me). I'll have to see if it makes a difference.

Since the infection wasn't disappearing I doubled my dose of clindimycin from 150mg/6 hrs to 300mg/6 hrs starting last Wednesday. On Thursday for the first time I had a little discharge from the drain, which to me is a good sign. This infection is incredibly stubborn and it seems only a "sledgehammer" approach will kill it.

Starting today I've been irrigating the drain but not nearly as aggressive as what the dentist instructed (more like commanded) me. I think it's one reason why I had so much pain--aggressively flushing the drain only exacerbated the infection and the surrounding tissues, which are still swollen.

Yesterday I contacted the dentist's office about 3:30pm. Of course, they didn't get back to me--something I expected. It's tremendously difficult to get in to see the guy, even if you are in incredible pain. If/when I do see him next Tuesday I will be emphatic in telling him what's happened and that his procedures are only prolonging the suffering. It's been almost 5 weeks now and I'm still in constant pain (unless I'm medicated). Unfortunately since I live in a rural area there are not many dentists available, maybe 1 or 2 of them. In any regard, I will see if I can get a hold of one of them.

I think what would help now would be to have the abscess drained externally, perhaps applying a local anesthetic and inserting a hole through my lower left jaw and a tiny tube. It may be a little painful but after what I've endured, it would be a relief in comparison. This is what I desired when I saw my dentist a few weeks ago but opened up a drain alongside my left gum and told me to irrigate it. Just getting whatever is in the abscess out of it I think would help tremendously.

Another long post--eek! I gotta go prepare/eat supper. Ahhh, the life of a bachelor.

 
Old 11-28-2011, 05:02 AM   #6
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Re: Irrigating an abscess properly

Hi again,
Did the dentist tell you to double the clindimycin dose? Please be careful if you did this on your own. Clindy is a very powerful drug and if you get C. Diff from it, your mouth will be the least of your troubles. If you doubled the dose of clindy.....increase your yogurt intake as well and get some acidophiles tablets as well. Also, if you have ANY gastrointestinal problems CALL YOUR DENTIST immediately. C, Diff can come on very suddenly and it's VERY difficult to treat.

Now that that's out of the way. I'm disturbed by your dentist's approach. After 5 weeks with no real result, doing the same thing over and over is the definition of insanity. Is there a possibility that the infection has gone into the jaw bone itself? Of so, IMO irrigation may just not do it. It may need surgical intervention at this point. Five weeks is a long time. Can you find a Board Certified Oral surgeon in your area?
It may be worth your while to seek out another opinion at this stage.

GOOD LUCK. Please come back and let is know how you are.
My very best to you,
Gellia

 
Old 11-28-2011, 02:40 PM   #7
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Re: Irrigating an abscess properly

Quote:
Originally Posted by Gellia View Post
Hi again,
Did the dentist tell you to double the clindimycin dose? Please be careful if you did this on your own. Clindy is a very powerful drug and if you get C. Diff from it, your mouth will be the least of your troubles. If you doubled the dose of clindy.....increase your yogurt intake as well and get some acidophiles tablets as well. Also, if you have ANY gastrointestinal problems CALL YOUR DENTIST immediately. C, Diff can come on very suddenly and it's VERY difficult to treat.

Now that that's out of the way. I'm disturbed by your dentist's approach. After 5 weeks with no real result, doing the same thing over and over is the definition of insanity. Is there a possibility that the infection has gone into the jaw bone itself? Of so, IMO irrigation may just not do it. It may need surgical intervention at this point. Five weeks is a long time. Can you find a Board Certified Oral surgeon in your area?
It may be worth your while to seek out another opinion at this stage.

GOOD LUCK. Please come back and let is know how you are.
My very best to you,
Gellia
I will be telling the dentist tomorrow of the increased dose. I increased the clindamycin on my own because I didn't have any adverse reactions to the clindamycin IV doses I had at the ER (the IV doses are considerably more than even a double dose). I had also been on the oral form since the surgery, though at 150mg. My double dose was/is 300mg every six hours and I've had no side effects. It has helped to keep the infection in check and the swelling down--the 150 dose didn't. I'm eating both regular and frozen yogurt daily as well as applesauce.

The dentist I'm currently seeing is actually a Board Certified oral surgeon. He also does cosmetic surgery. I'll be seeing him one more time tomorrow but if things don't go well I will try to get in and see the only one other oral surgeon in the area. If that doesn't work out I will see my family doc and tell her that I refuse to go back to that dentist and that she will have to treat me. I wish I had more options but I don't. I'd have to travel over 100 miles (one-way) for the next nearest oral surgeon.

 
Old 11-28-2011, 03:16 PM   #8
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Re: Irrigating an abscess properly

Hi,
I think it sounds like a plan! Just keep an eye on any gastrointestinal problems. As I said, C. Diff is insidious, can come on suddenly and is very nasty. Sounds like you are well covered though.

Please do let us know how you are. I hope you are pain free shortly and treatment is generally easy.

GOOD LUCK and GOOD VIBES!
My very best to you,
Gellia

 
Old 12-01-2011, 09:27 PM   #9
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Re: Irrigating an abscess properly

I went to the dentist last Tuesday (the 29th) and he was glad to see how I very aggressively irrigated the abscessed area because he cleaned it and nothing came out but I still have both swelling and the sharp pains that flare up the left side of my face. I finally "cornered" him about the numbness and he told me that it can take anywhere up to a few weeks to 18 months to get all the feeling back. It was a short visit then I was out the door. He seemed a bit nicer this time around but I still couldn't bring myself to recommend him to others.

After irrigating the drain again tonight I noticed something--I mistakenly used regular tap water and when I injected the water into the drain it put pressure on the mandibular vein where I could feel slight pain and tingling in my chin. So my guess is that all the irrigating has, in a way, contributed greatly to the numbness in my chin & jaw.

I went to my family doc yesterday and she prescribed me 500mg naproxen 2x/day and tramadol (Ultram) every 6 hours as needed for pain. She looked in my mouth and said she didn't think there was any infection remaining and in this case I'm glad to be wrong! She had me have some blood drawn for the lab because she's concerned about my temporal artery. I mentioned TMJ to her and she said it could be a possibility, especially considering where the pain is centered, but also mentioned that it's usually only temporary (except in cases of fibromyalgia). I asked her about an MRI but she said she wants to look at the blood results first then go from there.

The pain has subsided a little but I think only because I'm on the tramadol, which is masking it somewhat. I still get a lot of pain in between doses. Recently my thyroid was checked at 2.24 and my blood sugar's at 5.8, which are both excellent. My kidneys also test well (cholesterol was a tad high but nothing of major concern).

I've read where it's not recommend for anyone get wisdom teeth removed as a way of "preventive" surgery if one is not having any current problems with them, especially if you're in your 40s (or later) like me. My wisdom teeth were impacted but they were not causing me any pain, only a problem where I was biting my cheek. I went on the dentist's recommendation but I see now that was a mistake. My family doc said it's going to take a long time (a year or more) to recover, and in some ways I may never fully recover (numbness). In spite of that remain positive I will recover fully, just have to patient I guess. aarrgh!

I'll post more when my doc gets the results back from the lab.

 
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