Wisdom Tooth Extraction - questions on procedure and postop care

12-12-2004, 09:19 AM

Hi all, this is my first post here, but I've been reading messages for some time now.

I am 29 and went on Friday (it's now Sunday) to get a lower wisdom tooth extracted. It was impacted, but was not in a terrible position (i.e. was not horizontal and was partially erupted). But, my oral surgeon had a difficult time getting it out because apparently my roots were long and curved. The nurse showed me one of my roots after the extraction and it seriously looked like a tusk -- probably 3/4 of an inch long and fat. I asked her if it was the biggest root she'd ever seen, and she said just about! Anyway.

I have two sets of questions -- one about what folks generally experience during the process of extraction, and second about postop care.

The process of getting my tooth extracted was really painful and unpleasant. My oral surgeon gave me an IV with sedatives that made me fuzzy but definitely did not put me out, I was aware and awake and remember the procedure. He gave me several shots of novocaine and began. I could feel everything -- the cracking of the tooth, drilling and yanking and all of that. It was so painful, and such a horrible ordeal, that I couldn't stop myself from just bawling in the chair. I felt like a big baby, but there was nothing I could do. So my question is -- was there something he should've done differently? My mom felt like he should've upped my IV and put me out when it was obvious I was in that much pain. It was the first time I've ever had sedatives so I wasn't sure how I would respond, and my dad was notoriously hard to sedate, but it wasn't like he had me counting backwards. He asked if I felt the IV making me groggy, I said yes, and then they started.

My next question is on postop care. I'm now two days out of my surgery and it's still quite painful and swollen. I think that's to be expected. But I'm a little worried because last night I noticed that the wound site has become infected. It's oozing pus and has a bad taste and is making my breath absolutely lethal, and I think has made the wound more painful. For instance, when I put an ice compress on my jaw and press down, it hurts because it's inflamed. Of course I'm terrified of dry socket too. Is it common or uncommon to have a postop infection? Is it common for oral surgeons to prescribe antibiotics as a preventative? (Mine did not. I called him this morning to tell him about the infection and I have an appointment in the morning.)

I'm also apprehensive about the size of the socket hole. I don't think he put in any stitches (or if he did, I can't see them), and am wondering how long that takes to close up. It just looks so gaping, I drink water and think -- it can't be good for that water to be getting in there.

Anyway. Thanks for listening.

K.

12-12-2004, 11:09 AM

I'm sorry you have this going on. I had my wisdom teeth pulled when I was 16 so it's been many years but I will try and help ya.

You will be sore for awhile after this proceedure. It's a big ordeal and it's normal to be sore like that. The bad taste could be dried blood OR, infection. If you run fever and see puss, then the surgeon needs to see you and give you antibiotics.

I remember rinsing my mouth with warm salt water and some type of antibacterial mouth rinse after mine and it did feel good.

Don't put heat to the area, stick with ice. If you still hurt, definately let him take a look at you. You may need antibiotics for infection.

I sure hope you get better soon!

12-12-2004, 06:21 PM

Your experience isn't the norm. The whole point of going to an oral surgeon to me is for their expertise in extraction (which is FAR beyond what any general dentist has) and their qualifications to administer general anaesthetic. Most people who take the IV drugs for conscious sedation (including myself) had the experience of sleeping through the procedure and remembering nothing when it was over.

You're probably not infected- just keep following your orders and see what happens at your post-op consult, and that way you'll find out for sure. Preventative antibiotics are sometimes given, but I'm not sure there's any proof they make much difference. As for stiches- it all depends. Often they're not necessary.

12-12-2004, 06:48 PM

Doppler, thanks for the reply. I wondered about that myself (the sedation). I guess, for whatever reason, he didn't give me enough sedative. I'm a pretty big girl and I guess that plus my natural proclivity to resist being sedated didn't help things. Still, you'd think that when he saw how much pain I was in he would've bumped up my iv.

Anwyay, I'm pretty sure it's infected. There is visible pus, bad taste and smell and the area is inflamed, telltale red lines shooting up my cheek from the wound site. I think actually that is the source of most of my pain at this point, rather than the extraction trauma itself. I had some amoxicillin left over from something else so I started taking it this morning when it was really, really bad, and I already notice a small bit of relief. (I know, that's bad. But if my dentist won't call in a Rx for antibiotics for me, gotta do what you gotta do.)

K.

12-12-2004, 08:42 PM

k,

I would call your dentist. I had all 4 out Thursday. They had to give me 4x the sedation iv because i kept waking up and yelling and telling them i thought i would be asleep! I have antibiotics, I definately would get some, if your dentist won't get some from your doctor. The lower are the worst. I would also go in and see if you have a dry socket. I had to get one packed yesterday because the white gel came out ( I didn't have stitches) and my dentist said the clot would follow. it was already aching. The good news, once they pack it, it feels wonderful. I am not a doctor and I could be totally wrong, but I know how anxious I am. I would definately go in asap, get antibiotics and see if you have dry socket. I got a really good antiinflammatory that helps with pain (can't take vicodin) and it works well. it is called solundec or something like that. So know there is something you can do. Also do you smoke? don't drink through a straw or spit either. only rinse gently, my dentist told me to avoid it if possible.

I hope this helps!
Jenny

12-12-2004, 09:45 PM

Wow... red lines from the area is very bad... If you aren't going in first thing in the morning, go to the ER... Infections in the face can be very serious because of the proximity to the brain.

The dentist definitely should have given you more meds. I had laughing gas, then they put in the IV and I was completely out, then they did novocaine. I remember them putting in the IV and saying goodbye to my dad as he left the room, and the next thing I remember is walking in the hallway. The dentist told my dad that I was rather resistant to the meds, so they had to give me a lot to get me to go out, but I don't remember any of that at all.

If you ever have to have any other sort of oral surgery procedure, definitely discuss your previous experience with them and make sure that they clearly understand your goals for pain relief. It sounds like you were disturbed by the noises as well as the pain, so you would probably want to ask that you be completely unaware of what's going on.

I had a friend who went to the same oral surgeon that I went to and he had told me that he woke up while the dentist was finishing the stitches. So when I went in for my consultation before the surgery I made sure that the dentist understood that I didn't want to have any clue about any part of the procedure at all, and didn't want to wake up until they were done and completely out of my mouth. So they made sure that it happened that way.

Sorry to hear about your bad experience, but at least it's over now!

12-13-2004, 07:47 AM

So, I went this morning. Dentist said it's not infected (although I think it probably was -- but I caught it and cleared it up with the amox I took yesterday and last night). BUT, I do have dry socket. GREAT!

Anyway. He said the bad smell/taste was symptomatic of dry socket, took a look, and was like, yup, it's dry socket. Cleaned it out with some liquid and then packed it with extremely medicated gauze. Must be some kind of antiseptic/antibiotic, because the area around it's a little numb. Feels much better, though, not aching nearly the way it was. Even if it's dry socket, at least it's feeling better now. He said I'll have to go back in Weds and Fri morning to get it re-packed, and then I should be fine. Fine by me, as long as it stops the aching!

K.

Wisdom Tooth Extraction - questions on procedure and postop care

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