Ouch - wisdom dry socket?

[elgroucho]

Hi. Grateful for advice/thoughts. I had my bottom right wisdom tooth extracted under intra-venous sedation 8 days ago. It seemed to go fine. No stitches. On day 3 after the op., I had a dull throbbing pain and grim taste with bad breath, so I went to see my referring dentist on Day 4 (not the one who did the procedure as he's a long drive away).

My dentist prescribed me antiobiotics Metronidazole 400mg 3 times a day and to my horror stuffed the socket with a medicated pack thing which tasted of cloves & iodine! Today is last day of antibiotics yet I am still in pain, Every 3 hours I am having to take staggered doses of paracetamol and then ibuprofen to dull the pain. This morning I woke with a sore lymph node half way down my neck, which feels swollen and sore to touch.

I think I am going to have to go back next week (in Christmas week!). If anyone can shed any light on what be going on and what I should do I'd be grateful. Thanks.

[Jerome Tsang, DDS]

Just rinse normally and try to keep it clean.  The socket dressing will wash out on its own if you rinse it.  Keep an eye on your lymph nodes.  If they swell up and become painful, you may need to go back.  The antibiotics should keep any infection in check.  

It heals over the top and then fills in with bone.

[elgroucho]

I also forgot to ask: if the socket is fully packed, how should I rinse the socket out? Thanks.

[elgroucho]

Thanks so much. It might be on the mend but I am not 100% sure. On Sunday (yesterday) I woke with a second lymph node sore and swollen, above the first lymph node. It is just under my neck where the tooth was removed. I panicked, but then realised that I didn't need painkillers all day! Could this be a turn for the better, or is the calm before the storm? I woke this morning (Monday) and although both lymph nodes are still swollen, I didn't have the throbbing pain on waking for the first time since the extraction. It's a bit tender but I can manage without pain relief.

If you have a moment, are you able to explain what will happen to the packing during the healing process, ie will it come out eventually, dissolve etc? It looks to me as though it's higher and more visible to the eye than when the dentist first packed it. How does that huge hole heal - bottom upwards, or does it heal over the top and then fill itself in?

It's quite grim! Good luck with your own healing.

I had one done 2 yrs ago and a soluble stitch was inserted. I had no problems with that one so am mystified this time.

Thanks again.

[Jerome Tsang, DDS]

It sounds to me that you may have a possible dry socket although packing the socket should help.  If it is a dry socket, it may need to be packed more than once, sometimes even daily returns to the dentist to pack the socket.  Unfortunately, there's no way to speed up the healing time on a dry socket.  

At this point, I would recommend trying to rinse the socket out and try to keep the area clean.  The ache may be from food being stuck in there and rotting away resulting in a bad taste.  I just got my own wisdom teeth out about a week ago too and had that happen to me as well.  Maintain your hygiene and it may resolve on its own.  If not, probably dry socket and a visit to the dentist may help with that.

[elgroucho]

PS - Today is Day 5 of antibiotics.