Tooth extraction care

[Dreama713]

Had a lower molar removed Thursday morning (3 days ago) was doing fine yesterday, woke up this morning and have throbbing all the way down into my jaw bone. I have not disturbed the blood clot, but have noticed some white material in the wound around the stitches. Is this food or just the skin healing? If it is food how do I get it out from around the stitches? Rinsing does not help.

[Jerome Tsang, DDS]

Hm.. you're at the maximum dosage for Tylenol everyday.  Try using ibuprofen at 800mg 3 times day and see if that works better than the Tylenol.  Generally ibuprofen is 200mg per tablet so you would be taking 4 at a time, 3 times a day.  Use this for up to a week and let me know if it helps.  Obviously you shouldn't be taking this high a dosage for a longer period of time.  

[Dreama713]

Well, I'm 51, female, and a well managed diabetic. That's my only health condition. No hypertension and I'm not overweight. No insulin, just 500mg Metformin/once a day.  I'm managing the pain with 1000 mg Tylenol every 6 hours, and ice packs. That's about the best I can do. There's still a lump on my gum to the front of where the tooth was and a small hole in the middle of where he took the tooth out that I think is draining, I have a slightly salty taste in my mouth.  Hopefully, this will all clear up with time.  He did not, however, tell me to come back, unless it got worse. He prescribed enough Erythromycin for a week of 1000 mg a day.  It's just that the pain is wearing me down.  It's better, just never completely pain-free after 11 days.

[Jerome Tsang, DDS]

The prescription of antibiotics depends on various factors.  We don't generally prescribe it if there's a small risk of infection because sometimes people develop an allergy to a particular antibiotic and then it can't be used again on that patient.  So if we prescribe it, we usually want to make sure that its for a good reason.  

Well, its kind of late now but I would ask the dentist for some recommendation for over the counter pain medication such as ibuprofen, tylenol, etc.  I don't know your health condition so I can't advise you on what to take.

[Dreama713]

Unfortunately, I now have a massive infection and the dentist prescribed Erythromycin. Have been on it since Thursday, still no pain meds. The problem here is that I live in a very depressed area, and have lost my health insurance since being laid off my job. Unemployment in this county is 40%. So, the Health Dept. doctors assume when you ask for pain medication that you want to sell it to someone for extra cash. But, luckily for me, the pain is easing off now that the infection is clearing up. I personally think that antibiotics should have been a defensive instead of offensive measure. Thank you for responding to me when I needed help.

[Jerome Tsang, DDS]

Thursday?  Can you call the clinic and have them prescribe something stronger for the pain?  Removing the sutures may help although there may be something else going on.  Are you taking any antibiotics right now?

[Dreama713]

Sutures have to be removed Thursday.  No he did not give me a syringe. I went to a health clinic for the extraction and the dentist is only there on Thursdays and they will not give me another number for him.  He prescribed Tylenol 3 for the pain, but that's doing nothing. The pain is just a constant throbbing in the extraction site and under my lower jaw bone. I suppose it is a dry socket or an infection, I just don't know what to do about it.

[Jerome Tsang, DDS]

Did your doctor provide a syringe?  Sometimes they will give one so you can gently rinse the area out.  If not, I would try to gently rinse the area out or go back to your dentist to have it removed because its causing some discomfort.  

Do the sutures need to be removed or will they dissolve on their own?