Dry socket lasts 3 weeks, pain gets worse

[krisj]

About 3.5 weeks ago, I had all four wisdom teeth removed by an oral surgeon.  Three of them (both bottom and one top) were partially impacted under bone.  The bottom two wound up getting dry socket within a few days, were packed with medicated gauze, and were presumed to be healing.  The one on the left is now fine and has had the packing out since last Tuesday.  The one on the right is a different story.

The packing stopped helping that dry socket, so last Thursday they removed them, saying perhaps the packing is contributing to the pain and keeping the socket from closing.  I had been prescribed ketoprofen for the duration of this dry socket, but when I asked to have it refilled on Friday, they said I should no longer need it once I run out (later today).  Last night the pain was quite severe and I was glad to still have the ketoprofen, and this morning I woke up at 4am due to the pain, took more pills and went back to bed.  The pain seems to me like it's getting worse, and the pills aren't lasting as long.  And the right side of my face (the same side as this socket that refuses to heal) feels swollen today.  Last night I got a couple odd shooting pains in my jaw and along my jawline as well.

I have a suspicion that something is quite wrong.  The dry socket looks like there is a clot in it, like it probably shouldn't be hurting--this is the impression I got when the dental assistant looked at it too and suggested the packing was the problem.  I have not really been inspected much by the oral surgeon--everyone's just working under the assumption it's a dry socket.  From these symptoms, do you think there is any other explanation for my problems that I could suggest to my surgeon?

An aside: I do not smoke, though I take oral contraceptives.  I timed the surgery so it occurred during the last week of my cycle, and I stayed off them another week when I knew I had dry socket.  I have been taking them again for the last couple weeks though.

[Michael H Kirsch, DDS]

A dry socket should not last 3.5 weeks.  The surgeon should be looking into other causes such as foreign body reaction (food), infection, osetomyelitis, fracture, or problem with adjacent tooth.  

Insist on a more in depth discovering or obtain a second opinion.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.

[krisj]

Thank you for your advice.

Later on Saturday I gave the surgeon a call describing my symptoms.  That morning before eating I irrigated the dry socket and noticed some whitish clumps came out (not sure if they were pus or not, but I have be irrigating the sockets after each meal, inspecting with a dental mirror to make sure all the food particles were out and avoiding chewing on that side to begin with, so I don't think they were food particles).  He said that sounded like it was possibly infection and called in an antibiotic prescription for me.

Today I actually feel much improved, having taken several doses of the antibiotic drugs.  There is still dull pain but once again the pain pills are able to mostly cover it.  They also have resumed lasting the expected duration (6 hours).  Since the antibiotics seem to help, I think an infection was at least partly to blame.  If my recovery has not considerably improved by the middle of my antibiotics course, I expect to go back in and I will insist on a more thorough investigation as you suggested. Thanks!