Question:
I know my original post was rather wordy so I wanted to clarify my
immediate question, which is: what other kind of diagnostic tools or
technologies exist that can pinpoint the location of this infection in my
gums? Does xray imaging indicate where such an infection may lie?
Answer:
I am 22 and had all four wisdom teeth (impacted, not infected at the
time) removed by an oral surgeon 2.5 months ago. First, for anyone
searching these archives -- be aware that dentists seem to underplay the
risk and seriousness of extractions. This long after my surgery I am
definitely still suffering from complications of the surgery. I went into
this in top health and thought I'd be on the safe side of the odds, but
it has been a bad couple of months.
The surgery seemed to go quite well at the time. There was NOT a
lot of bleeding or pain after the operation, and although I continued
taking the prescribed penicillin I really did not have any pain after the
first couple of days resting at home.
One week after the surgery I had a follow-up appointment with my surgeon
and he said the healing looked well under way. After another week I felt
quite good, no stiffness, no swelling, no pain, no bleeding, no bad
taste. I continued rinsing my mouth with a warm salt water solution,
daily.
Exactly one month after the wisdom teeth surgery, I went back to
visit my regular dentist (not the surgeon) who took a look at the gums.
At this point I was feeling 100%. After that, the dental hygienist
performed a routine teeth cleaning. Allowing this cleaning appears to
have been my mistake. While my gums and jaw felt fine before the dental
visit, after two days I developed significant swelling and pain in one
(of the 4) corners of my mouth. I immediately went back to the orgal
surgeon who said I had become infected, and started taking amoxicillin
paired with metronidazole.
The antibiotics appeared to treat the infection quite well, as within 3
days the swelling was gone and by the end of the antibiotics course the
pain and stiffness was gone entirely. I again saw the oral surgeon on
[March 8] who said everything looks fine, provided the infection does not
come back.
Everything was fine since then, through March, until the last week of the
month when I started noticing an increase in level of discomfort in the
same corner of the mouth (there has only been one problem area during all
this). There was not anything significant that triggered this. By the
start of April I thought it wise to revisit the oral surgeon.
Observing the mild swelling/stiffness (and through my report of
mild pain along the bottom right gum) the surgeon determined that this is
likely a recurring infection. This time there was NOT any visible
infection. There was no puss or bad smell, and the site of the extraction
-- the socket -- looked clean and perfectly healed.
The doctor says that at this point the infection is likely lingering
below the skin, where it is not easy to reach short of invasive methods.
He did give me another shot at antibiotics - clindamycin - but near the
end of that course now I am observing little improvement. There are still
a couple swollen lumps along the cheek (can feel by hand) and a minor
pain if I press from outside. He warned that bloodflow might not even
reach infected areas, meaning antibiotics are of little use.
The doctor's next recommendation, although we have not done it yet, is to
perform a curettage surgery in order to remove granulated tissue from the
site of the surgery. This would of course disrupt the (otherwise well
healed) wisdom tooth socket but he hypothesizes that this would clear the
infected tissue. He says during the original surgery this site bled more
than the others, and he is guessing that the infection lies here.
At this point, I want to make sure an invasive procedure such as this
surgery is worthwhile. If the doctor does not know where the infection
actually is, wouldn't it be only guesswork that cleaning the (wisdom
tooth) socket will clear the wider infection? Maybe someone could suggest
other things to ask my doctor. I am wondering whether it is possible to
inject antibiotics directly into tissue, rather than take them orally.
Also, are there methods that could be used to determine where exactly
this infection is? Is there any harm in leaving my body on its own to see
if it can recover from this, without opening up new wounds? Today I am in
better shape then when I started taking the last antibiotics. There is an
improvement, and the pain/swelling is so minor that I don't notice unless
I poke around. If I can recover without surgery, I would rather do that.
Obviously I am nervous about any more antibiotics, as I have taken plenty
over the past couple of months. Having said that, my #1 priority is to
avoid a chronic dental infection. Any ideas are greatly appreciated,
