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Anyone have advice on an extraction site not healing after 4 months?

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Unread 12-20-2011, 12:26 AM   #1
Ana474
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Default Anyone have advice on an extraction site not healing after 4 months?

I am happy to have found this site. I had my top left wisdom tooth removed 4 months ago due to a cavity in the tooth (it was in my mouth, not impacted) and I had lost the clot, but had not gotten dry socket as far as I know. I am 40 yrs old and the one and only cavity I have ever had. The site was healing nicely in all areas except the area right next to the tooth in front of the one extracted.

I have been 4 months with what looks like a small line of gum not healed (not fused together side to side) and then a hole still remains very small against the tooth in front of the one extracted like no gum there up to the bottom edge of that tooth root. I hope this makes sense? The hole is causing me some serious stinging and I get a swollen area on the inner side of my mouth from the extraction site all the way to the eye tooth on the same side. It comes and goes and seems to swell when there is the pain as well. The pain in that area is on and off as well.

Some days the pain causes me to cry and other days it is just there slightly, then some days not there at all. I have been to 2 dentists and both say it is nothing to worry about, but that was a month ago and it is no better and looks a bit worse.

Also, I get itchy gums some days and not others as well. I am very concerned that 4 months later the area is still not healed and looks the same as it did 2 months ago. I had a dental laser that tests for mouth cancer run through my mouth, nothing, all is good. The area of the small hole is dark pink whereas the rest of the site of the removal is a very light pink like the rest of my gums. Some days when it hurts all the gums in my mouth will become red and inflamed around the tooth edges then on the days with no pain the gums all looks perfect and feel great minus the dark pink in the area of the hole.

My concern is the hole seems to be getting larger and when I talk too much in a day I go to bed in tears. 2 dentists, no answers other than having a deep cleaning on my gums which at this time I feel is just going to irritate the entire problem. I have never had gum swelling, itching, nothing until this tooth was removed, now some days I want to scratch all the gums in my mouth! I admit I seriously need a tooth cleaning and neither dentist I have been to will do a cleaning to begin and see if this helps. Last time I had my teeth cleaned was 4-5 yrs ago even though I use a water pic (not near the site) and brush 2x a day.

Anyone heard of this? I have no odd taste in my mouth, no funny color on the area with the hole other than dark pink, nothing, just what I described above.

I am a serious dental phobe and having the tooth removed was probably the worst experience of my life, and I just do not know what to do from here, but want this to heal and end!

Any advice is appreciated.
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Unread 12-20-2011, 11:48 AM   #2
Ana474
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Interesting Bryanna just posted a response below about medications that lead to dry mouth. I have been on xanax for panic disorder for 18 years and I do have dry mouth and constantly sipping water all day. Could this be the cause of my site not healing correctly?

If this IS the case what to do now as my doctors refuse to remove me from this drug due to the long term use and the severe implications of discontinuing this med.
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Unread 12-20-2011, 11:23 PM   #3
Bryanna
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Hi Ana,

The dark area at the extraction site near the adjacent tooth might be an area where plaque accumulates. If that is the problem, it is because plaque is an irritant to the gum tissue which would cause the dark discoloration and the hole that you mentioned. The longer the plaque accumulates there, the more extensive the problem will become.

You stated that the dentist suggested a deep cleaning.... that would indicate that there is a build up of plaque and probably some calculus below the gumline. It would be a good idea to have a thorough cleaning to remove these deposits before they cause periodontal disease.

To help you be more comfortable during the cleaning, you could ask to have it done in quadrants. The dentist could numb a quadrant prior to the cleaning so you would be comfortable. Afterwards, the gums may feel a little sore, but that's about it. Do you think you could handle something like that?

Bryanna



Quote:
Originally Posted by Ana474 View Post
I am happy to have found this site. I had my top left wisdom tooth removed 4 months ago due to a cavity in the tooth (it was in my mouth, not impacted) and I had lost the clot, but had not gotten dry socket as far as I know. I am 40 yrs old and the one and only cavity I have ever had. The site was healing nicely in all areas except the area right next to the tooth in front of the one extracted.

I have been 4 months with what looks like a small line of gum not healed (not fused together side to side) and then a hole still remains very small against the tooth in front of the one extracted like no gum there up to the bottom edge of that tooth root. I hope this makes sense? The hole is causing me some serious stinging and I get a swollen area on the inner side of my mouth from the extraction site all the way to the eye tooth on the same side. It comes and goes and seems to swell when there is the pain as well. The pain in that area is on and off as well.

Some days the pain causes me to cry and other days it is just there slightly, then some days not there at all. I have been to 2 dentists and both say it is nothing to worry about, but that was a month ago and it is no better and looks a bit worse.

Also, I get itchy gums some days and not others as well. I am very concerned that 4 months later the area is still not healed and looks the same as it did 2 months ago. I had a dental laser that tests for mouth cancer run through my mouth, nothing, all is good. The area of the small hole is dark pink whereas the rest of the site of the removal is a very light pink like the rest of my gums. Some days when it hurts all the gums in my mouth will become red and inflamed around the tooth edges then on the days with no pain the gums all looks perfect and feel great minus the dark pink in the area of the hole.

My concern is the hole seems to be getting larger and when I talk too much in a day I go to bed in tears. 2 dentists, no answers other than having a deep cleaning on my gums which at this time I feel is just going to irritate the entire problem. I have never had gum swelling, itching, nothing until this tooth was removed, now some days I want to scratch all the gums in my mouth! I admit I seriously need a tooth cleaning and neither dentist I have been to will do a cleaning to begin and see if this helps. Last time I had my teeth cleaned was 4-5 yrs ago even though I use a water pic (not near the site) and brush 2x a day.

Anyone heard of this? I have no odd taste in my mouth, no funny color on the area with the hole other than dark pink, nothing, just what I described above.

I am a serious dental phobe and having the tooth removed was probably the worst experience of my life, and I just do not know what to do from here, but want this to heal and end!

Any advice is appreciated.
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Unread 12-20-2011, 11:28 PM   #4
Bryanna
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Ana,

Having a dry mouth predisposes you to tooth decay and periodontal disease. If you must continue with the drug then it is best to get your teeth cleanied and then see your dentist regularly. So if anything comes up it can be dealt with while it is still minor.

You would have to be guided by a physician if you wanted to get off of the xanax. But even if he put you on a different medication, it would still have the same side effect. But you could talk to him about it.

Bryanna

Quote:
Originally Posted by Ana474 View Post
Interesting Bryanna just posted a response below about medications that lead to dry mouth. I have been on xanax for panic disorder for 18 years and I do have dry mouth and constantly sipping water all day. Could this be the cause of my site not healing correctly?

If this IS the case what to do now as my doctors refuse to remove me from this drug due to the long term use and the severe implications of discontinuing this med.
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Unread 12-21-2011, 12:38 AM   #5
Ana474
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Quote:
Originally Posted by Bryanna View Post
Hi Ana,

The dark area at the extraction site near the adjacent tooth might be an area where plaque accumulates. If that is the problem, it is because plaque is an irritant to the gum tissue which would cause the dark discoloration and the hole that you mentioned. The longer the plaque accumulates there, the more extensive the problem will become.

You stated that the dentist suggested a deep cleaning.... that would indicate that there is a build up of plaque and probably some calculus below the gumline. It would be a good idea to have a thorough cleaning to remove these deposits before they cause periodontal disease.

To help you be more comfortable during the cleaning, you could ask to have it done in quadrants. The dentist could numb a quadrant prior to the cleaning so you would be comfortable. Afterwards, the gums may feel a little sore, but that's about it. Do you think you could handle something like that?

Bryanna

Bryanna,

I will be honest, both dentists suggested debridement and honestly I KNOW I can not handle this I asked for a simple cleaning with maybe some plaque removal manually just to get me going and get used to the dentist again and both dentists I went to refused.

The worst part of my entire extraction was the numbing, 2nd being the giant hole I had that I thought would never start to go away. I hated it and I will say it was worse for me then when I suffered a surgery from cancer!

Here is one thing I have noticed that makes no sense. I had gotten some food stuck in that tiny hole (deep but not wide) a few weeks ago and i used the syringe the OS gave me and even though I did not touch my gum but held it away and bit and just flushed it out a bit the hole then caved in more which is what left me with the partially exposed root to the tooth in front of it. My fear is if they disturb this area too much the entire area will be just one giant hole considering just taking a syringe to it made the hole much deeper

What other options do I have here and is it even possible that a dentist should consider my phobias to dentists and allow me to have a regualr cleaning with some manual tarter removal in quadrants then work me up to a full debridement if it is really needed? I figure if they get rid of some of the bacteria in my mouth it has to help at least a bit no? None of these dentist want to understand that I need to be worked up to this. I mean geez it took me a year of a cavity in this wisdom tooth to finally have it pulled and I am soooo sorry I did now.
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Unread 12-21-2011, 10:19 AM   #6
KrisPPP
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I had my upper left wisdom tooth out almost two months ago and I am still having healing issues. I feel your frustration. Did you have any stitches? Mine was a straight pull by a dentist and took less than 3o seconds but still having issues......we have to stay strong and positive. I am almost 40 as well and maybe we just heal slower? I also was taking Lorazepam for anxiety -- but weaned myself off of it.. was only on for a month. That stuff is great but WICKED.
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Unread 12-21-2011, 11:17 AM   #7
ginnie
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Default Hi bryanna

I hate to come to you with another question, but there are issues going on with my housemate. We need your advise. One year ago, her childhood dentist of 25+years, discovered a loose molar, furthest back molar upper right. He attached the tooth to the one infront of it for stability. After that she was unable to floss between these teeth. She developed pain.
Update, one year later, she goes to my new dentist. He prompty tells her both of these teeth are loose and must come out. She had them pulled. Then he tells her she has a mouth full of peridontal disease, and must have all quadrants deep root cleaned. He also told her that this disease would have been apparant last year when she visited her origional doctor. Her former doctor said she was just fine with the rest of her mouth, no problems. So what is going on here? Should she go for another opinion before investing this money for deep root cleaning? Personally she has really good cleaning habbits, no bleeding, does floss etc. Which doctor isn't telling the truth? How is she able to make a choice if two versions of her mouth is being given. she could not have developed this serious a condition over night, or even in one year according to the new dentist. she had trusted her origional doctor. What to do? It is $700 to do all the deep root cleaning. thanks for your responce Bryanna, she really doesn't know what to think ginnie
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Unread 12-21-2011, 10:10 PM   #8
Bryanna
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Hi Ana,

Not having your teeth cleaned for several years means there will be a buildup of hard deposits called calculus on your teeth.... both above and below the gumline. Calculus is a build up of plaque that over time becomes very hard and tenacious. Bacteria thrive in plaque and calculus which causes chronic inflammation. Calculus below the gum line will literally erodes the bone, eventually leading to infection and loose teeth. There are also many systemic risks associated with this type of bacteria in the mouth.... diabetes, heart disease and kidney disease are just 3 of the major ones.

With that said, there is no such thing as a "regular cleaning" for someone with this condition because the teeth cannot be cleaned with the calculus still on them. It's not that easy to just remove some of it as it is literally layers upon layers that have hardened onto the tooth and root. Depending on how long it's been forming, the calculus can actually alter the shape of the tooth where it has been growing on. If someone were to try and remove pieces of it, it would be painful, costly and not at all beneficial.

A debridement is often the first step to a deep cleaning. It simply looses some of the tenacious calculus and removes some that is not below the gumline. But this procedure needs to be followed up with additional scalings to be beneficial. You can do one quadrant of debridement at a time.... that is the least invasive way to do it and the discomfort afterwards will not be that bad. This may be the longest way to get it all done but it may be the easiest for you. You can book the appointments at 2 week intervals times 4 appointments. Then at your last debridement appointment they can evaluate the remaining build up on your teeth and either do 4 more appointments of quadrant scaling or 2 appointments of scaling doing 2 quadrants at each appointment. It depends on how much buildup there is remaining.

With regard to the extraction sight caving in after you flushed out some food debris.... the food irritated the gum tissue causing it to inflame which made it look bigger or more full than it really was. When the irritant (food) was gone, the gum inflammation decreased to where the healthy tissue really is. It is normal to have some gum recession on the tooth next to the extracted one. If this area is not cleaned every day, it will recess further from the irritation of the plaque.

There is no benefit to removing some of the calculus in your mouth and not all of it because the bacteria literally comes back fourfold onto the calculus that has not been removed.

You shouldn't be sorry that you had that wisdom tooth removed if it had decay in it. You could have ended up with a major infection from that cavity and now that is one less thing you have to be concerned about.

Do you think you could try the quadrant debridement and scalings?

Bryanna






Quote:
Originally Posted by Ana474 View Post
Bryanna,

I will be honest, both dentists suggested debridement and honestly I KNOW I can not handle this I asked for a simple cleaning with maybe some plaque removal manually just to get me going and get used to the dentist again and both dentists I went to refused.

The worst part of my entire extraction was the numbing, 2nd being the giant hole I had that I thought would never start to go away. I hated it and I will say it was worse for me then when I suffered a surgery from cancer!

Here is one thing I have noticed that makes no sense. I had gotten some food stuck in that tiny hole (deep but not wide) a few weeks ago and i used the syringe the OS gave me and even though I did not touch my gum but held it away and bit and just flushed it out a bit the hole then caved in more which is what left me with the partially exposed root to the tooth in front of it. My fear is if they disturb this area too much the entire area will be just one giant hole considering just taking a syringe to it made the hole much deeper

What other options do I have here and is it even possible that a dentist should consider my phobias to dentists and allow me to have a regualr cleaning with some manual tarter removal in quadrants then work me up to a full debridement if it is really needed? I figure if they get rid of some of the bacteria in my mouth it has to help at least a bit no? None of these dentist want to understand that I need to be worked up to this. I mean geez it took me a year of a cavity in this wisdom tooth to finally have it pulled and I am soooo sorry I did now.
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Unread 12-21-2011, 10:23 PM   #9
Bryanna
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Hi ginnie,

It's OK to come to me with questions.... anytime!!

To clarify what this person's childhood dentist did.... he bonded two molars together because they were not stable enough to be on their own. This means that she had periodontal disease in at least this area of her mouth that was causing these teeth to become loose. The problem with doing this is that the outcome of both of these teeth will be hopeless because if she can't clean them properly the bacteria that is causing the disease in the first place is now able to proliferate. This bonding technique is rarely done anymore for just those reasons.

Your dentist was being honest with her. Generally, periodontal disease is not localized to one area of the mouth and if it starts out that way and is not brought under control, the disease will progress quickly to other areas of the mouth. If a tooth or teeth are so loose that they need a buddy to hold them up... that's a sure sign of periodontal disease and you're right, those teeth did not get loose over night! The bacteria had to be living in there for many months if not several years.

If she is uncertain as to what to do.... I would suggest she consult with a periodontist... she should bring her xrays (ALL of them, even from her previous dentist) to show a history of what is going on in her mouth.

Does this information help?? More questions.... just ask me

Bryanna




Quote:
Originally Posted by ginnie View Post
I hate to come to you with another question, but there are issues going on with my housemate. We need your advise. One year ago, her childhood dentist of 25+years, discovered a loose molar, furthest back molar upper right. He attached the tooth to the one infront of it for stability. After that she was unable to floss between these teeth. She developed pain.
Update, one year later, she goes to my new dentist. He prompty tells her both of these teeth are loose and must come out. She had them pulled. Then he tells her she has a mouth full of peridontal disease, and must have all quadrants deep root cleaned. He also told her that this disease would have been apparant last year when she visited her origional doctor. Her former doctor said she was just fine with the rest of her mouth, no problems. So what is going on here? Should she go for another opinion before investing this money for deep root cleaning? Personally she has really good cleaning habbits, no bleeding, does floss etc. Which doctor isn't telling the truth? How is she able to make a choice if two versions of her mouth is being given. she could not have developed this serious a condition over night, or even in one year according to the new dentist. she had trusted her origional doctor. What to do? It is $700 to do all the deep root cleaning. thanks for your responce Bryanna, she really doesn't know what to think ginnie
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Unread 12-23-2011, 11:42 AM   #10
Ana474
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Bryanna,

Honestly, after seeing debridement on youtube, can't link since I do not have enough posts, but OMG I do not know if I could do it. That is some serious invasive stuff there! I think my question is why would I realllyyyy even need that IF when I had that metal pick thingy probing all my teeth all of my gums were 2's and 3's and only 4 teeth were 4's (back top of course) when they checked for gum disease. I thought 2&3's were not bad??? The dentist also told me I had very very little bone loss for 40 years old, but yet still suggested this procedure a gum debridement. Maybe I am just crazy, but I do not seem to understand this. I figure do a deep clean of the teeth then attack the gums in stages??? After having this wisdom tooth pulled I am more fearful of the dentist then I was before and I was/am petrified of them :/ For me, just sitting in the chair I begin to have a panic attack and start crying so I just thought maybe, just maybe i could start out gentle and work my way up, but both dentists I went to refuse this so it's either "hey, you let us attack you at once or nothing" not very helpful for someone like me in my opinion.
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