Tooth extraction advice

mongoman

I have Just finished a five day course of antibiotics (Flagyl & Pinamox) pre removal of tooth with abscess ect. I am having a surgical extraction done on Monday. But I am now querying the wisdom of proceeding with this extraction. Based on the fact that the swelling has not subsided and external touching/pressure on my cheek remains tender and painful.

Since the dentist couldn't remove the tooth last Monday because of this same swelling and infection. Wouldn't it be very unwise to proceed on Monday if there is no improvement? Am I also right in assuming, that the antibiotics have not done the intended job of cleaning up the infection prior to the extraction?

The dentist had originally planned to call me in today, but decided on Monday instead. Which leaves me waiting two days without any kind of medication to treat or prep the tooth/infection. I'm wondering should the dentist have prescribed a seven day course of antibiotics instead of five, to cover me until the procedure?

All advice would be appreciated here, it's been a long time since I've required any dental treatment. So I'm really not familiar with normal protocols.

drunkmonkey

Any way to save the tooth if you can? Root canal once the infection dies down?

There's dentists open tomorrow if your in a lot of pain. Can you get back to the chemist for a repeat prescription?

mongoman

Tooth can't be saved, the dentist showed me the xray and said the tooth really has to come out. She did prescribe Ponstan which is keeping the pain under control. As I said in my op, touching outside of my cheek is tender and sore but aside from that I'm o.k.

I did try to contact the dentist today but only got through to voicemail. In fairness I only left my number and didn't spell out my concerns. Am I right in thinking that a repeat prescription is probably useless, since it didn't even reduce the inital infection?

helimachoptor

Op if the dentist doesn't think it's safe and proper to extract ie your suffering a major infection they'll evaluate once you turn up*


* not a dentist!

digzy

i'd agree with the dentist prescribing for 5 days. this is best practice. also the effect of the antibiotics lasts longer than the 5th day. I always try to keep prescribing ab's to a min in my practice. Unfortunately, for various reasons, there exists a mentality that ab's are required before a dental extraction. i'd a patient last friday with a serious infection under a lower premolar. The tooth came out very easily but there was an almost volcano like eruption of pus out of it. No ab's would have cleared it up IMHO.

I'd get that tooth out asap.

mongoman

Thanks everyone for the feedback on this. My main concern was if there is excess pus present on extraction, combined with a open wound = potential for septicaemia ect.

Dianthus

Your dentist will not do anything that will jeopardise your health- the best way of eliminating the infection,apart from root canal treatment, is extraction. Antibiotics may ease the symptoms of infection, or they may not- however they treat the symptoms of infection, not the source. As posted, the sooner the tooth itself is treated,the better.
Any pus directly after extraction is generally removed via a dental suction, you won't be swallowing it. Re the open wound after& pus draining through, it's no different from squeezing a spot, once the area is clean (bacteria/tooth removed) it'll heal as normal as no further pus can be produced.

DublinDilbert

Had an extraction 2 weeks ago, like yourself had been on antibiotics to help clear it up, but they didn't really touch the infection. Was very much still there when I went back.

Extraction went fine and infection has pretty much cleared up by itself. Prior to extraction it had been ozing daily, for months.

As others have said above dentist will not proceed if he is not happy. Best of luck tomorrow, you'll be grand...

mongoman

Thanks again guys.

mongoman

Got the tooth out yesterday and I needed a fair bit of local to freeze it. The lady dentist was lovely and I was amazed at how quickly it came out in the end. What amazed me was how much information I didn't retain when she spoke to me post procedure. Even when I asked her to repeat some information, I just phased out for some reason.

But I was virtually in a euphoric state and so relieved after the tooth was out. That my concentration wasn't all there I suppose. I got an information sheet to take home,but I thought I run this query by some of you leaned folks in here. After I removed the pressure pad that was applied to the extraction site. It seemed to have clotted quite well, with not much ooze so I left well enough alone.

This morning I have noticed some pus around the extraction site and I'm wondering is this normal? I'm also still quite swollen around the area and it is sore when I swallow above my Adam's apple area and on the side of the extraction. Since I have no baseline to go on, is this to be expected from a tooth that was neglected for too long?

Oral Surgeon

mongoman wrote: »

Got the tooth out yesterday and I needed a fair bit of local to freeze it. The lady dentist was lovely and I was amazed at how quickly it came out in the end. What amazed me was how much information I didn't retain when she spoke to me post procedure. Even when I asked her to repeat some information, I just phased out for some reason.

But I was virtually in a euphoric state and so relieved after the tooth was out. That my concentration wasn't all there I suppose. I got an information sheet to take home,but I thought I run this query by some of you leaned folks in here. After I removed the pressure pad that was applied to the extraction site. It seemed to have clotted quite well, with not much ooze so I left well enough alone.

This morning I have noticed some pus around the extraction site and I'm wondering is this normal? I'm also still quite swollen around the area and it is sore when I swallow above my Adam's apple area and on the side of the extraction. Since I have no baseline to go on, is this to be expected from a tooth that was neglected for too long?

In a patient with a good immune status, removing the infected tooth and allowing drainage of the pus should suffice and your body will get rid of the remaining infection. Important points; is the swelling increasing, is the area getting more painful, are you systemically unwell?? Any of the above, seek attention... Some dentists will put you on antibiotics to clear this residual infection up, some won't....

In more complicated cases, most would err on the side of caution and give antibiotics aswell as remove the tooth.

As always check with your dentist.......

mongoman

Just rang my dentist but she's not on today. So I'll hold off and see how it is tomorrow. Is it fairly puffy and swollen below jaw/chin and sore upon swallowing but I don't think it has worsened since last night. By biggest concern is if there is a pool of pus trapped beneath the clot, will this naturally dissipate if left alone?

Susie564

digzy wrote: »

i'd agree with the dentist prescribing for 5 days. this is best practice. also the effect of the antibiotics lasts longer than the 5th day

How long after are they still working for?

FOODFARMER

Why don't you change your dentist asking people online is madness any dentist is licenced and insured and highly trained in there field .
Do you think anybody with the right qualification's is reading boards in there spare time on what they do all day.?
Would you take advice from unknown random people on the net about your health?
If the answer to the above questions is yes you need a psychiatrist not a dentist.

btkm8unsl0w5r4

FOODFARMER wrote: »

Why don't you change your dentist asking people online is madness any dentist is licenced and insured and highly trained in there field .
Do you think anybody with the right qualification's is reading boards in there spare time on what they do all day.?
Would you take advice from unknown random people on the net about your health?
If the answer to the above questions is yes you need a psychiatrist not a dentist.

LoL.....loads of dentists on here giving advice, There are also several specialists in various dental fields (myself included). Your mistake apart from that is not appreciating that of all qualified dentists 49% are below average (by definition), so if your after a dentist that is above average a recommendation from a friend or impartial person is of some value.

Oral Surgeon

Yes and the fact that his thread is 5 years old!!

Santiago Noisy Sailfish wrote: »

LoL.....loads of dentists on here giving advice, There are also several specialists in various dental fields (myself included). Your mistake apart from that is not appreciating that of all qualified dentists 49% are below average (by definition), so if your after a dentist that is above average a recommendation from a friend or impartial person is of some value.

btkm8unsl0w5r4

Oral Surgeon wrote: »

Yes and the fact that his thread is 5 years old!!

Woops......sorry mods.