Pericoronitis Treatment

Question:

If we decide to extract the recurrent pericoronitis tooth [should we] give antibiotic before the extraction or after the extraction of tooth?
ThankYou

Answer:

Pericoronitis, infection of the soft tissue typically around the crown of an impacted tooth, usually has a tendency to recur if the causative agent (the tooth) isn’t removed.  The tooth should not be removed until all signs and symptoms of the pericoronitis have been resolved.  If not, incidence of postoperative complications, specifically postoperative infection and dry socket, are highly increased.  However, some sources indicate that IF the pericoronitis is mild, and if the tooth can be easily removed, than an immediate extraction may be performed.  In the end, the recommendation is to treat the pericoronitis, then proceed with the extraction.

Hope this helps and good luck,

SaveMySmile Team

Dry Socket

What is Dry Socket?

After a tooth is pulled out (extraction) from the bone, a blood clot typically forms.  As with any other scar on the body, the blood clot is the first step to healing and serves as a framework for the replacement tissue (bone, etc).  But sometimes, this blood clot can be removed too early!  This condition, called alveolar osteitis, significantly delays healing and be an uncomfortable and painful condition.

Dry socket occurs in about 1-3% of extractions and 25-30% of surgical extractions (used if you had an impacted tooth).

Signs of Dry Socket

Most symptoms for dry socket occur a couple of days after the extraction and can last for up to 40 days if not treated.

Symptoms include:

• Severe pain in the area of the extraction
• Dull, aching pain that radiates to the ear
• Swelling around the tissues in the area
• Foul mouth odor (bad breath)
• Foul taste
• Swollen lymph nodes (only happens occasionally)

Causes of Dry Socket

• Most often unpredictable and not related to a specific cause
• Excessive trauma during the extraction
• Patients on birth control have a higher chance of dry socket
  • If you are on birth control, it’s best to have an extraction performed between days 23 to 28 of your menstrual cycle (days without estrogen supplementation)
• Smoking
• A history of dry socket in the past
• Not following the post-op instructions given to you by the dentist/staff

Treatment for Dry Socket

• Return to the dentist as soon as you experience this pain.  The following steps will be taken:
• The socket will be rinsed out to remove extra debris
• The dentist will insert medicated gauze into the opening.  The medicated gauze contains:
  • Eugenol
  • Topical anesthetic
• You will be advised to change the gauze every 24 hours for the next 3 days.
• Then change the gauze every 2-3 days until the clot forms and you do not experience anymore pain

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

Do I have dry socket?

Question:

Last week,  I had 2 teeth taken out by the dentist.  But today, there was some type of bloody-white “ooze” coming out of the area where one of the teeth came out.  I haven’t had any pain, just the ooze.  Is this dry socket?

Answer:

From what your describing, it definitely isn’t dry socket.  Dry socket is quite painful and occurs when you’ve lost the blood clot in your tooth socket and the bone is exposed.  This sounds like an infection.  After an extraction, for the first couple of hours you can expect some bleeding and some slight pain.  The dentist should have prescribed pain pills and antibiotics so as to avoid an infection.  Depending on the severity of the infection now, the dentist may just prescribe some more antibiotics.  But please visit your dentist right away and tell him/her that you have an infection.

Good luck!