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!

Cavity Basics

What is a cavity/tooth decay?

A cavity is an open pathway in the tooth which is caused by bacterial invasion.  In the dental world, it’s referred to as a carious lesion.  The severity of the cavity/carious lesion will determine which type of restoration is needed.

How would I know if I have a cavity?

If you experience pain in the tooth, more than likely it can be attributed to bacterial invasion/cavity.  However, keep in mind that tooth pain can be attributed to several other factors such as periodontal disease.  The best way to tell if you have a cavity is to visit the dentist.  Sometimes, cavities occur between our teeth, and the only way to determine its presence is on a radiograph/x-ray. 

What can be done to prevent cavities?

Brush, brush, and brush some more!!  If you brush 3 times a day, or even better, after each meal, you will remove food debris and other agents that act as magnets for bacteria.  If you are unable to brush that often, be sure to chew gum with Xylitol after your meals.  This will aid in remineralizing your enamel after a meal, thus making it stronger and more resistant to bacterial invasion.  Please see our article on gum with xylitol for more information.

Please see our article on cavity prevention for more information on maintaining a healthy mouth.

So what’s a Canker Sore?

Canker sores, known in the medical world as recurrent aphthous stomatitis, are fairly common mouth ulcers that have various presentations.  Not to be confused with oral herpes, these lesions only present inside of the mouth.   According to medical texts, around 20% of the general population suffers from this ailment.

How do canker sores appear in the mouth?

Canker sores can appear as small (ranges from 3 mm to 3 cm in diameter) gray or white round lesions surrounded by a red border. Its appearance is due to an actual destruction of the mucosa by the immune system, primarily T lymphocytes.   These lesions can appear on the inside of the cheek, floor of the mouth (under the tongue), roof of the mouth (palate), or on the tongue only.

What are the symptoms?

A burning, tingling, or itching sensation may occur in the area before the sore appears.  Once present, the lesion is usually painful when eating, drinking, or even talking.  Any type of movement may initiate the pain.  Depending on the classification of the ulcer, a fever or swollen lymph nodes may also appear.

What causes the sores?

Though one definitive cause has yet to be identified, several factors can contribute to the appearance of canker sores including:

• Stress
• Allergies
• Family history (can possibly be hereditary)
• Nutritional deficiencies
• Direct trauma or agitation
• Major hormonal changes (i.e. puberty)
• Can be associated with major systemic disease

Which type of canker sore do I have?

There are several types of canker sores.  The charts below summarize the three types of clinical variants and two types of classifications.

Type	Appearance	Symptoms	Duration	Other Facts
Minor	3-10mm Circular shape Usually leave no scar when healed	Very painful Have burning or itching sensation before appearance 1-5 lesions per episode	Usually appear for 7-14 days Begins in childhood or adolescence	Most common Surrounded by red border Women affected more than men
Major	1-3 cm in diameter (larger than the two other forms) Irregular shape	Painful 1-10 lesions per episode	Usually associated with hormonal changes and may develop shortly after puberty Can last from 2-6 weeks
Herpetiform	1-3 mm Heals with no scar	Many lesions (up to 100) per episode	Begins in adult life Lasts 7-10 days	Has the most frequent occurrences of all 3 forms

Types of Canker Sores

Simple

• Usually associated with pain
• Heals in 1-2 weeks
• Few lesions
• Doesn’t occur that often

Complex

• Associated with severe pain
• Never completely heals. Lesions always present.
• Numerous lesions present

Treatment for Canker Sores

• If mild, the doctor or dentist may prescribe topical corticosteroid cream to apply to the area.
• If in a hard to reach area, like on the tonsils, a beclomethasone dipropionate may be prescribed.
• Anti-virals such as acyclovir
• Vitamins, especially zinc sulfate

Many cold sores are minor and will disappear on their own.  However, if your cold sore does not resolve on its own, or is reoccurring, please visit your dentist or physician for assistance.

Embarrassing Cold Sore on your Lips: Get the Facts!

Cold sores (Fever Blisters), better known as herpes simplex virus type 1 (HSV-1), are small, irregular shaped, yellow or white ulcerations/sores located in the mouth, lips, or surrounding skin.  The sores typically start off as red, then collapse to form a yellowish ulcer.  These lesions are usually painful.

The first breakout of HSV-1 is more severe than recurrent episodes.  The initial breakout is oftentimes seen in children between 6 months and 5 years and is known as acute herpetic gingivostomatitis.

Recurrent breakouts usually appear on the lip or surrounding skin and are known as herpes labialis.  15-45% of the population has a history of herpes labialis.

What are the symptoms of Cold Sores?

The following symptoms will occur 6-24 hours before a breakout:

• Itching
• Burning
• Tingling
• Pain
• Redness of the skin

Shortly after, multiple small red lesions will appear.  The sores rupture within 2 days, crust over, and generally fully heal in 7-10 days.

If this is an initial breakout, the following symptoms may also occur:

• Sore throat
• Fever
• Muscle pain
• Headache

What causes cold sores?

The sores are caused by a DNA virus known as herpes simplex virus.  Unfortunately the virus remains in the system even when no breakout is present.  Breakouts can also be provoked by the following factors:

• Stress
• Ultraviolet light
• Pregnancy
• Trauma
• Respiratory illnesses
• Allergies
• Other diseases
• Menstruation

Is there treatment for herpes labialis?

Unfortunately there is no known treatment that can completely cure the disease.  However, there are several treatments that can be used to decrease or temporarily alleviate the symptoms of herpes.  These treatments include:

• Anti-viral medications such as Acyclovir
• Nonsteriodal anti-inflammatory medications (NSAIDS) such as ibuprofen, to alleviate the pain
• Over the counter topical anesthetic gels can also help to decrease pain and discomfort