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Tooth extracted due to swelling. On clyndamycin, augmentin and arythmycin. Swollen gums persisting. Why?

Hi, my name is Mandee. I had a tooth extracted about two weeks ago due to extreme swelling . I have been on two antibiotics since including Clyndamycin and Augmentin and I am curently on Arythmycin. The swelling is actually getting worse and the pain is almost unbearable. The pain has increased on the gumline where the skin meets the gum and the swelling has doubled in the past two days when prior it was going down. Since I have ruled out infection due to the antibiotics, what else could be going on?
Asked On : Thu, 24 May 2012
Answers:  7 Views:  223
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Dentist 's  Response
Hello & welcome,
Since you extracted your tooth due to extreme swelling, means there was severe infection in surrounding tissue & tooth being the main focus of the infection.
What so ever may be the reason, you first need to undergo incision & drainage if the swelling has been from more than two weeks.
Remember one important thing, Long term use of Antibiotics drugs without swelling being drained properly with an incision or after extraction, makes that swelling to indurate or become hard ( called as Antibioma ) which then will take more than 3 months approximately to resolve completely.
Get an x-ray done by visiting to your dentist to check whether there is any remaining root piece which might get infected & cause swelling & pain.
If there is any remaining root piece in the socket, removal of the same would resolve the condition immediately, but if no root piece is there, then ideally incision & drainage should be properly done. For the same reason, you can visit Oral & Maxillofacial surgeon who may help you regarding this issue.
Since swelling is doubled in past two days, that clearly means you cant rule out infection due to oral antibiotics. You may need Antibiotics given through intra venous rout which will have faster results in your case. But off course these drugs will be given to you only by your Oral surgeon or dentist.

Take care.
Answered: Tue, 16 Oct 2012
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Dentist Dr. Yogesh Tripathi's  Response
hello
since you are taking good medications for long duration and still your swelling is not reducing
what i think is that you must have developed a dry socket which is common if you dont go for lukewarm saline rinses several times a day 24 hours after extraction
so what i would advise is that you goo to your dentist get the socket cleaned up
He will provide you with zoe enrolled in cotton
after that do lots of luke warm saline rinses and apply the zoe thing after rinsing
hope that will help
Answered: Thu, 1 Aug 2013
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Dentist Dr. Varun Mishra's  Response
hello and welcome to hcm
hope so that you have taken the medications with the regimen and not haphazardly because it causes development of undue resistance and can not stop the harbor of microbes.
you have also not mentioned that which tooth it was, because symptoms indicates that you have extracted your wisdom tooth and going in the stages of dry socket.
also maybe you have irritated the blood clot at extraction site.
so get your extraction site irrigated with warm saline and betadine followed by proper regimen of antibiotics.
take keterolac (NSAID) twice daily for 2 days for pain and visit the dentist asap.
thanks
Answered: Thu, 26 Jul 2012
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Dentist Dr. Gunjan Gupta's  Response
Hello Mandee,
Thanks for writing in.
As you provided the detail,it seems that the extracted tooth was wisdom tooth.
There are so many causes for the persisting swelling and pain since such a long time,like-
1. Dry socket.
2. Improper drainage because of wrong tooth extraction or need of more tooth extraction.
3. Any oral pathology related to concerned tooth.
4. Remaining tooth structure in the socket.
The detail provided by you is not complete,you did not mention some important points like-
1. Which tooth had been extracted?
2. Proper clinical and radiological examination had been done or not prior to extraction?
3. Consultation with oral pathologist to rule out the cause of swelling? etc..........
So i will suggest you please visit back to your dentist as soon as possible and get the proper clinical and radiological examination done,and one more thingh go for biopsy after the consultation with an oral surgeon or oral pathologist if needed?
nothing to get worried.
Take Care.
Dr.Gunjan Gupta
Answered: Wed, 17 Oct 2012
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Dentist Dr. Bindiya Bhaskar's  Response
hello and welcome,
since the swelling persist even after 2 weeks post extraction,visit your dentist to rule out any root pieces remaining at the site.if so,get it extracted.
get an x-ray of the site to rule out the chance of any periapical pathoses.
you must get done incision and drainage along with curettage to drain the pus and abscess if presnt,as this can cause swelling.
if you had taken antibiotics without draining the abscess,it can lead into hardening of abscess called antibioma.
in such cases,swelling persists.there is chance of dry socket too.
if so, get your extraction socket irrigated using betadine and socket dressings can be given by zinc oxide eugenol and iodoform paste.the dressing has to be changed daily.
regards
dr.bindiya
Answered: Tue, 16 Oct 2012
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Dentist Dr. Inderpreet Singh's  Response
hi mandee . it seems that probably the wrong tooth was extracted or more probably one more tooth needed to be extracted. nonetheless the causative factor is still present and so the antibiotics are not working.

always remember, the only treatment for swelling due to pus is to drain it and then a course of antibiotics. ask you dentist to relook at the cause. he/ she might have missed out on a cause.
Answered: Tue, 16 Oct 2012
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Dentist Dr. Qazi Ammara's  Response
Hi,

Thanks for asking the query,

Swollen gums indicates presence of infection , there could be a chance of any left over root particle in the socket , improper drainage of abscess, presence of any oral pathology.
I would suggest you to consult a Dentist,get the clinical examination done, take an x-ray, along with the biopsy report which will give the exact diagnosis of the lesion.
Take complete course of antibiotics and analgesics, get the abscess drained by the Dentist.
Take multivitamin tablets.
Maintain a good oral hygiene, take lukewarm saline gargles and antiseptic mouthwash rinses.

Hope this helps out.

Regards..
Answered: Sat, 27 Apr 2013
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