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Suggest ways to manage severe pain after tooth extraction

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Posted on Thu, 28 Jul 2016
Question: Hello, I am a 57 year old male who recently had front tooth number 8 extracted in preparation for an implant. The extraction was done on July 4th and was uneventful. On Sunday I woke up in terrible pain. I saw Dr on Tuesday, he said just sore and gave me Vicoden and Clindamycin 300 x 3 daily. I went back today still in excruciating pain.He xrayed and examined and determined it is a dry socket. My front gums, even where the stitches were are fine. The real pain is coming from a very swollen gum behind where the tooth was. My questions are, can a dry socket cause the gum to swell so much? If so, after a week , when can I expect it to heal? Outside of this, what other conditions would cause this gum to be so swollen, or not heal quicker?
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Answered by Dr. Honey Arora (1 hour later)
Brief Answer:
Can be dry socket, infection in the extraction socket...

Detailed Answer:

Hi..
Welcome to HEALTHCARE MAGIC..

I have gone through your query in detail and can understand your concerns..

As per your complain swollen gums is generally an indication of infection and as you had extraction done on 4th July then such a severe pain being caused due to Dry Socket is a bit questionable as it generally occurs after about a week of extraction..

It can although cause swelling and severe pain but in your case it seems to be more of infection..
I would suggest you to consult an Oral Surgeon and get evaluated..

A thorough clinical evaluation and examination of x rays can be done for diagnosis..
In case if it is due to Dry Socket then healing will not occur on its own..

It has to be initiated by placing sedative dressing like Zinc oxide eugenol in a gauze pack to relieve pain and promote healing of the socket..

Slower healing and infection can also be caused due to Diabetes..

In case of infection a course of antibiotics and painkillers will be continued and also irrigation of the socket with antiseptic solution and antiseptic mouthwash gargles will help in resolution..

Any further questions are welcome..

Regards..
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Honey Arora (1 hour later)
Hello,
In your answer you say that it is unlikely my dry socket is causing my one gum to be swollen, because dry sockets usually occur about a week after extraction. However Dr., today is exactly 1 week from the extraction. I am really anxious and tired about the pain. Tell me please, other than being on pain meds and an antibiotic, is their anything else that could or should be done. I cannot picture tolerating this pain for another week or more. Please tell me the antibiotic will eventually get this swelling down?
Lastly Dr., I forgot to mention that 2 days ago the periodontist said he observed what looked like a herpes infection (non sexual) on my front gums and in the socket. I've never had herpes of any sort. Would this change the healing process or the time for healing and ending this terrible pain? XXXX
doctor
Answered by Dr. Honey Arora (4 hours later)
Brief Answer:
More chances are of infection..

Detailed Answer:
Hi..
Welcome Back..

As per your query as it is one week exact by today that you have got extraction but pain is present before hand only along with swollen and painful gum the chances are still more likely that you have an infection but by now if the blood clot that is formed in the extraction socket is dislodged there must also be formation of dry socket..

Secondly if you are suspected for herpes infection inside the mouth it can also cause inflamed and infected gums and exaggerate the situation..

But for confirmation of herpes an oral swab culture and also blood tests has to be carried out for confirmation..

So my suggestion is that it will be best to consult an Oral Surgeon and get a proper examination done and treatment will be done accordingly..

As of now to relieve pain there is no other option than taking painkillers and also antibiotics to reduce infection...
Vicoden is however efficient in relieving pain while you can also take Ketorolac or Tramadol by consulting a local doctor..
Do cool compresses over the cheek..
Apply numbing gel over the swollen gum for relieving pain..
Do warm saline gargles..

Any further queries are welcome..

Regards.


Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Honey Arora

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Practicing since :2011

Answered : 13391 Questions

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Suggest ways to manage severe pain after tooth extraction

Brief Answer: Can be dry socket, infection in the extraction socket... Detailed Answer: Hi.. Welcome to HEALTHCARE MAGIC.. I have gone through your query in detail and can understand your concerns.. As per your complain swollen gums is generally an indication of infection and as you had extraction done on 4th July then such a severe pain being caused due to Dry Socket is a bit questionable as it generally occurs after about a week of extraction.. It can although cause swelling and severe pain but in your case it seems to be more of infection.. I would suggest you to consult an Oral Surgeon and get evaluated.. A thorough clinical evaluation and examination of x rays can be done for diagnosis.. In case if it is due to Dry Socket then healing will not occur on its own.. It has to be initiated by placing sedative dressing like Zinc oxide eugenol in a gauze pack to relieve pain and promote healing of the socket.. Slower healing and infection can also be caused due to Diabetes.. In case of infection a course of antibiotics and painkillers will be continued and also irrigation of the socket with antiseptic solution and antiseptic mouthwash gargles will help in resolution.. Any further questions are welcome.. Regards..