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Medical Forum / General / Dentistry / November 2006

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Wisdom tooth from hell

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MM - 03 Oct 2006 08:42 GMT
This is wife's experience.

Day 1 - Had one lower wisdom tooth surgically extracted
The doc said "no problems in the surgery", took 20 minutes
under local anesthesia

Doc prescribes
- Amoxycillin 250mg  Cloxacillin 250mg
to be taken 3 times a day (total 10 tablets - i.e. 3.33 days)
- Metronidazole 400 mg 3 times a day (total 10 tablets - i.e. 3.33 days)
- pain killers
Doc says Amox/Clox should be enough but prescribed
Metron also just in case - tells my wife, that if she has lot of vommitting
with Metron, she can stop it.

Day 2- Hardly any pain, but small part of the tongue feels wierd
(numb, heavy). After 4 doses of Metronidazole, wife feels heavy
nausea, vomitting all the time, stops taking Metronidazole.
Finishes 10 tables of Amox+Clox

Day 3 - same as day 2.

Day 4 -  same as day 3.

Day 5 & Day 6- tooth pain & ear ache starts.

Day 7 - same as Day 5 (tooth pain & ear ache), but
tongue feels normal (no numbness heavy feeling) -
visits dentist - dentists checks mouth, says everything
looks ok, looks healed, but there may be under the
surface infection causing the pain - maybe because
of the discontinued Metrondazole. Prescribes
Combo (Tinidazole  600mg & Ciprofloxacin
500mg) to take for 3.33 days (10 tablets).
Wife's tongue again feels wierd after dentist inspected
the mouth & this has continued till now.

Wife starts antibiotic again but again it makes her
feeling terrible. She manages to take for 2 days (i.e. 6 tablets)
but then stops again. Still some tooth pain & ear ache.
This continues till day 14, when everything suddenly
flares up. She has terrible bad ear ache. She also has
burning feeling in the mouth couple of times in the day.
Ear ache gets really bad.
Goes to emergency room on Day 16. Regular doc on duty
says there is drainage (or something like that) &
that is causing the ear ache. She gives pain killers & Iodione
gargle. She also gives probiotics/Vitamins for the mouth
burning. Next day all pain has gone, but ears still feel funny,
but no pain. Day 18 ear pain again. Day 19 everything feels
great. Day 20 bad ear ache again. Goes to regular physician
(not dentist). Ears are reddish inside & seem moist.
He says there may be infection - prescribes Gatofloxacin
200mg times a day for 7 days with pain killers. Wife starts
this & starts feels better after 2-3 days (day 23). Day 25
on she feels very good. She continues the gatofloxacin
for 7 days. On Day 25 she gets mild ear pain again (finished 5 days
of gatofloxacin). On Day 26 again ear pain - this is the last day
of gatofloxacin. We get scared & visit a ENT doctor. ENT
doctor checks ear - says that the infection is fully gone. Then
he puts his finger in wife's mouth & cheeks & press at various
points & asks my wife if she feels pain - based on these tests
he diagnoses that the pain which she currently has isn't the same
that she had before - it's muscular pain/spasms in the cheeks, he
says hot water pad on the cheeks whenever she feels the pain
along with pain killers should relieve the pain. ENT doc says
it may be Costen's syndrome/malocclusion caused either
by trauma during surgery or keeping mouth open for long time
during surgery or because the rest of the jaw/teeth have still not
got used to one teeth being removed - he says he should wait
for 3-4 weeks & then go a dentist again.

Wife gets ear pain in the night - she dips a towel in hot water
& presses it  against the cheek & takes 200 mg ibuprofen.
Pain goes away. Next day mild ear pain - just does the hot
water thing. She has been ok for the last 3 days now - no pain
at all.

Any opinions on the whole thing (been more than a month
now). Was the original dosage of antibiotics correct? Could
more antibiotics in the beginning helped? Did stopping
Metrondazole cause the problems?
Someone said she should have started Amox/Clox one day
before the surgery rather than after.

The only thing remaining is part of the tongue being numb.
I am wondering why it resolved itself in the first week & then
restarted again (& is still there) after the dentists examination.

Why did it get numb in the first place? The x-ray showed the
nerves being far from the teeth & the surgeon also said he didn't
see any nerve during the extraction.

Will being on pain killers/antibiotics for so long (she must have
taken pain killers maybe 10-15 days out of the 30 days)
cause any other problems. Wife is 36.
oN - 03 Oct 2006 10:04 GMT
......>
> Will being on pain killers/antibiotics for so long (she must have
> taken pain killers maybe 10-15 days out of the 30 days)
> cause any other problems. Wife is 36.

Have you OPT, x-ray s?
There is possible that some other teeth have some pulpitis, or bone is
broken, or some antagonist teeth is in some inflammation state, or...
Try to find second opinion.

all the best,
Proka
longhorndkr@yahoo.com - 21 Nov 2006 17:17 GMT
> ......>
> > Will being on pain killers/antibiotics for so long (she must have
[quoted text clipped - 8 lines]
> all the best,
> Proka

Being on the antibiotics should not cause any other problems.
Effectively, the reason why people should not be on antib's for a long
time has more to do with them becoming immune to the positive effects
of the drug and thereafter its efficacy not being the same should your
wife need antibiotics later down the road.  But one course of 15 days
should not make much of a difference.  Some people simply have
different levels of resistance to bacteria and normal courses of
Penicillin traditionally can run 3x/day for up to three weeks.

It is possible that your wife had some lingering effects from the
Wisdom teeth extraction; possibly the doctor hit a nerve and that is
what has effected the tongue?  It certainly sounds like she had some
bacteria infect the region. The mouth is replete with a very lot of
nerves and blood vessels being so closely squeezed together (near the
brain!) and consequently this is why antibiotics are prescribed.

As for myself, amoxicillin does not have the same level of benefit as
do the more recent synthetic drugs Azithromycin/Zithromax, Levaquin and
Gatofloxacin.   Generally, a doctor will prescribe the
amoxicillin/clamox first (in order to save these stronger drugs for
more dire cases), and if they do not see satisfactory results move to
Trimox, then to Augmentin, Gato, Azith, etc.

Hope that helps,
D
Mark & Steven Bornfeld - 21 Nov 2006 18:15 GMT
>>......>
>>
[quoted text clipped - 18 lines]
> different levels of resistance to bacteria and normal courses of
> Penicillin traditionally can run 3x/day for up to three weeks.

    There is another potential of course, and that is increased risk of
sensitization.
    Unstated in this whole saga is whether a C and S was done.

Steve

> It is possible that your wife had some lingering effects from the
> Wisdom teeth extraction; possibly the doctor hit a nerve and that is
[quoted text clipped - 12 lines]
> Hope that helps,
> D

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

 
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