How to deal with a tooth hole that has yet to close after 2-1/2 weeks?

[Playforfun]

Hey all, I was hoping to get some dental advice. So, I had my right upper wisdom removed 2-1/2 weeks ago. It seems to be a simple extraction as my dentist did it really fast and the whole tooth was intact when removed. However, my dentist said it was close to my maxillary sinus so he placed 2 pcs of dental gelfoam soaked in saline as protection for my sinus and as a hemostatic. Past forward, the wound healed quite well except for a mid-sized hole left on the center. This hole is hollow and a little deep, red at the bottom with no blood clot. The surrounding gums looked normal and a little pinkish. Have some minor pain and discomfort from the site at times. I noticed this as early as 1 week and didn't thought I had a dry socket since my pain was not severe. But by close to 2 weeks, I got worried so I called up my dentist and booked an appointment. On appointment day, my dentist checked and said I had a dry socket since I dislodged the blood clot on that center area. For context, I mouthwashed very frequently even just after the extraction and I must have dislodged it during that time. Any case, my dentist placed a temporary filling with Eugenol. He said that the filling will harden after several hours and fall off causing irritation on the area and bleeding which would hopefully start the healing process once again to fill up that hole. After 10 days, if in case this didn't work, he would have to inject me with local anesthetic and make the area bleed again and stitch it up for additional precaution. I'm quite afraid tbh since I have some dental phobia. I wanted to ask if anyone else had this situation and what happened. I would very much appreciate your input. Thanks

 

[Dr M]

If you had no pain, I would not have interfered with the socket. Dry socket, usually appears 3-5 days after an extraction and is accompanied by severe pain. It is also classified as a self-limiting disease, which means it would have cleared up eventually by itself, without any intervention. The only reason we intervene most of the time, is to relieve pain.
If you have no further pain, I would just be patient. A socket can sometimes take a month to fully close.

 

[Playforfun]

Thank you Dr. M. I wanted to ask have you heard about this procedure of making the area bleed again to restart healing and stitching it up to make sure the hole closes?

Also, how do I keep the area clean since it is exposed to toothpaste daily when I brush and food. I'm kind off worried about infection, at least until the socket closes?

 

[Dr M]

We do sometimes try to induce bleeding again to assist the healing process. There is different techniques to do this.
Best way to keep it clean is to rinse with luke-warm salt water after a meal and avoid brushing in this area.

 

[Playforfun]

Thank you very much! oh so, I can't brush with toothpaste for a while? I generally try to avoid brushing the area but toothpaste suds still gets into the hole since I brush all other teeth and the tooth near it

 

[Dr M]

Toothpaste should not cause any issues. Brush the rest of your teeth as normal, just not in that area

 

[dental_care]

Your dentist is managing the dry socket effectively with Eugenol to aid healing. Avoid aggressive mouthwashing to prevent further dislodging of the clot. Minor pain is normal; monitor for severe symptoms. Follow your dentist’s instructions and seek immediate care if the condition worsens.

 

[Playforfun]

Thank you all for the replies. So I just wanted to consult something. It has been a month since my upper wisdom tooth removal and the hole still persist with pain and discomfort.

So what happened is that the medicated cement with Eugenol that my dentist placed 3 weeks ago, just came off 3 days ago. It was originally supposed to fall off just SEVERAL HOURS after placement since he said that its purpose is to irritate and cause bleeding on the area to restart the healing process. That did not happen. On my followup with him 10 days after placement of the medicated cement, he said it would be okay to just wait until the medicated cement (Eugenol) to fall off on its own since it would also serve now as protection for the site. It did fall off, but only after almost 3 weeks.

Now, when it fell off, I was happy since I was thinking that there was already new gum tissue underneath that pushing the medicated cement upwards, but no, the area is still hollow and now reddish unlike before my dentist placed that cement 3 weeks ago. I told my dentist about this and he said the color will come back to normal. Now, I have a bit more pain and discomfort in the area since it is now exposed(?). Dentist said that is to be expected until the area completely closes.

My question is do dry sockets really last this long on healing? Will it even still heal after this long time? Could the medicated cement's presence have prevented healing since new gum tissue cannot grow with it being there (imagine it stayed there for 3 weeks instead of just several hours as originally planned)? Why is the area reddish, is it because the medicated cement irritated it? Is there really pain accompanying dry sockets? Coz whlie my pain is not severe, it increased from before (when the medicated cement was still there) and it is annoying. It seems my dentist's plan is to just observe it and take pain meds as necessary. He said the area is already in the process of healing but he said it may take 2 months? Does it really last that long? Kinda worried since its hard to manage the area and keep it clean.

Now, I am not sure if there is already evidence of healing present on my site, all I see is that the edges of the hole are reddish and in the center is a bit red with some whitish stuff. The surrounding gums are whitish-pink and looked normal and healthy, its only that spot that's reddish. Thank you for all the answers

 

[Playforfun]

Sorry for the lengthy post, but I hope someone could advise me regarding my questions. Thanks.

 

[Dr M]

Does not sound like a dry socket. The introduction of a foreign body into the socket, such as eugenol, could have delayed the healing process. A normal socket can take a month to close. Delayed healing could lead to a longer timeline of healing. If the pain is manageable, I would just be patient. It should gradually get better. If it doesn't in another 2 weeks, I would suggest taking another x-ray. Perhaps there is a root fragment left over or another tooth in the area that needs attention.

 

[Playforfun]

I am not sure about a root fragment, coz it was a normal fast extraction. The teeth was not sectioned and I even still have the teeth, its looks intact, even on the roots. The tooth beside it looks okay as well. No bleeding or inflammation whatsoever. I'll be more patient since it indeed might have delayed healing since the Eugenol stayed there for so long. Thanks!