Antibiotic After Extraction?

Discussion in 'Dental Archive' started by MS, Apr 3, 2010.

  1. MS

    MS Guest

    I had two teeth extracted yesterday from my dentist, on the lower left side
    of the mouth.

    He used a great deal of anesthetic, but it still was quite painful.

    Hours later, when the novocaine wore off, I felt a great deal of pain in the
    mouth.

    It occurred to me, that the dentist had forgot to prescribe pain pills,
    which I think would normally be the case after extraction.

    I got around that with OTC meds. For instance, four 200mg OTC ibuprofen
    tablets= one 800mg prescription Motrin.

    Today the pain is still bad, but not as bad as yesterday.

    It also occurred to me--besides forgetting to prescribe pain med, had the
    doc forgotten to prescribe an antibiotic as well? Should I have been
    prescribed an antibiotic?

    One of the teeth extracted was supposed to have been highly infected. After
    pulling it out, wouldn't the place where the tooth had been be infected,
    which perhaps an antibiotic could help?

    I am not asking dentists reading to prescribe for me, not having seen me as
    their patient. Only that if usually in such a circumstance an antibiotic
    would be prescribed, then perhaps I should call the dentist and ask if I
    should be prescribed one.

    Therefore, I would like to know, if often an antibiotic would be prescribed,
    in a situation like I described.

    Another question I have thought of, that I did not think of asking the
    dentist when I was there--would it be advisable to put an ice pack on the
    outside of my face, where the dental pain is?

    Also, where one of the teeth was extracted, the dentist immediately put on a
    temporary bridge. Also to get rid of infection, shouldn't it air out for a
    few days first, before being filled with an temporary bridge?

    Responses would be appreciated.

    Thank you in advance. :)
     
    MS, Apr 3, 2010
    #1
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  2. As a dental patient (I have no medical certifications,
    license, etc.). Here is what I've experienced.

    My last couple dentists used to send me home with a Rx for
    hydrocodone. The ones I got (Malancrodt or some similar
    brand name) from Walmart, were nearly useless. I got better
    relief from ibuprophen. I've heard Watson or Qualitest work
    better. Actually, my last pain scrip I asked for codeine
    instead, and that worked well. Lower, back teeth can be
    totally miserable to numb. The "right spot" to put the
    anaesthetic is often hard to find. I've had one oral surgeon
    who totally screwed up the anaesthetic. He was so proud of
    his technique, and it was nearly no pain relief at all.

    Antibiotics. I've had some write a prescription, and some
    not. The one dentist wrote a five day regimen of
    antibiotics. Most of the time doctors write ten days worth
    of meds, if there is an infection. I asked about this, and
    he said five days of meds was to help prevent infection. If
    I was still in pain a day or two after the extraction, I'd
    call the office, and ask for a follow up exam, and see if
    there was signs of infection.

    The last tooth I had out, they did send me home with a cold
    pack, and told me to keep it on for some time. Can't
    remember how long.

    I've found that different brands of ibuprophen work more or
    less. For me, the little round brown ones are useless. But
    the yellow Nuprin (sadly no longer made) were excellent. Try
    different brands, find out what works for you.

    I'm with you, I'd call the dentist back, and ask for a
    follow up visit.

    --
    Christopher A. Young
    Learn more about Jesus
    www.lds.org
    ..


    "MS" <> wrote in message
    news:uzCtn.72094$...
    I had two teeth extracted yesterday from my dentist, on the
    lower left side
    of the mouth.

    He used a great deal of anesthetic, but it still was quite
    painful.

    Hours later, when the novocaine wore off, I felt a great
    deal of pain in the
    mouth.

    It occurred to me, that the dentist had forgot to prescribe
    pain pills,
    which I think would normally be the case after extraction.

    I got around that with OTC meds. For instance, four 200mg
    OTC ibuprofen
    tablets= one 800mg prescription Motrin.

    Today the pain is still bad, but not as bad as yesterday.

    It also occurred to me--besides forgetting to prescribe pain
    med, had the
    doc forgotten to prescribe an antibiotic as well? Should I
    have been
    prescribed an antibiotic?

    One of the teeth extracted was supposed to have been highly
    infected. After
    pulling it out, wouldn't the place where the tooth had been
    be infected,
    which perhaps an antibiotic could help?

    I am not asking dentists reading to prescribe for me, not
    having seen me as
    their patient. Only that if usually in such a circumstance
    an antibiotic
    would be prescribed, then perhaps I should call the dentist
    and ask if I
    should be prescribed one.

    Therefore, I would like to know, if often an antibiotic
    would be prescribed,
    in a situation like I described.

    Another question I have thought of, that I did not think of
    asking the
    dentist when I was there--would it be advisable to put an
    ice pack on the
    outside of my face, where the dental pain is?

    Also, where one of the teeth was extracted, the dentist
    immediately put on a
    temporary bridge. Also to get rid of infection, shouldn't it
    air out for a
    few days first, before being filled with an temporary
    bridge?

    Responses would be appreciated.

    Thank you in advance. :)
     
    Stormin Mormon, Apr 3, 2010
    #2
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  3. MS

    MS Guest

    Thanks for the info, Amatus.

    As you say to leave the extraction site alone, what do you think of the fact
    that the dentist immediately put a temporary bridge where one of the
    extracted teeth was? (While having a permanent bridge prepared.)

    I vaguely think I recall, another time I had a tooth extracted, being told
    it should be left alone for a certain amount of time, before the dentist
    could work on the area, bridge, etc. My memory may be incorrect, however.

    This dentist, the very same day he extracted the tooth, did a mold for a
    bridge, and put on a temporary bridge. So the extraction site is in contact
    with the temporary bridge now.

    (He extracted two teeth. But the other one was the one all the way in the
    back, so there is no way to replace it with a bridge.)

    What do others think? Is it OK to put on a temporary bridge immediately
    after extraction, or should it be left for some days at least, open to the
    air, for infection to clear up, etc.?

    Thank you.


    "Amatus Cremona" <..com> wrote in message
    news:p...
    Prescription pain medication and antibiotics are NOT indicated for routine
    extractions even in the presence of infection of the tooth being removed.
    Some medical conditions will require antibiotics with an extraction, as
    could systemic signs such as fever, redness and swelling. OTC pain pills
    are more than adequate for 99.5% of the time if taken before the numbness
    wears off and continued on a proper schedule for the drug being used.

    Leave the extraction site alone, and do NOT poke anything into the site.

    AC


    "MS" <> wrote in message
    news:uzCtn.72094$...
     
    MS, Apr 4, 2010
    #3
  4. MS

    DrCrentist

    Joined:
    Mar 7, 2011
    Messages:
    1
    I am a dentist of 6years.

    1.
    If the extraction of your teeth was painful, and there was alot of infection, it may have been better to have sent you away without taking the teeth out and place you on an antibiotic for a week until the infection went down. This is because the infection actually interferes with the anethetic and makes it more difficult to anesthetize. This is probably why he used so much anesthetic. However, sending you away would mean you would have continued to have pain for a several more days as the antibiotic took effect. He could have put you on a pain killer as well to help manage the pain at this time, but often with tooth aches, I have found that the pain is difficult to manage even with pain killers.

    I will almost always take out the teeth immedeately rather then send the patient away. I will very rarely place them on antibiotics afer taking a tooth out. They have to have noticable facial swelling that did not drain during the extraction. Typically much of the purulence drains when the tooth, the source of infection, is removed.

    The swelling and problems you have are going to be related to trauma and not infection. Or perhaps dry socket, which again, isnt so much an infection as a failure to heal.

    2.
    I almost always give pain medication after removing teeth. However, all research shows that 3200mg a day of normal over the counter Ibuprofen is more effective in managing pain then prescription narcotics such as codeine or hydrocodone. It simply doesnt give the "high" that narcotics can. More effective then ibuprofen alone is taking it in alternating doses of acetaminophin......so take 400mg ibuprofen, 1.5 hours later take 400 acetaminophen, then 1.5 hours later take 400mg ibuprofen, then 1.5 hours later take 400mg acetaminophen.
    I typically give prescriptions because it is easier and people dont complain as much after. It is easier for them then following the above regiment.

    3. Placing a temporary bridge is very helpful for your healing. The socket does not need to be open to "air out". In fact, the opposite is true. You need the socket closed to hold a blood clot and heal. If the blood clot is lost you will get a dry socket and have even worse pain. A temporary bridge aids in healing. Also, having the temporary bridge placed at that time gets the healing tissue to adapt to its shape, it helps support interdental bone.......and basically your permanent bridge will look and work better because of it. Typically, you would return in 6 weeks for an impression for the permanent bridge once you healed up completely.


    Lastly, it is not necessary for your dentist to prescribe you antibiotics after an extraction. Nor is prescription pain medication necessary to manage the pain. However, pain medication is helpful for many people and easier then following the more difficult regiment i described and you should feel free to tell your dentist you are in pain and ask for a prescription. Do understand that we deal with alot of people seeking drugs and are wary of people asking for them. Also, do not tell the dentist that he "should have" prescribed you such and such. It is rude. It says the dentist made a mistake. It places you in the seat as expert and discredits all of his training. Pain is a normal side affect of having teeth removed. So is swelling. Sorry, but much of that you simply have to live with. We will try and help you to manage it, but you should expect pain after an extraction. You have an exposed hole into your jaw bone. Your body has to heal.

    Your dentist probably should have been more helpful and given you more instructions about what to expect and how to manage yourself after the extraction. But everything in his treatment was within the realm of normal.
     
    DrCrentist, Mar 7, 2011
    #4
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