I had tooth #14 extracted due to abcess and bone graft placed on 8/2/13. I have had worsening pain since Monday.I've only experienced slight relief when the sealant came out of the gum on Thursday (in 2, 1cm sized chunks. is that normal?).Yesterday,the doctor said everything looks great and the xray looked good.Because I was in so much pain he put me on a stronger antibiotic and gave me flexeril to take before bed (possibly grinding my teeth at night). I am feeling extreme pain at this point.
Can you get dry socket with a Bone Graft? How do you detect this?
Doctor Answers 5
Dry Socket or Infection?
Since the tooth was removed due to an abcess the graft most likely failed. The best thing to do is to treat the possible drysocket and infection. Once your tissue has healed the doctor should re-enter the site and place a new graft.
Bone Graft Pain
Worsening pain 3-5 days after an extraction that radiates is classic of "Dry Socket" pain. It is NOT common with a bone graft for socket preservation, especially in the upper jaw, although I have seen it rarely. Any exposed native bone around the extraction socket can cause this pain. See your surgeon for him to apply some topical medication to relieve the pain. There are dry socket preparations that will relieve the pain within minutes. If the pain is not relieved then something else may be occurring, possibly infection
Infection or dry socket?
If a tooth has a large infection the desired protocol is to remove tooth and infected tissue with curette and adequate irrigation. Let socket heal for about a weak to let the body manage the infected tissue. The dentist will then re-enter the site, graft, suture, and obtain primary closure. Since the tooth was grafted at time of extraction your risk of dry socket is higher. Are you a smoker? On birth control? All of these can interfere with proper clotting. Pain start 2-3 days after procedure? If so most likely dry socket.
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Detection of a dry socket is pain, but presence of pain does not mean dry socket. A dry socket is simply a description. It is when the space previously occupied by a root loses its clot and is an empty space. A graft prevents this by filling the space with material to induce healing and bone formation while preserving bone volume. What you are experiencing is likely NOT a dry socket and most likely attributed to the infection, or the graft material is integrating with the bone. I don't know what you mean by the sealant coming out of the gums (sealants are plastic fillings placed in the grooves of decay prone teeth). Perhaps a membrane was used to hold the graft material? If your doctor says everything looks great, then you likely just need to give it all more time to heal. Pain can sometimes last 2 weeks.
I would suggest another opinion
I would seek another opinion from a Laser trained Periodontist to see what is going on.
Best of Luck
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.