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Dr. Andrew Rynne

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Tooth Extraction Site Sensitive, Throbbing Sensation, Brown Bad Smelling Lump Popped Out. Any Ideas ?

I had a tooth extraction performed a week ago, it appeared to be healing as I expected. I just had a large brownish bad smelling lump pop out of it, i felt an instant relief of pressure (not that I was aware of this sensation until now) but now the extraction site is sensitive and a throbbing sensation is there. What has happened?
Thu, 18 Oct 2012
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Dentist, Periodontics 's  Response
Dear dutchiesmum,
Welcome to health care magic forum,

With the details you have given, I can tell you that you probably had a periapical granuloma or a periapical cyst. Periapical granuloma or cyst occurs when there is long standing periapical infection. (Periapical infection is the term used to explain infection which involves roots of teeth due to decay or any other reasons). In your case probably it was very large cyst/granuloma and was probably compressing the nerve beneath it. Now since the tooth has been extracted and the granuloma/cyst has been removed, you've felt instant relief of pressure. But since the extraction wound is still fresh, it is normal for you to feel the extraction site sensitive. Also when a tooth is extracted, the roots of adjacent teeth would be exposed till the wound heals, exposed roots could also be cause for sensitivity. One more reason for sensitivity could be the adjacent teeth might have a decay.
I advice you to wait for few days for initial healing to take place, the symptoms may reduce. If symptoms doesn't reduce even after 2 weeks you need to go back to your dentist and get examined thoroughly, if necessary you may have to consult oral and maxillo facial surgeon.
Wishing you speedy recovery
Dr.Avinash
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Dentist Dr. Varun Mishra's  Response
hello and welcome to hcm,
maybe you have disturbed the extraction site clot which forms after the extraction to fill the space and as a sign of healing. this may be the old and badly healed clot. so, do not touch it with finger or tongue.
visit the dentist and get it irrigated with warm saline or betadine .
thanks
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Dentist Dr. Geoffrey Ward's  Response
Hello and thank you for your question.
What you had pop out was either the blood clot that had formed when you had the tooth extracted or old food debris. This is the same way the other parts of your body shed a scab. This one happened to be in your mouth. You are experiencing the sensitivity and throbbing because now you have raw tissue exposed to the outside environment. This is a normal part of healing. I would suggest rinsing your mouth out with warm salt water to help keeping the area clean and reduce the swelling. 10oz warm water, 1/2 tsp salt swish and spit 4-6 times a day especially after eating. Also you can take NSAIDs such as ibuprofen, at this point I would take 600mg every 6 hours as needed for pain. If the pain continues or gets worse, go into your dentist to be evaluated for infection formation.

Best wishes and good health

Dr. Ward
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Dentist, Periodontics Dr. Saumya Khanna's  Response
hi, the symptoms you have described point towards dry socket as the blood clot got dislodged, you need to see an oral surgeon as soon as possible. The treatment includes dressing over the area since the bone is exposed it needs to be dressed regularly for correct healing. Avoid hot and spicy foods and avoid spitting often. You also need to take an antibiotic course for 5 days.

take care
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Dentist Dr. Gunjan Gupta's  Response
Hello,
Thanks for writing in.
As you provided the detail it seems that,there was a periapical pus formation in the concerned tooth,because of that you got instant relief after extraction.
But now you have sensitivity in the same region,so i will suggest you please visit back to your dentist as soon as possible and get the proper examination done including x-rays,for any remaining piece or proper curretage of the concerned tooth socket.
nothing to get worried.
Take Care.
Dr. Gunjan Gupta
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Dentist Dr. Inderpreet Singh's  Response

the blood clot that was supposed to form at the extraction site ahs probably disintegrated. this leaves the nerves in the extracion socket exposed.
as a result the area is ultra sensitive. this condition is known as dry socket. don't worry , go to a dentist and he will place a sedative dressing in the socket which will relieve you of pain along with some analgesics.
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Dentist Dr. Neha Sumra's  Response
Hello
Welcome to HCM
I would like to tell you that post-extraction healing takes some time from 1 week to 1 month depending on case.But while healing there is formation of granulation tissue that is whitish in color.
As per your history,i think you might be having some periapical infection in same tooth before extraction & while extraction that area was not curretaged properly with betadine. So perhaps your infection didn't subsided completely.Now that remaining periapical cyst or granuloma has popped out.You need to go for proper check-up.In case of granuloma get it excised & if thats a cyst get it enucleated. But first consult your dentist.Sensitivity might be due to surgical exposure of bone while extraction & it will take some time.
Please continue your analgesic & antibiotics as prescribed by your dentist.
Also maintain oral hygiene & do warm saline rinses 3-4 times a day.

Take Care
Regards
Dr.Neha
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General & Family Physician Dr. Ramesh M.Vachharajani's  Response
Hi, Thanks for query.
It seems that you might have developed infection at the site of extraction as you got throbbing sensation.
Consult your dentist and he will prescribe antibiotic medicine if he finds it necessary.
Ok and bye.
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Dentist Dr. Roshan Khan's  Response
Hi there,
looks like its a case of dry socket. It happens when the blood clot dislodges from the extraction socket. Its a painful condition. You need to meet the dentist asap so that he can do a dressing in the socket. You could take some pain killers a s well
dr.roshan khan
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Dentist Dr. Bindiya Bhaskar's  Response
hello and welcome,
the symptoms are that of dry socket/alveolar osteitis.
in such cases there will be intense throbbing pain due to blood clot dislodgement.
the extraction socket has to be treated by obtundant dressing using zinc oxide eugenol and iodoform gauze.dressing has to be changed daily.
warm saline gargle can be done frequently.
betadine irrigation will help in healing process.
please avoid irritating the area with your fingers.
maintain good oral hygiene.please avoid food lodgement in your extraction socket.
regards
dr.bindiya
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Tooth Extraction Site Sensitive, Throbbing Sensation, Brown Bad Smelling Lump Popped Out. Any Ideas ?

Dear dutchiesmum, Welcome to health care magic forum, With the details you have given, I can tell you that you probably had a periapical granuloma or a periapical cyst. Periapical granuloma or cyst occurs when there is long standing periapical infection. (Periapical infection is the term used to explain infection which involves roots of teeth due to decay or any other reasons). In your case probably it was very large cyst/granuloma and was probably compressing the nerve beneath it. Now since the tooth has been extracted and the granuloma/cyst has been removed, you ve felt instant relief of pressure. But since the extraction wound is still fresh, it is normal for you to feel the extraction site sensitive. Also when a tooth is extracted, the roots of adjacent teeth would be exposed till the wound heals, exposed roots could also be cause for sensitivity. One more reason for sensitivity could be the adjacent teeth might have a decay. I advice you to wait for few days for initial healing to take place, the symptoms may reduce. If symptoms doesn t reduce even after 2 weeks you need to go back to your dentist and get examined thoroughly, if necessary you may have to consult oral and maxillo facial surgeon. Wishing you speedy recovery Dr.Avinash