[48F] Experiencing bad breath and swelling post-wisdom tooth extraction

Patient Description

A 48-year-old female recently had a wisdom tooth removed and has been experiencing bad breath for the past two days. The patient reports difficulty brushing or cleaning the area, with mouthwash providing some relief. The bad breath is worse in the afternoon and may be exacerbated by certain foods. The extraction site is swollen and has some discharge. The patient experienced a fever on the day of the extraction and has had chills in the evenings since then. There is no pain at the extraction site or difficulty swallowing or opening the mouth, but an unusual taste is present. The patient smokes once a day. Medical history includes tonsillectomy, laparoscopy, and hypotension diagnosed 7 years ago. The patient is allergic to aspirin and is currently taking 300mg of Vulante once a day as part of her ARV medication regimen.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Post-Extraction Infection: It's common to experience some swelling and discomfort after a tooth extraction, but the presence of a bad smell, unusual taste, and discharge could indicate an infection at the extraction site. Infections can occur if bacteria enter the wound, especially if it's difficult to clean the area properly.

    • Treatment: Typically, a dentist or oral surgeon would prescribe antibiotics to treat the infection. They might also recommend a special mouth rinse to help keep the area clean.
  • Dry Socket (Alveolar Osteitis): This condition occurs when the blood clot that forms in the socket after a tooth extraction becomes dislodged or dissolves before the wound has healed. This can lead to severe pain, bad breath, and an unpleasant taste in the mouth.

    • Treatment: Treatment usually involves cleaning the socket and placing a medicated dressing to promote healing and reduce pain.

What you can do

While it's important to consult with your dentist or oral surgeon for a formal diagnosis and treatment, here are some steps you can take in the meantime:

  1. Maintain Oral Hygiene: Continue using mouthwash as it helps to reduce bacteria in your mouth. Be gentle around the extraction site to avoid dislodging any blood clots.
  2. Avoid Smoking: Smoking can delay healing and increase the risk of infection. Try to avoid smoking until the extraction site has fully healed.
  3. Stay Hydrated: Drink plenty of water to help flush out bacteria and keep your mouth clean.
  4. Soft Diet: Stick to soft foods that are less likely to irritate the extraction site. Avoid hot, spicy, or crunchy foods that could cause discomfort.
  5. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your healthcare provider.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Increased Pain: If you start experiencing severe pain that doesn't improve with over-the-counter pain medication.
  • Fever: If you develop a fever (temperature over 100.4°F) or if your existing fever worsens.
  • Swelling: If the swelling around the extraction site increases or spreads.
  • Difficulty Breathing or Swallowing: If you experience any difficulty breathing or swallowing, seek immediate medical attention.

Remember, while I can provide information and suggestions, it's important to consult with a real healthcare professional to receive a formal diagnosis and appropriate treatment.

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7 mo ago

People Also Ask


What are the signs of a post-extraction infection after wisdom tooth removal?

Signs of a post-extraction infection include bad breath, unusual taste, swelling, discharge from the extraction site, fever, and chills. It's important to consult a dentist or oral surgeon if these symptoms occur.


How can smoking affect the healing process after a tooth extraction?

Smoking can delay the healing process after a tooth extraction by reducing blood flow to the gums, increasing the risk of infection, and potentially dislodging the blood clot that forms in the socket.


What is a dry socket and how is it treated?

A dry socket occurs when the blood clot at the extraction site is dislodged or dissolves, exposing the bone and nerves. It is treated by cleaning the socket and applying a medicated dressing to promote healing and reduce pain.


When should I seek medical attention after a tooth extraction?

You should seek medical attention if you experience severe pain, a fever over 100.4°F, increased swelling, or difficulty breathing or swallowing after a tooth extraction.


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