Bone screw wound
Hello Doctor, I had a new bone screw reinserted in the left posterior area of my gums on October 25th (due to inflammation two weeks ago, which is why it was redone).
It has been a week since then, and I still experience pain when I press around the bone screw with a cotton swab or perform oral muscle exercises.
Yesterday, I used a flashlight to examine the bone screw and noticed a white area on the inner side that I cannot remove with an interdental brush.
I would like to ask if this white area could indicate exposed bone.
If so, will it heal on its own? Is there a possibility that it could develop into dry socket? Additionally, I have been applying iodine around the wound before bed for the past few days, and I started taking the antibiotics prescribed by my orthodontist today.
Since I cannot return for a follow-up appointment in the short term, I would appreciate your advice.
Thank you!
Tna, 20~29 year old female. Ask Date: 2019/10/31
Dr. Lin Jiayong reply Dentistry
Hello: The white area around the bone screw is usually the gingival mucosal wound; however, there are occasions when bone exposure may occur.
It is advisable to continue taking antibiotics and to return for a follow-up appointment as soon as possible.
Thank you!
Reply Date: 2019/10/31
More Info
After undergoing dental procedures such as the placement of bone screws (also known as temporary anchorage devices or TADs), it is common to experience pain and discomfort. This can be particularly pronounced if there has been a prior infection or inflammation, as you mentioned. The pain you are experiencing a week after the procedure may be due to several factors, including the healing process, the body’s inflammatory response, and potential complications.
The white area you observed around the bone screw could indicate several things. It might be a sign of necrotic tissue, which can occur if the blood supply to that area is compromised. Alternatively, it could be a sign of granulation tissue, which is part of the healing process. However, if the area appears excessively white and is not responding to your oral hygiene efforts, it may warrant further investigation.
Regarding your concern about bone exposure, if the bone is indeed exposed, it may not heal properly on its own and could lead to complications such as dry socket (alveolar osteitis). Dry socket occurs when the blood clot at the site of a tooth extraction fails to form or is dislodged, exposing the underlying bone and nerves. This condition can be quite painful and may require additional treatment from a dental professional.
The use of iodine around the wound may help with disinfection, but it is essential to be cautious with topical antiseptics in the oral cavity, as they can sometimes irritate the tissues further. It is advisable to maintain good oral hygiene, including gentle brushing and rinsing with a saline solution, to promote healing and minimize the risk of infection.
Since you are currently taking antibiotics as prescribed by your orthodontist, this should help manage any potential bacterial infection. However, if you notice increased pain, swelling, or any signs of systemic infection (such as fever), it is crucial to seek medical attention as soon as possible.
In terms of managing pain, over-the-counter pain relievers such as ibuprofen or acetaminophen can be effective. However, be sure to follow the dosage instructions and consult your healthcare provider if you have any underlying health conditions or are taking other medications.
If you are unable to return to your dentist or orthodontist in the immediate future, consider reaching out to them via phone or email to discuss your symptoms. They may be able to provide guidance based on your specific situation and history. Additionally, if you have access to a local dental clinic or emergency dental service, it may be worth visiting them for a professional evaluation.
In summary, while some discomfort is expected after the placement of bone screws, persistent pain, especially with visible changes in the tissue, should not be ignored. Monitoring your symptoms and maintaining communication with your dental care provider is essential for ensuring proper healing and addressing any complications that may arise.
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