Persistent White Discharge from Gum After Wisdom Tooth Extraction: Causes and Solutions

Q: Persistent White Discharge from Gum After Wisdom Tooth Extraction: Causes and Solutions

Hello： First, please confirm whether you are taking any medications for osteoporosis, and if you have undergone any cancer-related radiation therapy or immunotherapy. <br>If so, these factors may affect wound healing. <br>Additionally, long-term use of immunosuppressive medicatio

There is a small hole on the buccal gingiva of the second molar, and when pressed, white discharge flows out from there and the interproximal space?

Hello, Doctor: After having my wisdom teeth removed at the end of last year, I developed gum inflammation, and soon after, a small hole appeared in my gums.
When pressed, it releases pus.
I have been prescribed antibiotics several times at the clinic.
Although there was slight healing during the course of the medication, the symptoms recurred shortly after finishing the antibiotics.
The clinic diagnosed it as a bacterial infection, but even after debridement, the small hole in my gums has not disappeared.
Upon follow-up, the doctor concluded that there are no periodontal issues and could not determine what the discharge I mentioned was, attributing it to the wisdom tooth extraction site being too deep.
I was advised to return only if the gums became swollen.
However, it has been over a month since the debridement, and nearly six months since the wisdom teeth extraction.
Although there is no swelling and no pain in that area, I feel a slight tightness, and I continue to have white discharge.
I would like to ask the doctor what could be the cause of this.
Thank you.

Zhang, 30~39 year old female. Ask Date: 2022/05/12

Dr. Lin Jiayong reply Dentistry

Hello: First, please confirm whether you are taking any medications for osteoporosis, and if you have undergone any cancer-related radiation therapy or immunotherapy.
If so, these factors may affect wound healing.
Additionally, long-term use of immunosuppressive medications (such as in organ transplant or SLE patients) or poorly controlled diabetes can also complicate wound healing.
For difficult wound healing, it is recommended to consider laser sterilization and hyperbaric oxygen therapy for repair.
However, it is advisable to visit a medical center for a CT scan to confirm if there are any other sources of infection.
Best regards, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2022/05/12

More Info

After wisdom tooth extraction, persistent white discharge from the gum can be concerning and may indicate several underlying issues. Based on your description, it seems that you have been experiencing ongoing inflammation and discharge from the extraction site for several months, despite receiving antibiotic treatment and undergoing debridement. Here are some potential causes and solutions for your situation.

Possible Causes of Persistent White Discharge:
1. Infection: The presence of pus and the need for antibiotics suggest that there may be an ongoing bacterial infection at the extraction site. This can occur if bacteria have colonized the area, especially if the wound has not healed properly.
2. Residual Tooth Structure: Sometimes, small fragments of the tooth can remain in the gum tissue after extraction. These fragments can lead to chronic inflammation and infection, causing persistent discharge.

3. Dry Socket (Alveolar Osteitis): This condition occurs when the blood clot at the extraction site dislodges or dissolves before the wound has fully healed. It can lead to severe pain and a foul taste or odor, but it may also present as a persistent discharge.

4. Granulation Tissue: After surgery, the body forms granulation tissue as part of the healing process. If this tissue becomes infected, it can produce discharge.
5. Cyst Formation: In some cases, a cyst can develop at the extraction site, which may lead to ongoing discharge and inflammation.

6. Poor Oral Hygiene: Inadequate oral hygiene can contribute to the persistence of infection and discharge. It's essential to maintain good oral hygiene practices, especially after surgery.

Recommended Solutions:
1. Follow-Up with a Specialist: Since your primary care dentist has not been able to resolve the issue, consider seeking a second opinion from an oral surgeon or a periodontist. They may have more specialized knowledge regarding post-extraction complications.

2. Imaging Studies: If there is suspicion of residual tooth structure or other complications, imaging studies such as X-rays or a CT scan may be necessary to visualize the area and identify any underlying issues.

3. Surgical Intervention: If a piece of tooth or cyst is identified, surgical removal may be necessary. This can help eliminate the source of infection and promote healing.

4. Antibiotic Therapy: If an infection is confirmed, a longer course of antibiotics or a different antibiotic may be required. It's crucial to complete the full course as prescribed.

5. Oral Hygiene: Maintain excellent oral hygiene by gently brushing the area and using an antiseptic mouthwash as recommended by your dentist. Avoid vigorous rinsing that could dislodge any healing tissue.

6. Monitor Symptoms: Keep an eye on any changes in symptoms. If you notice increased pain, swelling, or changes in the discharge (such as a foul odor), seek immediate dental care.

7. Avoid Irritants: Avoid smoking and other irritants that can delay healing and exacerbate inflammation.

In conclusion, persistent white discharge from the gum after wisdom tooth extraction can be a sign of infection, residual tooth structure, or other complications. It is essential to follow up with a dental professional who can provide a thorough examination and appropriate treatment. Maintaining good oral hygiene and monitoring your symptoms will also play a crucial role in your recovery.

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