Dislodged blood clot

Blue_Mermaid

Hi, I had a tooth extracted on Friday. The dentist could not save it, as it was severely infected, with a large abscess at the root (I have advanced gum disease). During the night, I felt something on my tongue. On a tissue, it looked like a lump of red jelly. I suspected it was the blood clot and looked online to confirm, where I read about dry sockets. I took a picture of the blood clot on the tissue and sent it to the dentist for advice. The next day, he confirmed it was the blood clot on the tissue but he just said, it's normal and not to touch it. I didn't feel reassured, having read that the socket could now be unprotected. So, I asked my dentist for further advice, explaining that I was still concerned after reading about dry sockets. He didn't like me questioning further and sent a very curt and what I consider a rude reply, repeating that it was normal and to stop contacting him with questions, with immediate effect. He said I was not in pain (which wasn't true, I had been in severe pain that night following the extraction but painkillers had helped and I appreciate that this was just post extraction pain) and he suggested I refrain from searching on the internet for issues that I do not have, or will not have. He himself, confirmed the picture I had sent him was the blood clot, so I don't understand why he was saying I do not have any issues and will not have any (does he have a crystal ball?). I appreciate that not everything you read on the internet is true but I was looking at official sites (such as NHS sites) and when they are all stating the same things, then I believe them to be correct. So, I am left without any further advice from the dentist himself. Could a dentist here be kind enough to explain to me, whether I should be concerned that my socket is now left without the protection of a blood clot? Do I now have a dry socket? Should it be cleaned and covered by a gauze or whatever a dentist uses to protect the open socket? Or, is this only if I start to experience new or worsened pain, foul taste/smell? At present, the pain/discomfort is less than the first night, so still just post extraction discomfort. I have tried to look at the socket with a torch to reassure myself but I am unable to see it, as it is right at the back (top right of mouth) and the tooth next to it, is in the way. Thanks in advance.

Blue_Mermaid

Sorry, it wasn't Friday the tooth was extracted. It was Wednesday.

Pollycat

Blue_Mermaid said:

Hi, I had a tooth extracted on Friday. The dentist could not save it, as it was severely infected, with a large abscess at the root (I have advanced gum disease). During the night, I felt something on my tongue. On a tissue, it looked like a lump of red jelly. I suspected it was the blood clot and looked online to confirm, where I read about dry sockets. I took a picture of the blood clot on the tissue and sent it to the dentist for advice. The next day, he confirmed it was the blood clot on the tissue but he just said, it's normal and not to touch it. I didn't feel reassured, having read that the socket could now be unprotected. So, I asked my dentist for further advice, explaining that I was still concerned after reading about dry sockets. He didn't like me questioning further and sent a very curt and what I consider a rude reply, repeating that it was normal and to stop contacting him with questions, with immediate effect. He said I was not in pain (which wasn't true, I had been in severe pain that night following the extraction but painkillers had helped and I appreciate that this was just post extraction pain) and he suggested I refrain from searching on the internet for issues that I do not have, or will not have. He himself, confirmed the picture I had sent him was the blood clot, so I don't understand why he was saying I do not have any issues and will not have any (does he have a crystal ball?). I appreciate that not everything you read on the internet is true but I was looking at official sites (such as NHS sites) and when they are all stating the same things, then I believe them to be correct. So, I am left without any further advice from the dentist himself. Could a dentist here be kind enough to explain to me, whether I should be concerned that my socket is now left without the protection of a blood clot? Do I now have a dry socket? Should it be cleaned and covered by a gauze or whatever a dentist uses to protect the open socket? Or, is this only if I start to experience new or worsened pain, foul taste/smell? At present, the pain/discomfort is less than the first night, so still just post extraction discomfort. I have tried to look at the socket with a torch to reassure myself but I am unable to see it, as it is right at the back (top right of mouth) and the tooth next to it, is in the way. Thanks in advance.

I think what you are asking is maybe against MSE rules.

The sticky at the top of this board says:

Using this board - please don't give medical advice!.

Toothsmith

I'm sure at some point you will have googled your 'advanced periodontal disease' as well. From that you will know that tooth loss comes about because you will have lost the bone support from around the tooth. So going from that, when you have the tooth out - there will not really be a deep 'socket' left in the bone, it will be a much smaller depression, largely made of gum tissue, rather than bone.  Also from what you will already know about gum disease, that gum tissue is very likely to be quite inflamed and weak, so therefore a bit prone to oozing a little blood. (Gums bleeding when you brush) 

Put that learning into what your experiencing now, and you'll realise that the blood clot doesn't really have a deep, well supported 'socket' to live in - and that is why the immature 'jelly' blood clot is highly likely to fall out. Mostly, especially when asleep, it'd just be swallowed, and you'd be none the wiser, and therefore  not really worried. 

Infected (or 'dry') sockets do happen in about 5% of all tooth extractions, but this varies according to other factors. The biggest of which is smoking. (Which is also the biggest reason gum conditions deteriorate). They are painful, but not dangerous, and do sort themselves out after a few days. If particularly painful, they can be helped by various dressings your dentist can put in. There's not really anything you can do (other than not smoke) to prevent one happening, although occasionally in people very prone to them, a course of antibiotics started a few days before the extraction might help prevent one. But the 'clot' falling out does not mean you have a 'dry' socket. 

Use the instructions your dentist gave you, keep the rest of your mouth as clean as you can, the odd warm salt water mouth wash can help, and call your dentist if pain occurs that you can't easily control yourself with normal pain killers.

Oh - and stay off Google! 

Blue_Mermaid

I can't thank you enough for your detailed and reassuring reply. 
I consider myself to be quite an intelligent person and as such, I like to understand things. It was great to learn exactly why the clot falling out in my case, was not a problem. The dentist just telling me it was 'normal' was not enough to reassure me. I needed him to explain it to me. I don't think patients should be berated for this. I think they have a right to know.
You really have been a great help. If I have any more extractions in the future, I will know, the blood clot, in my case, is likely to fall out and that I don't need to worry about it and why.
I am sure your explanation will help others too, if they come here looking for answers. So, a google search can be very helpful, if it leads patients to explanations such as yours!
Thank you 

Blue_Mermaid

PS I don't smoke. Never have smoked. I don't know what caused my gum disease. The hygienist said, it could be hereditary. I did used to brush my teeth incorrectly, vigorously from side to side, growing up, so that could have caused my gums to recede. I have been following the home care meticulously, the last few years but I guess the disease is too far gone to really get it under control. Why can't you get periodontal treatment from a specialist on the NHS? It seems strange that you can only get it treated if you can afford to, especially, as they now say, the inflammation can cause other health problems.

Blue_Mermaid

Pollycat said:

Blue_Mermaid said:

Hi, I had a tooth extracted on Friday. The dentist could not save it, as it was severely infected, with a large abscess at the root (I have advanced gum disease). During the night, I felt something on my tongue. On a tissue, it looked like a lump of red jelly. I suspected it was the blood clot and looked online to confirm, where I read about dry sockets. I took a picture of the blood clot on the tissue and sent it to the dentist for advice. The next day, he confirmed it was the blood clot on the tissue but he just said, it's normal and not to touch it. I didn't feel reassured, having read that the socket could now be unprotected. So, I asked my dentist for further advice, explaining that I was still concerned after reading about dry sockets. He didn't like me questioning further and sent a very curt and what I consider a rude reply, repeating that it was normal and to stop contacting him with questions, with immediate effect. He said I was not in pain (which wasn't true, I had been in severe pain that night following the extraction but painkillers had helped and I appreciate that this was just post extraction pain) and he suggested I refrain from searching on the internet for issues that I do not have, or will not have. He himself, confirmed the picture I had sent him was the blood clot, so I don't understand why he was saying I do not have any issues and will not have any (does he have a crystal ball?). I appreciate that not everything you read on the internet is true but I was looking at official sites (such as NHS sites) and when they are all stating the same things, then I believe them to be correct. So, I am left without any further advice from the dentist himself. Could a dentist here be kind enough to explain to me, whether I should be concerned that my socket is now left without the protection of a blood clot? Do I now have a dry socket? Should it be cleaned and covered by a gauze or whatever a dentist uses to protect the open socket? Or, is this only if I start to experience new or worsened pain, foul taste/smell? At present, the pain/discomfort is less than the first night, so still just post extraction discomfort. I have tried to look at the socket with a torch to reassure myself but I am unable to see it, as it is right at the back (top right of mouth) and the tooth next to it, is in the way. Thanks in advance.

I think what you are asking is maybe against MSE rules.

The sticky at the top of this board says:

Using this board - please don't give medical advice!.

Thank you for your concern.
I apologise if I broke the rules. I can't help feeling very appreciative of receiving a professional reply though. I did approach my own dentist for advice first and he did say what I was experiencing was normal. The advice I received on the forum backed that up but explained, in detail, why it was normal. 

Pollycat

Blue_Mermaid said:

Thank you for your concern.
I apologise if I broke the rules. I can't help feeling very appreciative of receiving a professional reply though. I did approach my own dentist for advice first and he did say what I was experiencing was normal. The advice I received on the forum backed that up but explained, in detail, why it was normal. 

TBH, I'm not sure you have broken the rules but sometimes posts are deleted if medical advice is sought.

I knew there were 2 posters who would be capable of replying and I'm pleased that you have the reassurance you needed.

FTR, I've not reported your post as being against MSE rules.

Blue_Mermaid

Thanks very much Pollycat