Help please - wisdom tooth extraction and antibiotics

[Bobandbear]

I had a wisdom tooth out 8 days ago, complex extraction with stitches. I have dry socket as with my previous wisdom tooth extractions. It was packed and cleaned on Friday. Still sore and tasting bad today, though slightly improving. It’s been packed and cleaned again. Dentist suggested antibiotics too as lymph node is slightly up. Initially prescribed Metronidazole which I’m concerned about taking after reading other people’s experiences of side effects and given it’s more of a precautionary prescription. Side effects listed on Mumsnet thread about experiences of taking it include dizziness, vomiting, anxiousness, panic, issues with eyesight and hospitalisation. Have seen that amoxicillin can also be used which I know I tolerate well has anyone else been given this for post wisdom tooth extraction in relation to dry socket (I know it doesn’t cover such a broad range of bacteria) but would it be an ok alternative given that it’s a precautionary prescription? I would take the others if I had a clear need for them but feel very apprehensive. I will discuss further with my usual dentist tomorrow. Any experiences or advice hugely appreciated. We have lots planned over the next few days and I’m keen to avoid an antibiotic that may make me feel awful but equally don’t want to make a thing worse by pushing for amoxicillin.

Anyone please …

My experience is that dentists antibiotic of choice is metronidazole BUT dentists are very restricted in what they can prescribe. I can't tolerate metronidazole and wouldn't take it unless the alternative was dire illness. Amoxicillin sounds like a good choice and it can be used for dental issues but no idea if this includes dry socket (recently did a search when family member thought they might need antibiotics for gum issue) If you can't get it through dentist, get the dentist to email you with a note saying you need a prescription and show it to a GP who can prescribe.

You have my sympathy. I've had 2 dry sockets... not wisdom teeth. Last was a complicated maxfax extraction..I followed the post op to the letter. It was just before Christmas not even an emergency dentist open,then new year!! I was given amoxicillin before the packing,it didn't help at all. I had been prescribed metronidazole previously for diverticula disease flare up. I got diarrhoea, but was really confused,so my pharmacist told me to mark it as an allergy. Sorry this isn't much help to you. No one can predict if you will get side effects. I had an emergency dentist appointment yesterday. I was really terrified, turned out to be a piece of sharp food stuck in the gum in-between the teeth!

I've had that antibiotic at least twice and had zero side effects. But you cannot drink on it.

Thank you for your replies. I did discuss briefly with the dentist and he advised that it’s the antibiotic of choice and was reluctant to discuss alternative. Interesting that neither of you can tolerate metronidazole. I struggle with health anxiety which is generally under pretty good control but reading people’s experiences of this antibiotic has really triggered me and I know I’ll massively struggle with any side effects from an anxiety point of view. Hoping that amoxicillin is a suitable alternative, I think the dentist thought I was questioning his professional judgement so was very reluctant to discuss alternatives. I should have been more upfront about the level of anxiety that I have about metronidazole.

@Ubugly thank you, that’s really good to hear. I’ll take it if there’s no real alternative.

Health anxiety here. Never had dry socket but have had pericoronitis a few times and always given metronidazole- zero issues.

Metronidazole and amoxicillin combat completely different types of bacteria .
Metronidazole works against gram negative anaerobic bacteria which are the ones that mostly cause infected sockets. Amoxicillin is far more broad spectrum and less effective for this type of infection.

All medical professionals are antibiotic guardians because the world is getting more and more resistant bacteria due to over use and inappropriate use of antibiotics. The dentist chooses the most appropriate antibiotic, if necessary, for the clinical need.

Every antibiotic , every medicine has potential side effects and the professional chooses the drug weighing up the pros and cons.

Metronidazole and amoxicillin are not the same, do not have the same action and are not interchangeable . I would trust your dentists prescribing.

@Lollygaggle thank you, this is hugely helpful. I knew one had a broader spectrum but didn’t fully appreciate the extent of the difference. I completely appreciate that all antibiotics have side effects there just seems to be quite a high incidence of really nasty ones with this one. Also struggling as it seems to be precautionary rather than to treat an active infection. It’s my fourth wisdom tooth to be removed and I’ve had dry socket every time but never antibiotics.

Dry socket is not an infection , it’s where the blood clot either fails to form or is dislodged . Antibiotics will do no good as it is not an infection.

As your lymph node is up and there is a bad taste you have signs of infection therefore dentist has now prescribed antibiotics.

@Lollygaggle thank you, the taste is the same one I’ve had since two days after extraction and triggered the visit where the dry socket was diagnosed. I’ve had a bad taste with all my wisdom tooth extractions and this one is beginning to lessen but hasn’t yet gone. I’m going to have to take the antibiotics aren’t I 😭

Im sure we know that a dry socket is not an infection. I don't bleed at all after extractions. The first emergency dentist I actually saw after the Christmas/new year break "thought the pain was caused by an infection". Hence the antibiotics. Some weeks later, I managed to see the surgeon,who cleaned and packed the socket. My youngest son in his 40s, 2 years ago he had severe toothache, kept going back to his NHS dentist (nothing against them I had had a lovely young lady 8 years) he said the smell and taste was like faeces. He couldn't eat or drink 6 months, she just kept prescribing antibiotics different ones. I paid for him to see a private dentist and have an extraction. He was not far off suicidal with the pain.

Just a quick update in case it’s helpful for anyone reading this in the future. Chatted things over with the dentist this morning and was upfront about my concerns about Metronidazole combined with my health anxiety. Dentist advised that for any patients unable to take Metronidazole they’d prescribe amoxicillin so he was happy to try this first. He basically wants to reduce the a mount of bacteria in the socket to reduce the risk of an infection taking hold. He’s asked that I book a review for tomorrow so we can check it’s heading in the right direction. Checked which lymph node he felt was up and it’s one that seemed to be up very shortly after the extraction, so I think it’s actually improving rather than getting worse and the taste is the one I’ve always had with dry socket, so I’m praying it all settles and starts to heal soon.