January 10-March 3, 2020
Outside of the discovery of infection (periapical granuloma), the actual extraction of the crowned tooth went smoothly. However, some strange things occurred during the post-op recovery time. The first thing I noticed was that the sutures were all tangled up, like a cat’s cradle, as if the surgeon didn’t know how to sew. This caused considerable annoyance as they dangled out in loops and tangles until they finally dissolved. Another strange thing was that after the swelling went down, I noticed a hard lump on the gum outside of of the extraction site, as if something had been stuck inside or under my gum. This could easily be felt by touching the area with a finger tip and was very obvious to me. When I went to my follow up appointment with Dr Patel on March 3, 2020, the lump was still there. Dr Patel seemed unconcerned. What he said to me is that sometimes, during an extraction, a bit of bone can chip off, but that it usually “dissolves.” I remember this specifically because I thought it a bit odd (but not impossible) that bone would dissolve. He suggested that I wait to see if that happened but offered to do additional surgery. I opted to wait, and indeed the lump seemed to vanish soon after (within a couple of weeks).
On the notes associated with this visit, Dr Patel describes the situation as follows:
“There is a small buccal bone spur site 14. No (sinus) fistula… I recommended alveoloplasty of the bone spur versus observation as this may exfoliate with time. She elected to observe this for 2 to 3 weeks. If this persists she is to call me for alveoloplasty under local anesthesia.”
The sentence “I recommended alveoloplasty of the bone spur versus observation as this may exfoliate with time” is difficult to understand. It sounds like Dr. Patel is saying he recommended a surgical procedure called alveoloplasty, when my recollection is he recommended that I wait and see if it “dissolves.” Also, he told me he thought it was a bone “chip” while in the notes it’s described as a “spur.” I would think that this would be a significant difference, since a chip is something that flakes off of something else, while a spur is a type of growth from the bone. In fact, if he had called it a “spur” at the time, and told me what a spur was I would have pushed back, because clearly what I was detecting was something that was a direct result of the extraction process as it appeared as soon as the swelling went down, and it moved with the skin. It seemed conceivable that it was some kind of chip, but not a spur.
Later, after doing further research, even the idea that object had been a chip from a bone (or from the tooth itself) – stopped making sense to me, considering the type of extraction was, how smoothly it went, how intact the tooth was after extraction, how the issue resolved – the hard object was large enough that I should have noticed it exfoliate. To me, Dr Patel had used the word “dissolve” – not “exfoliate.”
The hard chip-like object was still present on March 3, after everything had healed. After that, it seemed to vanish, probably over a few days.
