Ughthedentist,

I am going to re post some of your thread and answer you in bold type.

Thanks for posting the xrays

<<Wouldn't I be showing symptoms of infection by now if she had not properly cleaned the area? >>

NOT NECESSARILY. SOMETIMES IT'S YEARS LATER BEFORE SYMPTOMS APPEAR. SOMETIMES THERE ARE NO SYMPTOMS AT ALL BUT THE PATHOLOGY SHOWS UP ON A X-RAY.

YOUR POST OP X-RAY SHOWS THAT THE BONE IS FILLING IN ON THE LOWER LEFT SIDE WHERE YOU HAD RECENT EXTRACTIONS. YOU DO HAVE BONE LOSS ALONG THE BUCCAL RIDGE AS I HAD EXPLAINED EARLIER PERTAINING TO THE AREA OF THE SECOND MOLAR. SO WHEN THAT SITE FILLS IN COMPLETELY, THAT PORITON OF THE BONY RIDGE WILL BE LOWER. FYI... UNDER IDEAL CIRCUMSTANCES THE BONE TAKES UP TO A YEAR TO COMPLETELY FILL IN.

<<Also I am very confused with tmj and grinding/clenching. As I said I don't ever recall having any of these issues before these extractions. Has the trauma of the extractions led to tmj and the clenching.>>

THE JAW TRAUMA FROM THE EXTRACTIONS CAN CAUSE A TEMPORARY TMJ PROBLEM. HOWEVER IN YOUR CASE THE LOSS OF ALL OF YOUR POSTERIOR MOLARS ON BOTH SIDES (EXCLUDING TOOTH #32) IS PROBABLY WHAT IS CAUSING OR CONTRIBUTING TO A MUSCULAR PROBLEM WHICH IS AFFECTING THE TMJ. PEOPLE WHO HAVE NO POSTERIOR TEETH IN ONE OR BOTH ARCHES RELY ON THEIR ANTERIOR TEETH FOR CHEWING WHICH MAKES THE JAW MUSCLES WORK A LOT HARDER. BRUXISM HABITS ARE COMMON IN PEOPLE WHEN MISSING THIS MANY POSTERIOR TEETH AS THE NATURAL CURVATURE OF THE ARCHES BEGIN TO COLLAPSE CAUSING THE OCCLUSION TO BECOME ABNORMAL. THE TEETH ARE NOT HITTING IN A NATURAL PATTERN TO SUPPORT EACH OTHER SO THEY ARE TRYING TO CREATE A PLACE TO REST. THUS THE BRUXING HABIT. THIS PUTS A LOT OF STRAIN ON THE VARIOUS MUSCLES, LIGAMENTS, NERVES.... ETC., IN THE HEAD, FACE, NECK, SHOULDER, ETC.

<<I am just having the pain/discomfort on the extraction side sometimes the whole bottom jaw but rarely. I do have that other wisdom tooth on the bottom jaw it has not broken through yet. Also the top back tooth on the extraction side is a wisdom tooth.>>

THE PAIN COULD BE DUE TO A BACTERIAL ISSUE BUT IT MAY BE DUE TO THE SURGERY AND THE BITE ISSUES. THINK OF THIS EXAMPLE.... YOU HAVE SURGERY ON YOUR ARM AND IT'S AFFECTED THE MOBILITY OF THE ARM. INSTEAD OF IMMOBILIZING THE ARM YOU KEEP USING IT. IT'S GOING TO HURT AND THE PAIN IS GOING TO BECOME MORE PROFUSE.

<< Sometimes I feel fine and sometimes I just ache. My neck, ear, cheek. It seems when I turn my head to the left it irritates it more....especially the neck. Only on the extraction side really. The side of my neck and the back of my neck.>>

AS I SAID THERE COULD BE A BACTERIAL ISSUE GOING ON. IT DOES NOT APPEAR THAT WAY ON THE X-RAYS THAT YOU POSTED BUT IT COULD BE MICROSCOPIC OR IT MAY BE IN AN AREA THAT WAS NOT PICKED UP ON THESE X-RAYS. HOWEVER, THESE ARE TYPICAL COMPLAINTS OF SOMEONE WITH A MUSCULAR ISSUE RELATING TO THEIR MAL OCCLUSION.

<< I have tried some of the at home remedies for clenching and tmj. Sleeping on my back doesn't seem to make a difference. Applying wet heat doesn't either. I am taking it easy with eating and working the jaw too much.>>

IF NOTHING ELSE IS GOING ON, YOU DO HAVE AN ANATOMICAL ISSUE DUE TO THE LACK OF POSTERIOR TEETH AS THE MUSCLES, LIGAMENTS, ETC., ARE BEING OVER WORKED AND YOUR TEETH CANNOT FIND A COMFORTABLE PLACE TO REST IN.

<< I have noticed that I am clenching even during the day. I have never done this before.>>

THIS IS A NATURAL RESPONSE WHEN YOUR TEETH ARE NOT ABLE TO LINE UP WITH OPPOSING TEETH. THEY KEEP LOOKING FOR A PLACE TO REST COMFORTABLY. YOUR JAW MUSCLES KNOW THAT THEY ARE NOT AT REST SO YOU SUBCONSCIOUSLY KEEP TRYING TO MAKE IT HAPPEN.

<< I am wondering if it is trauma and if it will resolve itself once my jaw heals. I just have no way of knowing how bad the jaw is hurt. Maybe the X-rays show something?>>

THE JAW TRAUMA THAT YOU HAVE EXPERIENCED BY HAVING THE TEETH REMOVED IS EXACERBATED BY THE ALREADY EXISTING PROBLEM OF THE MISALIGNED BITE THAT YOU HAVE HAD BUT HAS NOW GOTTEN WORSE AFTER REMOVING THOSE TWO LOWER TEETH. BEFORE YOUR UPPER TEETH HAD SOMETHING TO REST AGAINST... NOW THEY HAVE NOTHING. YOUR BIT SITUATION STARTED BEFORE YOU HAD THESE TEETH REMOVED, IT HAS JUST GOTTEN WORSE.

<<I know the constant worry is not helping me here and probably causes me to clench more. I have been reminding myself throughout the day to relax. It is just hard when it is 2 months later and you're still in discomfort. I also cannot settle the fears of infection setting in.>>

GIVEN THE HISTORY THAT YOU HAVE PROVIDED HERE ALONG WITH THE X-RAYS, I TEND TO LEAN TOWARDS THE MAL OCCLUSION AND MUSCULAR PROBLEMS MORE SO THAN A BACTERIAL ONE.

THIS SEEMS LIKE A NEW PROBLEM TO YOU BECAUSE IT HAS BECOME MORE NOTICEABLE SINCE REMOVING THOSE TWO MOLARS AS THEY WERE SOMEWHAT SUPPORTING THE UPPER ARCH. HOWEVER, THIS MUSCULAR PROBLEM HAS BEEN SLOWLY HAPPENING AS YOU LOST MORE AND MORE POSTERIOR TEETH.

My suggestion would be to speak to your dentist about having a night guard made to help support your jaw when you sleep. Secondly, discuss your options of replacing the posterior teeth to help support the upper arch. It is important to do something sooner than later because this problem is not going to correct itself. You may eventually become "comfortable" as your bite settles in but you will still have a misaligned bite which will cause you to lose other teeth. The upper and lower arches need an appliance or teeth to support the anatomical balance of both the upper and lower jaws.