Hi muffie,

<<I had increased facial pain yesterday and noticed more clicking when I talk. The pain developed into a full headache.>>

CLICKING? DO YOU MEAN IN THE JAW OR THE JAW JOINT?

<<I have had tooth 2 pulled a while ago and it appears wisdom tooth has shifted over diagonally (crooked). Now with tooth 3 being removed, could the wisdom tooth be irritated and pressing on a nerve which is causing me discomfort? >>

TEETH CAN SHIFT WHEN ADJACENT TEETH ARE EXTRACTED. THE SHIFTING OF A TOOTH OR TEETH CAN ALTER THE ALIGNMENT OF THE JAW JOINT AND THE BITE. YES, SHIFTING OF A WISDOM TOOTH, DEPENDING ON WHERE IT IS LOCATED IN PROXIMITY TO THE NERVE BUNDLES IN THE JAW BONE, CAN CAUSE IRRITATION TO CERTAIN NERVES. ESPECIALLY IF THAT WISDOM TOOTH IS GETTING USED TOO HARSHLY WHEN YOU CHEW AS IT COULD BE IF IT HAS SHIFTED OUT OF IT'S ORIGINAL PLACE.

<<Could this be symptoms of TMD? If so, who is the best to treat this? The orofacial pain specialist I saw suggested TMD but all he did was send me to PT and they worked on my back and shoulder for neck pain but didn't address facial pain.>>

IT COULD BE TMD OR TMJ, SAME THING. DID YOU HAVE TMD PROBLEMS BEFORE YOU HAD THE TEETH REMOVED? IF NOT, THEN THE SHIFTING OF YOUR BITE COULD BE CAUSING THE CURRENT JOINT PROBLEM. P/T WILL HELP ALIGN THE BACK AND SHOULDER IF IT IS BEING THROWN OFF BY THE JAW PROBLEM. WHICH BY THE WAY, IS PRETTY COMMON. HOWEVER, P/T WILL NOT BE A PERMANENT FIX UNLESS THE MISALIGNED BITE IS CORRECTED.

<<Lastly if I want to get a partial denture for tooth 3 replacement will the wisdom tooth need to be pulled, since it is crooked. and I get a partial denture. I have heard negative stories about wisdom teeth being pulled, particularly in the 40+ age group.>>

IT IS NOT IDEAL TO USE A CROOKED WISDOM TOOTH TO ANCHOR A PARTIAL DENTURE OF PERMANENT BRIDGE. HOWEVER, IN ORDER TO HAVE A PARTIAL DENTURE, IT IS BEST TO HAVE A BACK TOOTH TO ANCHOR THE PARTIAL ONTO SO IT IS STABLE WHEN YOU CHEW. YOUR DENTIST WILL HAVE TO EVALUATE YOUR BITE AND GIVE YOU OPTIONS OF WHAT IS BEST SUITED FOR YOUR PARTICULAR SITUATION.

<<I will ask the oral surgeon about the x-ray you suggested. Would he also be able to evaluate the health of the wisdom tooth, not as it relates to decay but to position, and TMD?>>

OKAY, GOOD IDEA. YES, HE CAN EVALUATE THE HEALTH OF THE WISDOM TOOTH AND ALSO THE JOINT PROBLEM.