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12-21-2009, 10:42 PM | #1 | ||
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Junior Member
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Hello. I'm not sure what to do. I'm now 4 months+ after a complicated extraction and still having significant jaw pain. I'm worried that there may be an infection in the jaw bone? How would I know, and what should I do?
That's the brief question, but for those who may be interested, the background is a long story: I was referred to Maxillo Facial clinic rather than my own dentist doing the surgery. I had a partially exposed, impacted wisdom tooth (lower left). To extract the tooth, the gum and cheek had to be cut, the tooth had to be dissected and part of the jaw bone also removed. My jaw was clamped open and my tongue clamped to the side. (All very nice, eh? ) When the anaesthetic wore off, I couldn't believe the pain. Also, it kept bleeding, despite my gum and cheek being stitched. I had to call my G.P. for stronger painkillers. Over the next few days, I had to contact my G.P. several times for increasingly stronger painkillers (codeine and amytriptaline). Nothing he gave me relieved the pain, just took the edge off it. I never felt pain like it - child birth was easy by comparison, and that's saying something! By day 5, I couldn't stand it any longer and called out of hours surgery (it was the weekend). I ended up at A&E where I had to wait over 3 hours to be seen by junior maxillo facial doctor, who poked me (agony) and told me it all looked fine, although it was what they would consider "the extreme end of normal" There was no sign of infection and it would just take time to heal. So home I went......... The pain got worse. This was now my 5th sleepless night in agony. I went back to the hospital the next day and insisted on seeing the surgeon who had performed the extraction. After some persuasion, the surgeon agreed to clean out the wound and see what was going on, but quite sure that there was nothing wrong....... It turned out I had a nasty infection AND dry socket!!!! I had it packed, and I had to go back several times to have it repacked. Eventually, I was seen again by the same junior who had dismissed me (wrongly) from A&E, and once again he told me that it all looked fine and I wouldn't need to come back..... Well, a week later, I ended up going to my own dentist because the packing that had been left in by the junior doctor had now started to go sceptic. I had it packed another twice by my own dentist. Meanwhile, I was feeling particularly unwell and exhausted (perhaps not surprising). I was not fit to go back to work and my doctor diagnosed a relapse of M.E./chronic fatigue syndrome. (Although I've had M.E. for a long time, I had been keeping quite well before the dental surgery.) It is now over four months since the dental surgery. I am still off my work ill and the pain in my jaw seems to be getting worse instead of better. The gum has not entirely healed over, which means I am still getting sensitivity in the tooth in front of the extraction site, and the "hole" that is left is big enough to catch small particles of food, but small enough that it is very awkward to try to clean out. I am now concerned that I may have an infection in the jawbone itself. I feel as if the medical professionals involved in my case just think I'm a pest, but I am scared NOT to have this investigated, because if there IS something wrong and it's not dealt with, it will just be worse in the long run. The pain I have now is nothing compared to what it was in the early days, but it does seem to have got worse again over the last few weeks. It is more of an ache in the jaw, sorer if I press it, and it sometimes feels like it's itchy inside the bone. It's just grumbling away all the time. To make matters worse, I've had a headache EVERY DAY since the surgery. I'm really, really getting fed up with it and just want to be well again. If I'd known what was ahead of me, I'd have kept the "slightly problematic" impacted wisdom tooth!!! Anyway, to those of you who made it to the end of my story, thank you for reading I hope someone can offer me some advice as to what to do next, if indeed anything needs doing. Hopefully a bit of reassurance is all I need. Many thanks. Take care of yourself. Jamsine x p.s. I did ask my doctor to phone the maxillo facial surgeon to ask them to see me to x-ray and scan the jaw, but he seems to have "forgotten" to do it and is off on holiday until the new year. Would it be improper for me to phone the hosptial direct myself? (location: Scotland, UK) |
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12-22-2009, 08:07 AM | #2 | ||
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Junior Member
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Hello again. Short update...... My G.P. did follow up with maxillofacial, but the message that came back from the surgeon's secretary was that I didn't need to be seen, and I will have to wait until February for a routine appointment. I am quite frustrated by this - How do they KNOW that I don't need to be seen from a conversation between 2 secretaries? How do they know I don't need to be seen, unless they see me and examine me, or scan me or whatever needs to be done?
Please can someone offer me some advice. J x |
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12-22-2009, 11:19 PM | #3 | |||
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Grand Magnate
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Hi Jasmine,
After reading both of your posts...... it sounds like you "may" have a jaw infection that is referred to as NICO.... Neuralgia Inducing Cavitational Osteonecrosis. This condition can be brought on by the extraction of a wisdom tooth. It is worsened by certain health issues, medications and/or lifestyle habits. It is a progressive condition and needs proper treatment by a dentist who is experienced in treating it. Unfortunately, many conventional dentists including some oral surgeons do not recognize this condition until it becomes severe. This is not something to wait and see what happens as it can be very progressive and very difficult to treat successfully the longer it goes on. NICO link..... http://www.drshankland.com/osteocavitation_lesions.html One sure way to properly diagnose this is to have a dental CT scan done. I would not go to a dentist who has never treated this before. An organization that may be helpful to you is called IAOMT... International Academy of Oral Medicine & Toxicology. Here is there website: http://www.iaomt.org/ Here is the listing of a dentist in the UK.....http://www.moonfleet.co.uk/ Again, I would not wait to get this properly diagnosed. Your pain is real, your problem is real and it needs to be addressed by someone who is familiar with this condition. Please let me know how you're doing! Bryanna Quote:
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12-23-2009, 04:56 AM | #4 | ||
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Junior Member
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Hello and thank you for your reply.
I followed the links. It looks like there is no specialist anywhere near me. It also sounds like I might have trouble convincing anyone that this is worth investigating, until it is too late. Fortunately, my family doctor is very caring, so hopefully when I get to speak with him, he will be able to do something to help move things along. The trouble is that if the "specialists" are unfamiliar with the condition, or don't know how to correctly diagnose it, then what hope is there? My hope is that I do not have this condition, since it sounds pretty gruesome, but obviously the sooner it is diagnosed (or ruled out) the better. Thanks again for your input. I'm just playing a waiting game at the moment. I will post again once I have some news. Merry Christmas! |
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12-24-2009, 07:03 AM | #5 | ||
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Junior Member
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I have received a referral appointment to go back to maxillofacial department for mid-February. So, as far as my family doctor goes, he's done all he can to speed things along. I guess I'll just have to wait until then, and in the meantime hope that my symptoms improve.
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12-29-2009, 08:09 PM | #6 | |||
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Grand Magnate
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Hi Jasmine,
Happy New Year! I too hope your symptoms improve but it's a good idea to follow through with the dental appointment even if they do. Please keep us posted on how you're doing Bryanna Quote:
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"Thanks for this!" says: | Jasmine33 (01-31-2010) |
01-31-2010, 08:03 AM | #7 | ||
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Junior Member
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Hello all. Here is an update on my situation:
I managed to get an earlier appointment to go back to the hospital. It was the senior consultant I saw this time, so I guess that I have to trust that he knows what he is doing and what he is looking for. Although, he said that in 30years, he had not come across anyone still complaining of this kind of pain after 5months following surgery. (I find that quite surprising! - Surely I am not alone in this???) Anyway, he took a look in my mouth and said the gum has completely healed (an opinion shared by my own dentist). I however, am frustrated by the fact that there seems to be a small pocket left which traps food (this was the whole reason for getting the tooth out in the first place, because the gum trapped food!) Apparently, this "pocket" is perfectly normal and no cause for concern. The consultant sent me for an x-ray to see what was going on in the jaw, but said he didn't expect it to show anything abnormal...... The x-ray didn't show anything abnormal and he said it looked exactly as he would expect it to look after this length of time. "Why the pain then?", I asked. I was told that as there was nothing to see, there was nothing to treat and basically I should just try and get back to my normal life as soon as possible. So, basically, it's tough luck, just get on with it then? It has however, been discovered that I have TMJdisorder which is so far progressed that there isn't very much can be done about it. I have to wait for an appointment to go back and get fitted for a soft splint to see if that helps. I have been aware of a problem with my jaw for 20 years (clicking and popping and sticking at times) but no doctor or dentist I spoke to about it seemed to think there was cause for concern, and now I'm told it's too far gone to do anything about it??????? So, the situation now is that I guess despite the lack of CT Scan, I have to trust that the senior consultant knows his stuff and there is no infection in the jaw or anything else nasty going on (an opinion shared by my own denstist). I am fairly convinced, although there is still a small element of doubt in my mind. I concede, however, that although I am still in pain, the pain has not got any worse over the past few weeks, which if there was a progressive infection, I guess it would. The pain must therefore just be down to tender tendons and joint pain from TMJ disorder, made worse by having my jaw clamped open for surgery. I suppose I will just have to learn to live with it. This, on top of the trouble I have with M.E./C.F.S. is not a joyful prospect, and ever so frustrating. I just have to hope that when I [I]evenually[I] get fitted with a jaw splint, that over time my symptoms will improve. I am now going to read up on TMJ disorder and see if there's anything I can do to help myself. To anyone reading this in a similar situation, good luck to you. I hope your outcome is better than mine. Be assured by the fact that my consultant said he hadn't come across this in 30 years of practice - so that must mean that for the majority of people have no further problems. All the best! Any further advice or info would still be appreciated. Many thanks. - Jasmine |
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02-01-2010, 08:51 PM | #8 | |||
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Grand Magnate
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Hi Jasmine,
I may be wrong, but your description of the events that have taken place along with your current pain sounds to me like there is a lingering problem in your lower jawbone. Yes, the pain could be aggravated by your TMJ disorder...... but that is a separate issue from any lack of healing that may be going on from the infection that you had brewing in that surgical socket after the extraction. I'm not sure why your OS told you he has never come across a patient who has had lingering pain from an extraction, especially a wisdom tooth extraction. The only thing I can say is perhaps he does not see patients for long term follow up care? I'm in dentistry for over 30 years also and have been the surgical assist on many, many hundreds of patients. I have also cared for these patients post operatively and without any question, I have seen many hundreds of patients with post op complications months to years after they've had an extraction. So this is definitely not a rare occurance as you were led to believe. At least not in dental offices that diagnostically investigate the pain that their patients come in complaining about. I guess health care is very different in the UK than it is in the USA and I am not familiar with it at all. However, if it were me, I would make every effort to find someone who is willing to investigate your concerns further. I found this info in a quick google search. Perhaps it is somewhat helpful or can lead you to something else that is?? You can call the IAOMT and ask for a dentist in your area. They may be able to help you. The dentists listed below are from the internet..... I have no idea about their reputation. the International Academy of Oral Medicine and Toxicology, Huddersfield, on (01484) 514451 Wright, Stewart BDS George Square Dental Centre, 6 George Square Greenock, Renfrewshire, International PA15 1QP Country: Scotland Phone: 044-1475631010 Fax: - Website: www.stewartjwright.co.uk White, Andrew DDS 630 High Road, Finchley, London, International NI2 ONU Country: United Kingdom Phone: 208-492-0020 Fax: 208-445-3537 Website: Please know that you are not alone with this situation at all. It is not your imagination and I really believe it should be evaluated more thoroughly. I will keep looking for you....... please keep in touch and let me know what you come up with! Bryanna Quote:
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03-11-2010, 05:28 PM | #9 | ||
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Junior Member
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Thank you Bryanna.
My feelings were the same as yours in that I felt it was a separate pain issue from that of TMJ problems. However, as time is going on, it is not getting any worse. In fact, it is slightly improved and I now only occasionally need to take pain killers because of it. I guess if the bone or socket were infected I would be a lot worse. I have been to have impressions taken of my teeth for a splint, but the waiting lists are so long it is mid-May before I will get it. I need to give that a shot and see what difference that makes to the discomfort in the jaw. In the meantime, I am mostly reassured that the socket and jaw have healed, or are healing normally. I won't be entirely convinced until I have no pain left, but I guess that is perhaps unrealistic considering the amount of jaw bone that was taken away. e.g. I fell and hurt my leg over a year ago and was told I had "bruised the bone" and it still hurts sometimes, so maybe it's just the same kind of thing - like a scar, I suppose - it never completely goes away. I just wish I had known that before I got the wisdom tooth taken out, or I might not have bothered! Thanks for your help and support. I'll let you know if anything changes. Take care. Jasmine x Quote:
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