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)

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

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

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!

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.

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