Hello Bryanna and all,

I was googling the troubles I've been having since my Wisdoom tooth was extracted; and I found this site. I read several of Bryanna's posts and I'm hoping she or others can help.

Here are my details:
-29 years old
-In good health. Recent physicals good.
-Occasional drinker but not since the extraction. No tobacco products but occasional marijuana.
-No medication

Exactly 2 weeks ago I had 1 wisdom tooth removed on the lower left side. Prior to the extraction it was painless and not abscessed or anything. My dentist wanted it removed he said because "it is impacted and could be trouble down the road." So after an X-ray or two I went into an Oral Surgeon to have it done.


The extraction was difficult, I was awake with local novocaine to numb it. It took 45 minutes to remove the one tooth. With much sawing and cracking to the tooth to bits. Finally they did dissolvable stitches and sent me home.

I was put on Omoxicillin and Vicodin and told come back in a week. The bleeding took 12 hours to cease.

I went back a week later. More X-rays, still some pain. He found and removed a bone chip but said the clot wasn't big enough to fill the socket. He said he was glad to see it was not dry socketed or infected, but wanted to pack it with this clove packing to help my pain and fill the exposed socket so he packed it for 4 days. I went back again and he said it "looked good come back later this month" and he gave me more Vicodin which makes me woozy.

So now here I am 2 weeks post extraction. I don't have pain like before... However the teeth next to extraction site are tender if I chew on that side, and I have to keep flushing out my socket with some tenderness still in the gums. Also the packing he had in made the socket LARGER which I thought was weird.

Furthermore the tooth directly next to the empty socket is SENSITIVE to hot and especially cold, because its base is so exposed deep in be socket. Also the socket doesn't seem to be closing much. I feel another sharp piece I am pretty sure is another bone chip. It feels like the other bone chip did.

Is all of this normal? I feel like what was a painless tooth has turned into a nightmare. I wish I never had it removed and Im just so upset.

I would appreciate any advice.

-Kev

Hi Kev,

Your situation is fairly typical. Lower impacted wisdom teeth can be a bit of a PITA to remove as they sometimes get locked into the bone. It is also typical for small bony fragments to come out as the site is healing. These are actually pieces of the jaw bone that splintered during the surgery. These usually pose no harm and either come out on their own or the surgeon removes them if they cause inflammation, infection or pain.

What are you irrigating the socket with? You should only be using warm salt water and use only gentle pressure with the irrigation syringe. No mouthwash what so ever as the chemicals and alcohol in it can prevent the site from closing all the way. And never use force with the syringe.

I know you think why did I do this in the first place since it wasn't bothering you before you had it done. Well if this tooth was positioned in a way that it was (or could have been) damaging to the second molar, then it was wise to remove it. It is typical for the other teeth in that quadrant to feel sore to chewing and for the second molar to be sensitive until the area heals closed. There was quite a bit of bone manipulation during the removal of that wisdom tooth and the nerves and ligaments in that quadrant are upset about all of that. So they will calm down. The sensitivity in the second molar may be due in part to gum recession. If that doesn't subside completely then your dentist may be able to cover any exposed root surfaces after the extraction site has healed.

Hope this is helpful to you. If you feel the site needs to be rechecked by the surgeon for any reason, don't hesitate to do so.

Also... refrain from smoking (anything) or drinking alcohol until the site closes over completely

Bryanna

Hi Bryanna,

Thanks so much for the reply, I think its neat you help out so many folks here.

I have been irrigating it with warm salt water using a syringe they gave me. I normally use alcohol free mouthwash, but since the extraction I have been diluting it 50/50. I will stop however and just do the warm salt water gargles and syringe going forward after brushing. (Currently using sensodine)

Yes the base of the tooth next to the extraction site is exposed and the Surgeon says this is the cause for sudden extreme sensitivity. He said tissue should grow to cover it, but I don't see any tissue growing around the base of that tooth and it doesn't appear to have progressed or desensitized. He said he might have to do a tissue graft to cover it if tissue doesn't grow over the base.

I'm worried how little my tissue growth has progressed.

He also said there is normally a little nub of bone between teeth and gum tissue between teeth, but since my impacted wisdom tooth was literally sideways there was not tissue or bone between the wisdom tooth and the now exposed molar. He said bone should grow next to the newly exposed tooth and tissue should cover it. I sure hope so!! It's so sensitive to cold especially.. Even breathing through my mouth on a cold day causes the sensitivity to flare... So as long as Im not eating or breathing I'm OK

Do you know how long the neighboring teeth on that side will hurt to chew with? (I've been mostly chewing on the other side)

Hi Kev,

Thanks for your warm reply to me. Very appreciated

The angulation of the wisdom tooth had actually deteriorated the bone that normally is found in between the teeth. New bone and tissue will form there, but it may not be adequate. It is a wait and see situation. The sensitivity should lesson but it may not go away completely without some intervention. Again, wait and see. Using sensodyne toothpaste or prevident fluoride toothpaste (rx from your dentist) on that area may be helpful in reducing the sensitivity.

As for the length of time before that quadrant calms down... every one is different. It heals continuously so that is a good thing, right?! It is bes to avoid eating on that side so as to give those teeth a rest. Soft foods however, are okay to eat on that side. Whatever you feel you can tolerate.

Hope this was helpful to you. Check back with us soon...

Bryanna

Thanks again,

I'll be sure to come back an update on how things turn out.

I noticed this morning the sharp bone chip is gone, I suppose it worked its way out in my sleep. So that's good!

I still can't believe how sensitive my molar is though! Oddly enough when food debris collects in the socket while eating the sensitivity goes away. I guess this is because the food debris acts as a barrier to cold liquids stopping cold from touching the exposed root. Of course after each meal I flush out the socket with warm salt water to keep it clean... so the sensitive pain returns.

I sure hope my bone and tissue grows quickly to provide a natural barrier for my now exposed tooth root.... Because Ouch!

Update: (and a question)

Hey Bryanna!

I went to my dentist yesterday for my sheduled 6 month cleaning which came up by coincidence. (This was my regular dentist, not the Oral Surgeon who took out the wisdom tooth 3 weeks ago. I am scheduled for a follow up with the Surgeon in 1 more week.)

After the cleaning was done by his assisitant he came in to look at things. He said he was surprised at how much of the root was exposed below the "Crown" and "Neck" of this molar next to the socket. He said this exposure was the reason for the sudden sensitivity pain in that molar. I asked him if he thought normal bone or tissue would eventually grow to cover this newly exposed part of the root and he said "no, I dont think so." The socket is still open and I am keeping it clean, but the way the tissue is closing it doesnt appear to be growing towards the exposed root this molar. It looks more like to socket is collasping in on itself and slowly closing.

This is a bummer. I think this means once the socket fully closes my root will still be left exposed on this molar next to the extraction site. The sensitivity hasnt gotten any better either, infact I feel its gotten worse.

When I see the Oral Surgeon next week, Im going to ask about a tissue graft to cover the root. He had mentioned something about it before, and I'm worried it might be the only way to correct this sensitivity. But if thats the way to fix it than I want it done, the sooner all of this is over the better. Also I'm not too keen on my root being exposed forever if I do not get a tissue graft. That cant be good for the long term health of the tooth.

Also, I wanted to ask...... is it normal to still be experience tender pain when chewing with that tooth after 3 weeks? This "tender pain" is seperate from the sensitivity pain to hot/cold but is affecting the same molar. This pain only occurs when pressure is applied ontop of that tooth while chewing.

There is no pain when my mouth is at rest.

The sensitivity pain is an 8-of-10 when hot/cold touches that root. And the tender pain is a 3-of-10 when chewing. All of my other teeth, gums, and tongue feel fine. So it's just the one tooth that still hurts me.

Thanks in advance for any input/advice, gosh I just wish this was over

-Kevin

Hi Kevin,

Yea, like I said the wisdom tooth was up against the second molar which either prevented bone growth in that area or the bone deteriorated. The new tissue looks like it is collapsing because the bone level is very low there. When you see the oral surgeon ask if he is going to put in a bone graft as well as harvested tissue. Sometimes they do both.

In cases like yours, it is very normal for that second molar to be sensitive/tender to chewing. The tooth is not being supported properly in the bone which hopefully will get better on it's own or after you have the graft done. Does that tooth have a large filling or crown?

Bryanna

No, that tooth has not had work. Looks pretty good too if it was tender and sensitive!

He did mention grafting, I think he even might have said bone in addition to tissue. But I'm not sure, I guess I'll find out next week.

Whose bone are talking about? Lol

Does he transfer my bone and tissue? Where does he take it from?

Hi Kevin,

Well it's not my bone

A synthetic calcium material can be used or sterilized bone granules from a cadaver source. You could use your own bone but that is not always recommended. The tissue would be taken from someplace in your mouth... perhaps your palate. The surgeon will explain all of that to you in detail.

Please let us know what he says....

Bryanna

Hey Bryanna,

I hope you're doing well.

I just got back from the Oral Surgeon. I explained how I was still having sensitivty pain to hot/cold. And also how when I chew with that tooth it hurts when the pressure of chewing is applied to the tooth. He said he understood the 2 distinct types of pain I was still having. He asked if the pain when chewing was sharp or dull/achy and what food set it off. I said it didnt seem sharp more achy and chewing softer foods is OK, but crunchy things or steak mean more firm pressure is applied and thats when I feel the chewing pain. And obviously anything cold sets off the sensitivity pain.

It has been exactly 1 month since the original wisdom extraction.

He patiently listened to my symptoms, and went over my Xrays again and examined my mouth again. He tapped my teeth, used his mirrors, and had me bite this "carbon copy" paper to check where my teeth meet. He kept patting me on the shoulder and genuinely seems to feel bad about the trouble Im having.

His diagnosis was that this tooth had the root and "pulp" inside the tooth traumtized during the extraction. And this was causing the pain when chewing. He said the sensitivity was due to the small bit of exposed root where the wisdom tooth and tissue had been.

I asked him if he thought this tooth might have been fractured since it was next to the wisdom tooth that was extracted, but he said no, he said he did not see any fractures on the X-ray or during examination. He said other than the pulp trauma and exposed root the tooth seemed healthy.

He said there are 2 types of pulp trauma. One type heals and the other type is permanent and would require a root canal. He said he thinks the pulp in my tooth will settle down over the next month and that he didnt think any permanent damage was done to this tooth. (Im hope he's right!!!)

Now he is sending me back to my regular dentist to have 2 things done: The first is a liquid gel will be applied to the exposed root to "desensitize" it untill tissue can naturally grow to cover it. The other thing is to have this tooth filed down ever so slightly to releive the pain from pressure when chewing. He said after having these 2 things done he wants me to come back in 1 month to see him.

When I go back to the oral surgeon in 1 month he is hoping the pain when chewing will have subsided, and he is hoping enough new tissue will have grown around the exposed root to defend it from hot/cold naturally. If not he said he will be doing a bone PLUS tissue graft, but usually he only has to do that with people in their 50's and older. Since I'm 29 he thinks enough tissue will regenerate and he will only do the graft if all else has failed...

-Have you heard of the 2 types of pulp trauma he talked about? Where one type heals and another is permanent?
-Is it possible if this tooth was fractured below the gum line he could miss it in X-rays?
-Is there any other advice or questions I should be sure to ask next time I see him?

Thanks again for all your help. Having this discussion with you has made me feel more informed before going to see him and a little less frustrated with the situation. Take care!

-Kev