A couple of months ago I posted some questions about a dry socket/pain that developed after having 4 teeth pulled at once from various locations in my mouth. You were able to help me then so perhaps you can help with my current questions.

I KNOW I need a lot of work done on my mouth because for many reasons (some good and some not so good) my dental health has been neglected for many many years. I cannot have root canals so that's why those four teeth were pulled a few months ago. After I went in for my cleaning in February and to follow up after having those teeth pulled (with a different dentist because things didn't go so great with the extractions and care after the fact) we came up with a plan for crowns for the front teeth (there were so many cavities and various issues that crowns were only slightly more expensive than getting all the cavities filled). I felt good about the plan but wanted to wait a few months so that I could 1) let my mouth recover from the dry socket and various complications and 2) so I could save up some money and not have to finance the expensive dental work. The plan was to wait until May to get the work done.

Of course...my teeth had other plans. In early March one of my front teeth just broke off at the gum line. So I headed back to the dentist to figure out how this would affect the plans and what needed to be done to deal with this now very unsightly broken tooth at the front of my mouth. So we sat down and came up with a new plan to remove the rest of the broken tooth (not enough left to put a crown on it). We also decided to finally pull this horrible eye tooth that was WAY out of alignment with everything else up towards the top of my gums (not even down by the rest of my teeth at all). Then we would put in a bridge to span those front teeth. The dentist acknowledged that this is not the best long term solution but short term it would deal with the immediate issues of appearance and pain as well as give them an idea of the condition of the other front teeth (which he was worried looked like they might break off like this other one just had...especially the one that was right next to it). The dentist put in writing that he would credit 2/3 of the cost of this work towards future crowns or implants in the future whenever I decide to invest in a better long term solution to the problem.

Okay...so I went ahead and had this work done Tuesday morning. Got there at 6am and left a little after noon (this was done under sedation...that's why such a long appointment). During this appointment they extracted the two teeth and placed a temporary bridge in my mouth which spans a total of 7 teeth. Yesterday (Wednesday) morning I went back in and they checked the bite and did some additional drilling where my bottom teeth were hitting the bridge and making it difficult to close my mouth all the way. I slept most of Tuesday after I got home so Wednesday morning was really the only time I had to really try and adjust to this new feeling and try to explain at the dentist's office how the new bridge felt. Never having had this done before I really didn't/don't know what is normal and what is not. Some of my questions and concerns were addressed at the appointment and some not and some are things that I have become concerned/curious about since leaving the dentist yesterday. So I was wondering if you guys could help me out with some of my questions about what it normal and what is not and if there is anything I should follow up with the dentist on sooner than my next appointment (in three weeks). So here goes:

1. The bridge feels heavy. This honestly feels better today than yesterday and I am wondering if maybe it just feels that way because the gums are so sensitive from all the work done...or if it's something I should be concerned about. This is just the temporary one...so they told me at the dentist's office that it won't feel as natural as the permanent one once they put that in and that I may be feeling awkward because they HAVE changed my bite significantly with the bridge. Makes sense I guess...just curious if that "heavy" feeling is normal...like something is pulling down on my gums?

2. On either side of the bridge it feels like the teeth are hitting the outside of my mouth. That doesn't sound right...it's the INSIDE of my mouth but on the outer part just above where my upper lip is. Do you think this is just from swelling and will go away in a few days? I have a VERY tiny mouth so I guess I'm just worried that the bridge may be a little large for my small mouth. Probably just worried about nothing but no one really answered this question at my dentist's office.

3. They did a bunch of drilling yesterday while I was there to adjust the bridge where my lower teeth were hitting it. Since then it feels like the entire bridges has shifted there the top of the bridge on the back side has moved up into the contour of the roof of my mouth. At least...that's what it feels like when my tongue runs along it and there is increased pain in that area. Plus, when I tried to clean in there like they showed me with floss in between the teeth at the top by the gums...there's on place where the floss and pick won't go through and it did yesterday at the dentist's office. So would it really shift like that or are the gums at the top of the bridge/roof of my mouth just hard and raw and sore from all the work that was done? I tried to look with a mirror but I just can't see anything well at all. I think I'm just paranoid...but would also like to point out that while it felt better after they did the drilling with my lower teeth barely touching the bridge after they were done...it's now MORE comfortable and the lower teeth don't touch at all. So it's not necessarily a bad thing because on the one hand it's more comfortable bite wise and on the other I'm having pain in the gums back there at the rood of my mouth and top of the bridge.

4. Where the eye tooth was extracted...it is black all around the top of the bridge. There's clearly a big hole there but when I floss/use the pick they gave me between that tooth and the teeth next to it, it's all black and oozy. No pain though or bad taste...just black and oozy. There was a LOT of decay in that tooth because of where it was and it had many cavities that were filled over 10 years ago. Does this sound normal and is there anything I should do to take care of it and clean it besides what I am already doing (brushing, flossing, mouth rinse)? It's odd because unlike when I had the four teeth extracted a couple months ago, these teeth have something placed over them so the wounds are not open in the same way the others were and I can't flush them out in like I could the others. The tooth that was broken and that they pulled the rest of looks fine and you cannot see any difference in the gums over that tooth than the rest...just where that eye tooth was which was in really bad shape. If the back pus continues to seep out...should I go back to the dentist. They had to see it yesterday when I was there and they didn't say anything about it or about caring for it differently.

5. Obviously I have soreness and tenderness in my gums and face after having all this work done. At what point will it be normal for this to die down...a week? Two weeks? Just curious more than anything else so I can know if I should be worrying as time goes on. I cannot use ice packs so I think I just have to deal with the puffiness and swelling without much to help calm it down.

6. When biting into food there is a definite pressure. I am fairly certain this is normal given the way a bridge works with it being over several teeth and all. Does it ever go away or do you just get used to it? Is it less once the permanent bridge is put in vs the temporary I have in now.

7. I talk with a slight lisp now with the bridge in. I assume I just have to get used to the feel of it and then that will go away. Is that normal or should I be worried that maybe it's not the right fit for me.

Overall I am very happy with the appearance of the bridge and at this point I don't have any serious concerns. But because I am used to dealing with pretty high pain levels I do worry that I might ignore signs of more serious issues because I can "deal" with the pain and soreness. I've been taking Tylenol and Advil for the pain and have needed to take them every 4 hours to keep the soreness at a manageable level. I also want to make sure that if any of these things I am experiencing are signs that the bridge needs adjustment that I am not waiting the full three weeks before telling the dentist and then having to wait even longer for the permanent bridge. I know they will tinker with the temporaries until we have it right and the gums are healed and where they should be before we get the permanent ones in...I just would rather not prolong that process unknowingly by not bringing something to the attention of my dentist. I also don't want to be a paranoid bother to my dentist if all of this is normal and I am worrying unnecessarily about things that are perfectly normal.

Okay...that was really long and I apologize. Just trying to get it all out and try to be as clear as possible (I know some of my descriptions may or may not make sense...hard to describe certain things).

Thanks in advance for any help in answering my questions or easing my concerns. All advice is very much appreciated and was a big help a few months back.

Hi Catra,

I will post your questions and answer in bold letters.

<<1. The bridge feels heavy. This honestly feels better today than yesterday and I am wondering if maybe it just feels that way because the gums are so sensitive from all the work done...or if it's something I should be concerned about. This is just the temporary one...so they told me at the dentist's office that it won't feel as natural as the permanent one once they put that in and that I may be feeling awkward because they HAVE changed my bite significantly with the bridge. Makes sense I guess...just curious if that "heavy" feeling is normal...like something is pulling down on my gums?>>

YES, THIS HEAVY FEELING IS NORMAL. YOU SAID THIS IS A 7 TOOTH BRIDGE. COULD YOU TELL ME WHAT TEETH IT IS REPLACING AND WHICH OF THOSE TEETH ARE MISSING?

<<2. On either side of the bridge it feels like the teeth are hitting the outside of my mouth. That doesn't sound right...it's the INSIDE of my mouth but on the outer part just above where my upper lip is. Do you think this is just from swelling and will go away in a few days? I have a VERY tiny mouth so I guess I'm just worried that the bridge may be a little large for my small mouth. Probably just worried about nothing but no one really answered this question at my dentist's office.>>

THERE CAN BE SOME DISCOMFORT LIKE THAT FROM INFLAMMATION. BUT GENERALLY TEMPORARIES CAN BE QUITE THICK AND A BIT BULKY... DEPENDS ON THE MATERIAL THAT WAS USED TO MAKE THEM. THIS IS AN IMPORTANT THING TO MENTION TO YOUR DENTIST WHEN YOU GO BACK TO HIM FOR THE SECOND APPOINTMENT IF IT IS STILL BOTHERING YOU BECAUSE HE CAN HAVE THE LAB MAKE ADJUSTMENTS ON THE BRIDGE SO IT IS LESS BULKY.

<<3. They did a bunch of drilling yesterday while I was there to adjust the bridge where my lower teeth were hitting it. Since then it feels like the entire bridges has shifted there the top of the bridge on the back side has moved up into the contour of the roof of my mouth. At least...that's what it feels like when my tongue runs along it and there is increased pain in that area. Plus, when I tried to clean in there like they showed me with floss in between the teeth at the top by the gums...there's on place where the floss and pick won't go through and it did yesterday at the dentist's office. So would it really shift like that or are the gums at the top of the bridge/roof of my mouth just hard and raw and sore from all the work that was done? I tried to look with a mirror but I just can't see anything well at all. I think I'm just paranoid...but would also like to point out that while it felt better after they did the drilling with my lower teeth barely touching the bridge after they were done...it's now MORE comfortable and the lower teeth don't touch at all. So it's not necessarily a bad thing because on the one hand it's more comfortable bite wise and on the other I'm having pain in the gums back there at the rood of my mouth and top of the bridge.>>

IT IS IMPORTANT TO BE ABLE TO CLEAN IN AND AROUND THE MARGINS OF THE BRIDGE. HE MAY HAVE CLOSED SOME GAPS THAT WERE ALONG THE GUM LINE ON THE PALATE AND FACIAL SIDE. THIS WOULD MAKE THE BRIDGE FEEL TIGHT ALONG THESE AREAS. IT IS IMPORTANT FOR THE BRIDGE TO FIT ALONG THE CONTOUR OF YOUR GUM LINE BUT JUST AS IMPORTANT TO BE ABLE TO USE FLOSS THREADERS TO CLEAN THERE ALSO. IF THIS BECOMES VERY SORE AND/OR SWOLLEN, THEN SEE THE DENTIST. IF THE ISSUE IS DUE TO SOME INFLAMMATION FROM THE RECENT DRILLING AND IT SUBSIDES, THEN YOU WILL BE ABLE TO USE THE FLOSS THREADERS. NEVER FORCE THE THREDDERS INTO THOSE AREAS. FOR NOW JUST BRUSH WITH A SOFT BRISTLE TOOTHBRUSH ANGLED ALONG THE GUM LINE TO KEEP THE PLAQUE DOWN.

<<4. Where the eye tooth was extracted...it is black all around the top of the bridge. There's clearly a big hole there but when I floss/use the pick they gave me between that tooth and the teeth next to it, it's all black and oozy. No pain though or bad taste...just black and oozy. There was a LOT of decay in that tooth because of where it was and it had many cavities that were filled over 10 years ago. Does this sound normal and is there anything I should do to take care of it and clean it besides what I am already doing (brushing, flossing, mouth rinse)? It's odd because unlike when I had the four teeth extracted a couple months ago, these teeth have something placed over them so the wounds are not open in the same way the others were and I can't flush them out in like I could the others. The tooth that was broken and that they pulled the rest of looks fine and you cannot see any difference in the gums over that tooth than the rest...just where that eye tooth was which was in really bad shape. If the back pus continues to seep out...should I go back to the dentist. They had to see it yesterday when I was there and they didn't say anything about it or about caring for it differently.>>

THE EYE TOOTH AREA... IF THERE IS ANY "PUS" WHAT SO EVER, YOU NEED TO SEE YOUR DENTIST. HOWEVER PUS IS NOT BLACK... IT IS WHITE OR YELLOW AND SOMETIMES MIXED WITH BLOOD. WHAT I THINK YOU MAY BE DESCRIBING IS DARK BLOOD FROM THE BLOOD CLOTTING. BECAUSE THE BLOOD HAD NO PLACE TO DRAIN AFTER THE EXTRACTION, WHAT HASN'T BEEN ABSORBED BY THE BODY IS JUST SITTING UP IN THE SOCKET WHICH IS OKAY FOR NOW. IT MOST LIKELY WILL DISSIPATE ON IT'S OWN. BUT IF YOU THINK IT IS INFECTION... THEN SEE YOUR DENTIST.

<<5. Obviously I have soreness and tenderness in my gums and face after having all this work done. At what point will it be normal for this to die down...a week? Two weeks? Just curious more than anything else so I can know if I should be worrying as time goes on. I cannot use ice packs so I think I just have to deal with the puffiness and swelling without much to help calm it down.>>

THE SORENESS AND TENDERNESS WILL SUBSIDE WITH EACH DAY SO LONG AS THERE ARE NO COMPLICATIONS. I THINK YOU ARE OVERLY WORRIED ABOUT THIS AREA OF YOUR MOUTH DUE TO THE EXTENT OF THE PROCEDURE... WHICH IS TOTALLY UNDERSTANDABLE. HOWEVER, I SUGGEST THAT YOU NOT OVER DO TRYING TO CLEAN THIS. JUST BRUSH AS THOROUGHLY AS POSSIBLE AND IN A FEW DAYS OR SO ATTEMPT TO USE THE FLOSS THREDDERS AGAIN. IF THEY STILL DON'T FIT BUT THE GUM FEEL GOOD AND THE SORENESS IS LESS, THEN JUST CONTINUE ON THAT PATH UNTIL YOU SEE HIM AGAIN.

<<6. When biting into food there is a definite pressure. I am fairly certain this is normal given the way a bridge works with it being over several teeth and all. Does it ever go away or do you just get used to it? Is it less once the permanent bridge is put in vs the temporary I have in now.>>

FEELING PRESSURE WHILE CHEWING IS EXPECTED. THIS SHOULD LESSON OVER TIME AND THE PERMANENT BRIDGE MAY FEEL SIMILAR AT THE ONSET BUT LESSON AS TIME GOES ON. KEEP IN MIND THAT THIS AREA OF YOUR MOUTH BEEN TRAUMATIZED AND THAT YOU ARE NOW MISSING AN INTEGRAL PART OF YOUR DENTITION ...THE EYE TOOTH. THE EYE TEETH ARE CONSIDERED THE CORNERSTONE OF THE ENTIRE BITE, SO WHEN THEY ARE REMOVED THE BITE COMPLETELY CHANGES. IF EVERYTHING IS MADE PROPERLY YOUR BITE WILL BECOME STABLE AGAIN.

<<7. I talk with a slight lisp now with the bridge in. I assume I just have to get used to the feel of it and then that will go away. Is that normal or should I be worried that maybe it's not the right fit for me.>>

YOU SHOULD DISCUSS THAT WITH YOUR DENTIST AT YOUR NEXT APPOINTMENT BECAUSE HE MAY BE ABLE TO ALTER THAT. THE LISP INDICATES THE THE TEETH ARE NOW LONGER OR SHORTER THAN YOUR NATURAL TEETH WERE. KEEP IN MIND THE DENTIST IS TRYING TO FIT THESE TEETH INTO YOUR EXISTING BITE WHICH WAS PROBABLY NOT THAT GREAT TO BEGIN WITH. SO SPEAK WITH HIM ABOUT THAT AND SEE IF HE CAN ALTER IT FOR YOU.

Hope these answers help a bit!
Bryanna

Thank you so much Bryanna...that answers a lot of my questions and I feel pretty sure everything is normal and I just wanted that reassurance since they didn't answer all my questions when I was at the dentist.

My bridge spans teeth 6-12 and the missing teeth are 7 and 11.

What you mentioned about the eye tooth makes a lot of sense. The tooth was not actually really a part of my "bite" before because it was so high up it didn't even go below the gum line...which would explain why it feels so very different now. That's actually the spot where I feel like the teeth are rubbing against the inside of my mouth...it's probably just that I'm not used to actually having a TOOTH there with the rest of them.

I think the bridge teeth are longer than my natural ones so if the lisp thing doesn't go away then I will go over that with the dentist for sure.

The black stuff around where the eye tooth was has gone down a lot so I think you were right about it being excess blood. It probably just looked worse than it was. There's still some but it's definitely less.

I've been very good about using the threaders and cleaning around the bridge. I think the problem yesterday where I couldn't get through was just from swelling...it was fine tonight and no forcing or anything was needed. All went smooth.

I am really so happy that I had this work done and am feeling comfortable now that all is as it should be. I'll make notes of anything that is still bothering me before my next appointment in 3 weeks and hopefully we can make any adjustments then.

The pain is still pretty bad today...but better I think. Woke up in a LOT of pain this morning but throughout the day it has evened out to mostly just discomfort.

Thanks again.

Hi catra,

You are very welcome!

Glad to hear you are happy with your decision and that you are able to clean those areas better now.

Healing takes time... we can't rush it no matter how hard we try. Patience is a virtue.... that's for sure

If your pain does not continue to become less and less each day then you may have something to be concerned about and should see your dentist. Otherwise hopefully you will continue to heal okay.......

Keep us posted!
Bryanna

The pain hasn't really gotten any better the past few days. Every day I seem to go through the same cycle. I wake up in the wee hours of the morning (usually around 4:00am-4:30am) in excruciating pain. I take some Tylenol and Advil but it takes several hours to kick in. By around 10am the pain has subsided to a dull ache but only after taking 2 Tylenol and 2 Advil every 4 hours from the time I wake up to the end of the day. If I am even half an hour late taking them then the cycle starts all over again.

It's not my whole mouth or gum line along the bridge...it feels like it is more localized to the area where the eye tooth was extracted. I think I will call the dentist on Monday and see if they can check it out. The gum where that tooth was extracted is looking particularly inflamed, red, and it's pretty sore.

Hi catra,

I think it is wise to see the dentist on monday.

You mentioned that you felt the teeth were longer than your natural teeth. We also talked about how the "new" eye tooth was going to change the shape of your arch and alter your bite. Both of these things will cause your bite to be much different than it was before which could result you clenching down while you sleep. This would cause you to wake up in excruciating pain and would tend to subside as the day goes on.

I would discuss this possibility with your dentist tomorrow. Sometimes a minor adjustment can make the world of difference.

Regarding the discoloration and inflammation at the sight of the eye tooth... this could have something to do with you clenching as you may be pushing that portion of the bridge up into the gum area and also you may be cleaning too well (!!) in this area with the floss threaders. The area is tender from the surgery and needs time to settle down.... so over stimulating it can cause it to inflame and be sore. Again, I would discuss this with your dentist.

Keep me posted...
Bryanna

Thanks for the info...I didn't think about how the fact that I was sleeping might be a factor but that makes a lot of sense. I will definitely mention all of this to my dentist and see what they think. Hopefully I can get in tomorrow before work or at the latest on Tuesday since I have the day off. Thanks again.

Oh boy...not very good news. I was able to get in to see the dentist this morning and this just kind of sucks.

Apparently the last tooth in my bridge (next to the eye tooth...tooth 12) is infected and now needs to be pulled. Fantastic.

So the plan is to cut my current bridge (the temporary) in between the two front middle teeth and leave it in place on teeth 6-8. Then a new bridge will be created for 9-13 and they will pull 12. I just cannot seem to catch a break...but these are just the unfortunate consequences of years of neglect and health problems.

So for now I am on antibiotics and have been given hydrocodone. That's supposed to relieve the pain until I can get in to get this new work done...which unfortunately won't be for several weeks. I've got to try and arrange my schedule to make it work...hopefully sooner rather than later.

This will make 7 teeth pulled this year...seems like a lot...

Catra,

Did the dentist do a complete comprehensive examination of your entire mouth prior to the removal of #11? Or is he just focused on dealing with this area at this time? If a comp exam and full mouth series of x-rays has not been done, then I urge you to have that done before you move forward with any further treatment. It is imperative to see what is going on with all of your teeth and not just this one area as your treatment plan may change according to what else is going on.

It concerns me when a dentist preps teeth for bridgework and very shortly thereafter a prepped tooth shows up infected.

I know you said you have been neglectful with your dental care..... so have lots of other people, you are not alone in that. But I just hope that your dentist is not patching up the obvious areas and instead is offering you total comprehensive dental care. What do you think is happening??

Bryanna

Yes...I've had a comprehensive exam of my whole mouth, complete set of xrays, and all that jazz. I felt horrible as they went through the list of everything wrong in my mouth. This is a different dentist than the one I saw in January...but they pulled four teeth all at once and those were all pulled because they were infected and HAD to go. It is my understanding that almost every tooth except the bottom front four have cavities. The dentist said that he can visualize the tooth as they were prepping it and he really did not think the tooth would have been infected because it didn't look like it had progressed that far (though it DID have a cavity because apparently they all do).

Our plan is to pull 12 and create that new bridge that uses 13 as an anchor...but we also discussed the possibility of having it go all the way to 14 if 13 doesn't look good when he gets in there. I know my teeth are bad...I really don't fault the dentist for this sort of thing because realistically I know that my whole mouth is in bad shape. When those 4 teeth were pulled in January it did a lot to improve the health in my mouth because all of them were infected.

I think the problem is that yes...we are trying to tackle the worst most obvious areas first...but on the other hand we have to start somewhere because I can't have it all done at once. Though admittedly it seems very tempting to want all my teeth just pulled and get some dentures and move on. I know that's not a good option...but depending on how this plays out I may end up there anyway. Frustrating...but facts are facts.

All I can do now is hope that this is the last obstacle I face this year and that things get resolved with this new plan a few weeks from now when I am able to get in to get this work done. Well...that and hope that the pain meds and antibiotics help enough to get me through until then without being miserable. Despite the pain and everything I am still happy that I have chosen to move forward with treatment. I wish things were going smoother but years of neglect do have consequences and unfortunately it seems to be my time to pay up.