[Berus]

Greetings all,

First, let me say how grateful I am to have stumbled on this site. I searched on wisdom tooth pain and landed here. I can see that there's a real atmosphere of helping and caring here, and that's just what I could use. Bryanna, especially, seems to be some sort of saint in terms of her patience and understanding with the many who have posted their problems here.

I'm 51 (male) and had never had dental problems. 6 weeks ago, I developed an abscess (a fistula) beneath the molar just in front of my lower left wisdom tooth. I saw a dentist, who referred me to an oral surgeon here in Palm Springs where I live. I was told I needed all 4 wisdom teeth out. Iwas placed on antibiotics, first clindamycin (to which I had a reaction and severe headaches/diarrhea) after which I was changed to 7 days of Azithromycin (Z-Pack). I was about to have the procedure on that Monday, but because I had bronchitis, I wanted to wait a few days because I couldn't imagine adding post-op recovery pain to my already weakened and highly congested state. Fast forward a week to the next Monday; I show up, and have the surgery under IV sedation. I was told after the surgery that there was a tiny piece of the lower left wisdom tooth that the surgeon thought it better NOT to remove, for fear of damaging the nerve. He said what he did remove was difficult to get out, and that it had taken him quite a while. He said that recent studies had proven that it was less damaging to allow the piece to either heal over or slowly migrate up to the surface where it could easily be removed if that occurred. (Note that this oral surgeon is reputed to be the best in the area.)

So, I go home, groggy, and begin the recovery. 3 or 4 days later I return with pain and am told I have a dry socket. He packed it and I got some relief. At this point, I was off the oxycodone and managing the pain with Advil. The pain wasn't excruciating, but was enough to warrant a couple of Advil at night. Another 10 days went by, and I was now 2 weeks post-op. Pain persisting, with some pain radiating up into my left temple area. Not terrible, just enough to be annoying. The surgeon (who is a nice fellow, but is a bit hurried in his manner) told me that there was no sign of infection. I continued to use the syringe to clean out food which got stuck in the lower holes. (also note that, despite having a small knot in my left cheek near the difficult extraction, I was always able to open my mouth fully. There was a bit of swelling in my left cheek, but that has now gone.)

I'm writing now, because tomorrow will be 4 weeks to the day, and I just had to pop another two Advil for the pain that always seems to show up around 7:30 in the evening. The Advil controls the pain, but I'm concerned that it's still there. There is no visible sign of infection at the extraction site - just the rather large hole, and I would not say is it extremely tender. I have been eating mostly normal food for the past 2-3 weeks, but still avoiding things like nuts and tortilla chips with sharp edges. I also have no fever according to my thermometer. On a scale of 1-10, I'd say the pain will max out at about a 4 or 5 if I don't take the Advil. I CAN see the oral surgeon again, but I feel that he's just going to tell me to keep doing the saltwater rinses. I'm fine with that, and I can keep dealing with the pain at this level (Assuming that, at some point in the not too distant future it will go away) but I don't know how to assess whether or not this pain could indicate some sort of deep (bone?) infection, or whether it is just nerves that have been disrupted, muscles stretched, or something more or less benign. Learning about terms like "Ludwig's angina" and NICO has me concerned that the dry socket may not be healing properly and that this pain is just the first warning sign of something worse to come. But... if there's no swelling or fever or discharge... or other sign of infection, no numbness... could the pain just be post-op pain from the difficult extraction? Would that last 4 weeks or more??

Sorry for the long, rambling post, and thanks in advance for anyone who might have the patience to read through this and offer their perspective or advice. I realize as a 51 year old that I do not heal as quickly as a younger person, but I do not smoke and am healthy overall. My only symptom (no fever, no swelling) is just this evening pain and my anxiety that it could be some sort of warning sign.

Thanks