Hi, I'm new here and it's a bit of a long story but I am in a world of pain and hoping someone can help.

About 2 months ago, I had my lower left impacted wisdom tooth extracted. I lost the clot within the first couple of days but it wasn't a dry socket just healed a little slowly and I had some jaw soreness that seemed to improve over time. Christmas eve I had the tooth next to the wisdom tooth extraction site were the wisdom tooth had been impacting filled. I did ask the dentist if the extraction site looked healed enough to do the filling and he told me it " looked good " . The filling gave me nothing but trouble from the beginning - you could see just by looking at it the the dentist had built the tooth up to be a lot bigger than the original tooth - the filling was especially sensitive to hot and cold and biting down. When I called the dentist's office (my dentist was by now on holiday ) and they read his notes they told me it may be the wisdom tooth extraction site as it was inflamed and I had gingivitis there on the day of the filling - the dentist made no mention of this to me.

Anyway, I have been back to the dentist office twice where junior dentists have ground it down to what now feels normal but I still have pain in my jaw. The pain is now mainly spontaneous and not so much set off by temperature and not at all by pressure. The junior dentist did say the filling is quite close to the pulp. A couple of days after the filling I started on Amoxicillin as I also developed tonsillitis, an after hours doctor then swapped me to penicillin VK. This morning I went to my GP as I was in pain and dizzy and she says some of my pain is in my glands rather than my jaw and has now swapped me over to Clindamycin. She didn't seem to think there was an abscess but suggested I go back to the oral surgeon - which I can't get into until Friday.

My face is only slightly swollen on that side but I've just woken up at 5 am because of the pain. Does anyone have clue about what may be going on? Nerve pain? Jaw infection? Is it the extraction site or the filled tooth? I do think a little bit of it is TMJ but there is something else going on too.

Oh, and I must mention that one of the upper premolars on the same side was re - root canaled back in October and still had the temp filling when I got the wisdom tooth extracted. With the extraction, the root canaled tooth became the most painful tooth in my mouth so it has been left with the temp filling to settle - it seems to get referred pain from the other 2 teeth that are currently in pain. Otherwise my teeth are all good, other than minor fillings to date the only work I had had done was that 1 root canal. I am 50 years old.

Thanks for any assistance.

Hi Mytoothhurts2,

I am in the dental field and can offer you some information here. By now you may have already been back to your dentist.

I will re post some of your thread and answer you in bold type.

<<About 2 months ago, I had my lower left impacted wisdom tooth extracted. I lost the clot within the first couple of days but it wasn't a dry socket just healed a little slowly and I had some jaw soreness that seemed to improve over time.>>

THE FORMATION AND RETENTION OF THE BLOOD CLOT IS NECESSARY TO PROTECT THE BONE FROM BACTERIA AND INFECTION. SO IF THE CLOT DID NOT FORM PROPERLY OR IT DISLODGE EARLY ON WITHIN THE FIRST FEW DAYS THEN THE BONE WAS VULNERABLE TO BACTERIA. I MENTION THIS BECAUSE OF WHAT SEEMS TO HAVE PROCEEDED SINCE THAT TIME.

<< The filling gave me nothing but trouble from the beginning - you could see just by looking at it the the dentist had built the tooth up to be a lot bigger than the original tooth - the filling was especially sensitive to hot and cold and biting down.>>

THE DENTIST MAY HAVE MISJUDGED THE CIRCUMFERENCE OF THIS FILLING BECAUSE OF THE EMPTY SPACE FROM THE RECENT EXTRACTION OF THE WISDOM TOOTH. SIMPLY BECAUSE THE CIRCUMFERENCE OF A NEW FILLING NEEDS TO FIT IN ACCORDANCE TO THE ADJACENT TEETH AND THE BITE. THE TEMPERATURE SENSITIVITY IS NORMAL FOR A NEW FILLING, ESPECIALLY IF IT WAS LARGE AND/OR DEEP. HOWEVER THAT SHOULD NOT LINGER FOR MORE THAN A WEEK OR SO.

<< When I called the dentist's office (my dentist was by now on holiday ) and they read his notes they told me it may be the wisdom tooth extraction site as it was inflamed and I had gingivitis there on the day of the filling - the dentist made no mention of this to me.>>

OF COURSE THE DENTIST SHOULD HAVE INFORMED YOU OF THESE FINDINGS ESPECIALLY SINCE HE FELT THEY WERE SIGNIFICANT ENOUGH TO NOTE IN YOUR CHART. ALSO AS A SIDE NOTE... DRILLING INTO A TOOTH CAUSES BACTERIA TO FLY ALL OVER THE PLACE SO IDEALLY THE WISDOM TOOTH SITE NEEDED TO BE CLOSED OVER BEFORE ANY DRILLING WAS DONE.

<<The junior dentist did say the filling is quite close to the pulp.>>

THIS COULD BE WHY YOU ARE EXPERIENCING THESE SYMPTOMS. THE PULP BECOMES INFLAMED FROM DRILLING AND WORKING ON THE TOOTH ESPECIALLY IF THE DECAY WAS NEAR THE PULP. IF THE PULP WAS NOT EXPOSED DURING THE DRILLING AND IF THE FILLING FITS WELL INTO YOUR BITE SO YOU ARE NOT HITTING THAT TOOTH ABNORMALLY HARD, THEN IT IS POSSIBLE FOR THE INFLAMED PULP TO CALM DOWN. BUT THIS COULD TAKE WEEKS.

<< A couple of days after the filling I started on Amoxicillin as I also developed tonsillitis, an after hours doctor then swapped me to penicillin VK.
This morning I went to my GP as I was in pain and dizzy and she says some of my pain is in my glands rather than my jaw and has now swapped me over to Clindamycin. She didn't seem to think there was an abscess but suggested I go back to the oral surgeon - which I can't get into until Friday.>>

IN CASE YOU ARE NOT AWARE... IT IS IMPORTANT TO SUPPLEMENT WITH A PROBIOTIC ANY TIME THAT YOU TAKE AN ANTIBIOTIC BECAUSE THE ANTIBIOTICS WILL DESTROY THE HEALTHY BACTERIA IN YOUR INTESTINES WHICH CAN MAKE YOU VERY ILL. PROBIOTICS ARE HEALTHY BACTERIAS THAT REPLACE THOSE DESTROYED BY THE MEDICATION. IT IS IDEAL TO A PROBIOTIC ONE HOUR PRIOR TO YOUR ANTIBIOTIC OR TWO HOURS AFTER AS THEY EACH CAN INTERFERE WITH THE ABSORPTION IF TAKEN TOO CLOSELY. IT IS ALSO IDEAL TO CONTINUE ON THE PROBIOTIC FOR SEVERAL WEEKS OR MORE AFTER THE LAST ANTIBIOTIC PILL IS TAKEN TO CONTINUE TO REPLENISH THE GOOD BACTERIA TO HELP KEEP YOU WELL. IF YOU ARE NOT FAMILIAR WITH PROBIOTICS AND WANT INFORMATION ABOUT THEM, LET ME KNOW.

<<My face is only slightly swollen on that side but I've just woken up at 5 am because of the pain. Does anyone have clue about what may be going on? Nerve pain? Jaw infection? Is it the extraction site or the filled tooth? I do think a little bit of it is TMJ but there is something else going on too.>>

I THINK IT WOULD BE WISE TO CALL THE ORAL SURGEON AND EXPLAIN THE CHANGE AND SEVERITY OF YOUR SYMPTOMS TO GET IN TO SEE HIM SOONER.

<<Oh, and I must mention that one of the upper premolars on the same side was re - root canaled back in October and still had the temp filling when I got the wisdom tooth extracted. With the extraction, the root canaled tooth became the most painful tooth in my mouth so it has been left with the temp filling to settle - it seems to get referred pain from the other 2 teeth that are currently in pain. Otherwise my teeth are all good, other than minor fillings to date the only work I had had done was that 1 root canal.>>

THE ORAL SURGEON SHOULD ALSO TAKE AN XRAY OF THAT RECENTLY ROOT CANALED TOOTH TO EVALUATE IT. ROOT CANALED TEETH ARE NEVER MADE HEALTHY AGAIN BECAUSE THE HUNDREDS OF TINY CANALS THAT ARE NOT ACCESSIBLE REMAIN INFLAMED AND INFECTED. THE ROOT CANAL PROCEDURE IS DONE TO RETAIN A NON VITAL TOOTH, IT IS NOT DONE TO CURE AN INFECTION. SO IT IS VERY COMMON FOR ROOT CANALED TEETH TO BE PROBLEMATIC.

I hope this information has been helpful. Please check back with us with any more concerns or questions.

Bryanna

Thank you Bryanna, for your detailed answer. I ended up speaking to the Oral Surgeon yesterday and will now be seeing him tomorrow. He didn't know what was going on but said he will have a look and do a panoramic xray. He did say the tooth with the filling (2nd molar) may need to be either pulled or a root canal - if that is the case I will have it pulled. Even though I worry a little about eating without it, I don't think I would ever opt again for a root canal. I will mention the existing root canal to him as well as it is now giving me a lot of (referred?) pain.

Again, thank you for your response and I'll put in an update once I've seen the oral surgeon.

Mytoothhurts2,

An example of a typical referred pain would be if you were grinding your teeth and you developed pain in say your temples or behind your eyes, etc. The cause of the pain that you feel in that root canaled tooth is due to the bacterial inflammation and it is being exacerbated by the generalized inflammation in your lower jaw from whatever is going on with that molar and/or the extraction site.

A panoramic x-ray will show your upper and lower jaw, tmj, frontal sinus area, etc. Which is helpful. However, this type of x-ray does not give a close up of any particular area. So it may behoove you to also have the surgeon take one or two periapical x-rays of the extraction site and lower molar and then one more periapical of the upper root canaled tooth. Taking all of these xrays will be more conclusive. Sometimes the patient has to ask to have these done.... I know that seems silly but don't be shy or hesitant to request them.

Yes, please keep us updated.
Bryanna




QUOTE=Mytoothhurts2;1118056]Thank you Bryanna, for your detailed answer. I ended up speaking to the Oral Surgeon yesterday and will now be seeing him tomorrow. He didn't know what was going on but said he will have a look and do a panoramic xray. He did say the tooth with the filling (2nd molar) may need to be either pulled or a root canal - if that is the case I will have it pulled. Even though I worry a little about eating without it, I don't think I would ever opt again for a root canal. I will mention the existing root canal to him as well as it is now giving me a lot of (referred?) pain.

Again, thank you for your response and I'll put in an update once I've seen the oral surgeon.[/QUOTE]

Thanks again Bryanna - I so admire how you dedicate yourself to we who are confused and scared - I do hope that all you do comes back to you ten fold.

I saw the oral surgeon today -he doesn't think it's the filling but the actual wisdom tooth extraction site. It looks on the xray as though the bone isn't filling in and he says the extraction site is still a really deep hole. I think the filling maybe just upset the whole thing - maybe even drilling debris is in the hole? Anyway, I'm to go back on Friday and he said he would clean it out an do a curette on the bone. Regarding the pain in the root canal - he said that all the inflammation is just upsetting it - to be honest ALL of my teeth are now becoming really sensitive so I'm willing to let it go and see what happens once we fix the pain in the wisdom tooth region.

He said it wouldn't take long and he would give me a local anaesthetic. What I didn't think to ask is will there be a lot of bleeding? Will healing be the same as the first time the wisdom tooth came out? I so don't want to go through all of that again (of course I have no choice).

Also, I have been having an upset tummy with the Clindamycin (and I had penicillin before the Clindamycin) - it's not diarrhea yet just frequent bowel movements and the OS suggested I stop the Clindamycin before it progresses further. I assume that I'll be OK without antibiotics? and that the procedure will be enough to control the infection?

Again, thanks a million.

Hi Mytoothhurts2,

Thank you for the kind words... I'm glad I can be helpful to you

I am still skeptical about that new filling on the molar and think it and the root canaled tooth will need to be addressed at some point. As I mentioned before, root canaled teeth remain inflamed due to the bacteria still present inside the tooth irrelevant of there being symptoms or not. But I agree that the wisdom tooth site is the priority.

The surgical debridement of the wisdom tooth site is done to remove any residual ligament and granulation tissue which is connective tissue with little blood vessels that fills in the site during the initial healing phase. Since the blood clot was lost early on, the bone was unprotected and it just didn't heal properly. The idea is to remove all that and get a good healthy blood supply going so a new clot can form. Depending on the individual case, the post op discomfort of this debridement may be similar to that of the extraction. It is usually short in duration if the clot stays in place and the sight heals well.

Regarding the antibiotic..... usually the patient is on antibiotics for the debridement. However, it sounds like your intestinal health is becoming compromised from the antibiotics so before that becomes worse, he is suggesting that you stop those meds. I am going to assume that you do not supplement with probiotics? If not, then it is imperative that you start to do that now. Antibiotics can deplete the intestines of all of the healthy bacteria and when that happens you can end up with an intestinal infection. Even weeks after you stopped the antibiotic. The probiotics can help prevent or lesson the degree of that from occurring.

If you want information on probiotics, let me know.

Bryanna

I had the socket debrided today. It is now 9 hours later and a bit painful despite taking ibuprofen. The socket/ teeth are still quite sensitive - is this usual until it all settles? As I was having tummy problems on the antibiotics, I wasn't prescribed more and OS thought the fact I had been on them for 2 weeks should have been enough. He gave me an alcohol free mouthwash and told me to keep flushing the site with salt water. Before going to bed this evening I just did a gentle salt water rinse - no mouthwash or flushing as I thought it may be too soon? I was very careful to try not to get any food near the socket this evening. Any advice? I so want this to be all over!!!! Thanks so much

Hi Mytoothhurts2,

I personally would not use any mouthwash or irrigate that site with a syringe. Just gentle rinses with warm salt water 3-4 times a day. For today and tomorrow, just "gently swish" the salt water in your mouth. By the 3rd to 4th day, you can swish a bit harder but do so in a manner that you are slowly building up the degree of swishing over a period of 7-10 days. Use about 1/4 of a teaspoon of salt to about 3 ounces of water.

The socket and teeth are going to be uncomfortable, that is normal. There is a lot of healing that needs to happen in that area. It is important to realize that you have had surgery, not once but twice in that area. Treat it like you would if you had surgery elsewhere on your body.

It is important to eat a soft food nutritious diet. Nothing too chewy, spicy, anything with seeds or rice, avoid sugar as this feeds on bad bacteria... drink plenty of water throughout the day. Do not drink through a straw, drink from a cup.

Probiotics would be most helpful in the healing process not only your intestinal healing but your surgical healing as well. You have not commented on this subject but because I know how necessary they are, I am just going to give you the information and you can choose what you want to do. Some very good probiotics that you can buy in a drug or health food store are:

*** Culturelle
*** Any Garden of Life probiotic product
*** Any Douglas Labs pro product
*** Any Jarrows formulas pro product
*** Any Natren Healthy Trinity pro product

Bryanna

Thanks again for your helpful info Bryanna. I'm actually not convinced that the tooth with the filling isn't contributing to the pain. My bite feels "off" but the last dentist I saw said there was no more filling to grind down from that recently filled tooth (the filling was on the backside of the tooth near the extraction site so I'm not sure why there was so much filling material on the top of my tooth to start with). Maybe my bite is just feeling strange from the pain and swelling - if it doesn't feel better by the end of the week, I may contact the oral surgeon again.

Regarding the probiotics, I do appreciate the info. I have however suffered from irritable bowel most of my life, and while I know probiotics are supposed to help, they seem to make it worse. My IBS is pretty much under control these days but I can't tell you the number of times I have tried probiotics over the years only to have the IBS made worse with stomach pains and diarrhea - even if I try to persist with them the IBS is always worse on them than off them - I must just have a delicate balance going on in there. I have tried most brands on the market (I am not in the US so your brands recommended are not available) but thanks.

Hoping I'll feel better in few days - I'll let you know how I go. You are wonderful - thanks

Hi Mytoothhurts2,

Did you know that millions of people have IBS? Yea, it is so common that it's unfortunately misdiagnosed as a "functional" disorder when in fact it is a telltale sign of any number of underlying problems. To find out the causes, it will take some self discipline and some cooperation from your doctor but this disorder can be cured.

Dr. Mark Hyman is a well known educator, author and well respected physician who specializes in Functional Medicine. His articles on various health topics are truly informative. So I thought I would share this one with you...

http://drhyman.com/blog/2010/09/16/5...without-drugs/

I hope you find it helpful

Bryanna