Bryanna,

I had increased facial pain yesterday and noticed more clicking when I talk. The pain developed into a full headache.

I have had tooth 2 pulled a while ago and it appears wisdom tooth has shifted over diagonally (crooked). Now with tooth 3 being removed, could the wisdom tooth be irritated and pressing on a nerve which is causing me discomfort?

Could this be symptoms of TMD? If so, who is the best to treat this? The orofacial pain specialist I saw suggested TMD but all he did was send me to PT and they worked on my back and shoulder for neck pain but didn't address facial pain.

Lastly if I want to get a partial denture for tooth 3 replacement will the wisdom tooth need to be pulled, since it is crooked. and I get a partial denture. I have heard negative stories about wisdom teeth being pulled, particularly in the 40+ age group.

I will ask the oral surgeon about the x-ray you suggested. Would he also be able to evaluate the health of the wisdom tooth, not as it relates to decay but to position, and TMD?

Hi muffie,

<<I had increased facial pain yesterday and noticed more clicking when I talk. The pain developed into a full headache.>>

CLICKING? DO YOU MEAN IN THE JAW OR THE JAW JOINT?

<<I have had tooth 2 pulled a while ago and it appears wisdom tooth has shifted over diagonally (crooked). Now with tooth 3 being removed, could the wisdom tooth be irritated and pressing on a nerve which is causing me discomfort? >>

TEETH CAN SHIFT WHEN ADJACENT TEETH ARE EXTRACTED. THE SHIFTING OF A TOOTH OR TEETH CAN ALTER THE ALIGNMENT OF THE JAW JOINT AND THE BITE. YES, SHIFTING OF A WISDOM TOOTH, DEPENDING ON WHERE IT IS LOCATED IN PROXIMITY TO THE NERVE BUNDLES IN THE JAW BONE, CAN CAUSE IRRITATION TO CERTAIN NERVES. ESPECIALLY IF THAT WISDOM TOOTH IS GETTING USED TOO HARSHLY WHEN YOU CHEW AS IT COULD BE IF IT HAS SHIFTED OUT OF IT'S ORIGINAL PLACE.

<<Could this be symptoms of TMD? If so, who is the best to treat this? The orofacial pain specialist I saw suggested TMD but all he did was send me to PT and they worked on my back and shoulder for neck pain but didn't address facial pain.>>

IT COULD BE TMD OR TMJ, SAME THING. DID YOU HAVE TMD PROBLEMS BEFORE YOU HAD THE TEETH REMOVED? IF NOT, THEN THE SHIFTING OF YOUR BITE COULD BE CAUSING THE CURRENT JOINT PROBLEM. P/T WILL HELP ALIGN THE BACK AND SHOULDER IF IT IS BEING THROWN OFF BY THE JAW PROBLEM. WHICH BY THE WAY, IS PRETTY COMMON. HOWEVER, P/T WILL NOT BE A PERMANENT FIX UNLESS THE MISALIGNED BITE IS CORRECTED.

<<Lastly if I want to get a partial denture for tooth 3 replacement will the wisdom tooth need to be pulled, since it is crooked. and I get a partial denture. I have heard negative stories about wisdom teeth being pulled, particularly in the 40+ age group.>>

IT IS NOT IDEAL TO USE A CROOKED WISDOM TOOTH TO ANCHOR A PARTIAL DENTURE OF PERMANENT BRIDGE. HOWEVER, IN ORDER TO HAVE A PARTIAL DENTURE, IT IS BEST TO HAVE A BACK TOOTH TO ANCHOR THE PARTIAL ONTO SO IT IS STABLE WHEN YOU CHEW. YOUR DENTIST WILL HAVE TO EVALUATE YOUR BITE AND GIVE YOU OPTIONS OF WHAT IS BEST SUITED FOR YOUR PARTICULAR SITUATION.

<<I will ask the oral surgeon about the x-ray you suggested. Would he also be able to evaluate the health of the wisdom tooth, not as it relates to decay but to position, and TMD?>>

OKAY, GOOD IDEA. YES, HE CAN EVALUATE THE HEALTH OF THE WISDOM TOOTH AND ALSO THE JOINT PROBLEM.

Bryanna,

I went to see oral surgeon as we discussed. I told him of the pain on the right side of my face and that bite guard helps some but does not address soreness in mouth. He did not take x-ray of my teeth to evaluate condition of other teeth, said all looks good, and suggested I use a bite guard if it helps. He said "I believe you are in pain but there is nothing medically or scientifically I can address." So irritating when you don't know what to do and you don't get the help you should because someone has decided nothing is wrong.

It has been 2 months since tooth extraction and I have a bony lump on the gum on top of the extraction site. When I run my tongue over the spot, it is sore. I have read about bony fragments. I wonder if this is what I have.

1. Is it common to get bony fragment on gumline on top of the extraction site? The lump does feel smaller than it was a month ago but it is still sore and I am still having some neck discomfort. Can this irritation cause pain in face and jaw?
2. My chiro says neck discomfort could be from jaw/c1 vertebrae connection as the c1 atlas doesn't seem to want to stay in place. Could this be from inflammation? bloodwork doesn't show any inflammation markers so doctor thinks all is well, but I know I still have headaches and neck discomfort. I have no swelling, no fever.
3. Also could neck discomfort be from healing of bony fragment? How much time should I allow for this?
4. I do have stomach discomfort, not sure if it is from pain or from irritated stomach from antibiotic therapy. I have also read about tooth meridians and tooth 3 is connected to stomach so I wonder if there is some connection there as well?
5. Lastly I wonder if there is vagus nerve involvment as I have had the stomach and heart and neck connections which can all have vagus involvement. Heart rate is getting better when I treat stomach irritation (taking digestive enzymes). Any suggestions on how to get a proper diagnosis?

Thanks Bryanna.