Hi,

I'm a 32 yr. old who is 18 days post-op lower right wisdom tooth removal with a bone graft. I did a round of Amoxicillin for 7 days, starting one day before my surgery. Immediately after surgery and ever since, I have had numbness of my lip/ chin area (including the teeth and gums in that area). I've had pain varying from constant, dull throbbing to excruciating, stabbing pain that usually lasts around 10 min (I think these are "zingers"). I have not been able to chew or open my mouth fully since surgery.

I went and saw the surgeon 5 days ago, and an infection was found so I am currently on Clindamycin. About 2.5 days into the new antibiotic, I had shooting pain so bad, like I was being stabbed in the face, I was literally jumping out of my seat and in tears. I've been taking ibuprofen around the clock for pain, and sometimes it dulls it, but most of the time it does nothing. I've been doing salt water rinses, tea bags, clove oil, the whole nine yards. I emailed my surgeon and told him what I was experiencing and he said that this was normal and likely the nerve healing and infection resolving, and to call the office if I still have swelling after 3 or 4 days on the antibiotic.

Today is day 5 and I still have a hard lump on my jawline that is so painful, I can barely touch it. I don't see any pus coming from the extraction site anymore (last saw some yesterday). However, last night for the first time since surgery, the pain woke me up in the middle of the night and kept me up until 5:30am. I'm starting to get extremely frustrated. Should I try and wait it out a few more days? Should I go for a second opinion? I'm very concerned about this developing into a much worse infection, and I feel like at this point, I should be much better. And I am so freaking hungry. Sorry for the novel and thanks for any advice!

The symptoms you describe are consistent with an inferior alveolar nerve disturbance. Was the surgery done by an oral surgeon or a dentist? You really need to be seen by an OS asap and ask for pain medication....

It was done by an oral surgeon. I told him I was in a lot of pain and taking OTC ibuprofen around the clock and he gave me an RX for 20 tablets of 600mg ibuprofen, which I have 8 left, and I highly doubt will last me until 2/10 (my next appt.) Not a huge deal, I can always double up on my OTC ibuprofen, but I'm kind of surprised he didn't give me something stronger.

Side note, I'm also on Prozac and I've seen comments in my quest for some resolution to this pain that it's not good to take ibuprofen long term while on Prozac? I asked my pharmacist friend and she said I should be fine, but it's another reason why I was kind of scratching my head at being given more ibuprofen. I don't know if this guy has an aversion to dispensing pain meds, I know there are a lot of RX abusers out there, but I think I have a pretty good reason to need something stronger.

One more thing I forgot to note in my above post, the extraction site is completely open. I can see down into the hole and I'm pretty sure I can see the bone graft. Could this be a reason why it's so painful? My teeth on my right side were super hot/ cold sensitive for a couple of days, but not really anymore.

I wouldn't wait till the 10th. I would call now and ask if you should go to ER or their office to have it looked at.

Thanks, Cleo. I have requested an appointment with another OS for a second opinion. I don't want to mess around with this, and my current OS doesn't seem too concerned (which maybe it really is nothing to be concerned about) but I would like someone to at least explain it to me and verify whether or not my concerns are legitimate.

As of now, I'm still in quite a bit of pain, can't chew and I'm even more limited in opening my jaw now. I mean, this can't possibly be normal for a wisdom tooth extraction, can it? Shouldn't I have improved at least a little bit by now? I haven't had any zingers since this morning, and I only had a couple. No sensation coming back yet. I'm probably getting myself worked up over nothing, but better safe than sorry.

I'm 57 and I had my two lower wisdom teeth extracted 14 years ago; I also had my #19 molar extracted about a month ago and I did not have any problem; I had very little swelling and I took only one 600mg ibuprofen twice after the surgery to control the minor pain. What you experimenting is not normal especially after 18 days! Actually my extraction site is about 30% to 50% closed after 18 days and I'm a lot older than you.
Please seek another surgeon to check it out; I know there are many incompetent dentist out there. Be careful and take care.

There are known nerve complications associated with third molar extraction. I wouldn't say its a normal complication and I doubt there is any normal in pus and a open extraction site where bone is visible almost 3 weeks later. Did the stitches dissolve or did you have to get them removed?

Hi kmd,

Sometimes when a lower wisdom tooth is removed there is an irritation to the nerves in the lower jaw bone in the area of where the wisdom tooth was located. This irritation can most commonly temporary but sometimes it can be permanent. When that happens, a variety of symptoms can occur similar to what you have described. However, these same symptoms can also occur for the following reasons:

1) If there is an infection in the bone irritating those same nerves.

2) If the blood clot was disturbed in the early stages of healing.

3) If there was chronic irritation to the deep wound from:
a) over rinsing
b) using a tea bad past the first day of post op
c) using medicament's like clove oil too often that were irritating to the wound
d) from smoking, drinking alcohol or soda.

4) Certain medications such as Prozac and continuous use of Ibuprofen can cause a decrease in saliva which predisposes the deep oral wound to becoming dry.

All of those things I have listed can cause a disturbance in the early stages of healing and in the proper formation of the blood clot, which will cause the deep wound to become dry and irritated. The result is usually radiating, shooting, sharp, and sudden pain as you have described it here.

So it is best to see an oral surgeon who is going to evaluate your situation very thoroughly. You should have an xray taken to see if there is any additional pathology occurring in the wound or around the bone graft. The bone has not yet started to fill in as that does not start to occur for several weeks or longer. The bony socket from where the tooth was removed, takes up to a full year or so to completely fill in with bone. The gum tissue generally covers a healthy extraction wound within 4-6 weeks. Some people a bit sooner, others a bit longer.

Please let us know how the appointment goes with the new oral surgeon.
Bryanna

Hi. I had my teeth taken out last year. All four. I am sorry to hear you are having such issues with your post op. When they took the X-rays for my pre surgery they said that the roots of my teeth inter twined with the nerve in the jaw, and they wouldn't be able to remove all due to the fact that it could cause numbness and such problems similar to your discription. So they had to leave a small amount of tooth in not to bother the nerve. I think you should ask to get a copy of your pre surgery X-ray and bring it to another OS and just even ask if it looks intertwined if they won't see you. The only other real problem that I had was a dry socket, the blood clot didn't stay and it felt as tho my bone was rotting, they put this strip in that caused amazing relief within 30 minutes. Best of luck to you. I would deffinetly look into a lawer to at least even consult with and get the xrays with. You could try a pay only if you win lawer.

The original OS office called to see how I was doing and scheduled me for a possible incision and drainage on Monday (under anesthesia). I went to my PCP and she checked my temp (I wasn't running one) and she checked the skin color and made sure it wasn't hot and everything. She said it definitely wasn't cellulitis, she thinks it's an abscess but she said it wasn't really behaving like one. My lymph nodes are swollen on my right side so she was thinking it might be an aggravated lymph node, but obviously there was a presence of infection so she felt I should have an MRI so she could see exactly where the lump is. She said there's a lot going on in that area, salivary gland, lymph node, jaw bone, etc. and she felt an MRI would provide a much clearer picture than an x-ray. I haven't decided if I want to do that just yet.

Ymelissa1fish: you bring up a really good point because my other bottom wisdom tooth had the nerve wrapped around it and that OS had a really difficult time extracting the tooth. I'm going to ask my OS about the possibility of a tooth fragment still being in there when I see him on Monday. Sounds like you had a really rough time, as well!

I really think once the lump is drained, I will feel so much better. It's the source of the pain, and even my extraction site is almost healed up now, I think there's just a build up of pressure in my cheek. It's like I have a golf ball on my jaw. When OS 2 attempted draining it, I had a bunch of tingly sensations in the numb area of my lip, so I think the inflammation is aggravating the nerve, which is making this so painful. I'm just so ready to eat normal food again, lol! Thanks for the support, I really appreciate it!