I had my 2nd molar extracted 10 days ago. There is no wisdom tooth behind it as it was removed years ago. The extraction hole is fine, no real pain but the outer gum where there also were some stitches is so tender. If I touch it, ouch (I haven't touched it otherwise, I rinse with salt water but I wanted to check which part hurt and it is SO sore). I can see an indentation where the stitches were, little lines. My question is, is this normal, to still be sore and how long does it last? I am older so maybe heal slower?

Another question...although no sign of sinus perforation (like I was afraid of last week and you asked me to see if water seeps into my nose) but my cheek hurts on and off on the bone below my eye and sometimes next to my nose. I am getting worried again and just hope it's just radiating from the whole darn thing and not my sinus. My nose is not running, no blood, no congestion, just pain that comes and goes.

Hi Sandy,

It is normal for the gum area of an extraction site to be sore or tender for a couple of weeks after the procedure to remove the tooth. It is also normal for the face and bony area around the extraction site to be uncomfortable for a couple of weeks as the area is healing.

Sometimes, the gum tissue at the extraction site develops a canker sore from hot, sharp edged or spicy food. Keep in mind that the extraction site is an open wound that is subjected to everything you eat even if you are not eating directly on that area. If that is the case, then salt walter rinses will help heal the gum tissue. It is also imperative to make sure that you brush the first molar (in front of the extraction site) very thoroughly to avoid any plaque from building up along the gumline of that tooth. If plaque accumulates around the gumline of that first molar, it will cause a sore to develop which could spread to the extraction site.

The area along the cheekbone can be tender for a variety of reasons but one that is common is due to trauma with the Zygomatic Major muscle. The Zygomatic Major is a very thick muscle that runs diagonally from the ear, down along the outer edge of the cheekbone to the corners of the mouth. This muscle is referred to as the Smile Muscle. When you have an upper molar extracted, this muscle may be overstretched especially if the patient tightens their facial muscles during the extraction. As the muscle starts to relax and heal, the cheekbone area can feel tender or achey. This condition can last for a few days to a few weeks, but it is temporary.

The nose can be tender from referred pain from the overstretched zygomatic major muscle.

On the other hand, sinus issues or infection can also make both of these areas tender. Usually when there is infection present, the patient doesn't feel very well and may run a fever. Are you feeling ok in general?

If by friday of this week, the gum area is still "very" sore and the area at the side of the nose is "very" sore or you develop swelling or a fever ...... it wouldn't hurt to let the oral surgeon or your general dentist take another look at the area and even take an xray.

Please try not to worry...... your situation does not sound serious but if you are very concerned that something is wrong, it is always best to let the dentist take a look to make sure all is well.

Please keep us posted on how you are healing!

Bryanna ~'.'~

Thank you SO much, Bryanna. I have no fever and feel fine otherwise but I am on amoxicillin 500 for 8 days. I was on penicillin for 5 days after the extraction. What I didn't mention (this is not my week!) is that I developed a periodontal abscess on tooth 11 (root canaled and crowned) and had it traced yesterday by my dentist with a piece of gutta percha and an x-ray. It is very close to the gumline so they suspected that it was periodontal and not a tooth abscess. This happened last year also. The periodontist opened my gum, looked for a crack, found none, attributed it to a pocket, did a guided tissue regeneration and all was well....til Saturday when a big white bump appeared again. It drained on its own on Sunday after rinsing with salt water all day. I called, they phoned in a prescription and I went in yesterday to see what's going on. I am seeing an oral surgeon tomorrow for a consultation. I heard that sometimes they can't see tiny cracks and this can be what causes it. So I am faced with more surgery and they may find nothing again, or extraction if they do find a crack or just feel it's a goner, or leaving it and praying.

I also have to talk to them about a horizontally impacted wisdom tooth (lower, my luck) that has now developed resorption. I am a nervous wreck over all this at the same time. My dentist and the oral surgeon saw the x-ray and both said take another x-ray in a year or two, they didn't seem alarmed. I have an immense fear of this extraction's danger, dry socket, paresthesia and I am petrified. I am almost 60 so wish I had done this when I was young, they saw it and never advised me and I certainly didn't know about this stuff as a younger person. Again, thanks for the advice regarding the extraction site and the great information about the muscle and soreness. I just used 2 mirrors and cleaned the first molar very carefully...there was some food on it and I used a rubber tip to gently swab it off and brushed it very carefully, not touching the extraction site. You're a Godsend and I will let you know the outcome of my consult if that's ok.

Hi Sandy,

Your tooth problem with #11 is very typical with root canaled teeth and it is referred to as a perio/endo infection. Our body has a way of trying to rid itself of irritants and it does so by causing an inflammation to occur. In your case, your tooth is the irritant and the opening of the gum pocket is your body trying to get rid of it. Infectious bacteria set up house in the pocket because it's warm, moist and dark. Irrelevant of how many times your periodontist opens this up, or how many antibiotics you take, you will continue to have an infection because the tooth is not healthy and the body will continue to try to get rid of it. This type of chronic infection will spread to other teeth and other areas under the gum so long as the irritant, the tooth, is present. This is a situation where the tooth should come out sooner than later. Every time it develops a fistula (bump on the gum) more of the bone has become involved as the bacteria has tunneled through the bone trying to let off some pressure. This is not a healthy condition for your overall well being.

I know all the tactics that are used to pinpoint the origin of the infection with the gutta percha and flapping open the gum tissue looking for a crack in the tooth.......... there may or may not be a crack but in this situation it is simply an infected tooth irritating the bone and gum tissue.

Your impacted lower wisdom tooth........ unless you have pain or there is cyst or area of infection on the radiograph, you probably could leave this alone for now. However, you may want to inquire if this tooth is in any way negatively affecting the molar in front of it. Is it pressing up against the molar causing a periodontal pocket? If it is, then you may want to ask how they would proceed with removing it.

I know none of this is pleasant......... far from it!!! I would address tooth #11 ASAP because it can slow down the healing of the other surgery that you had because there is a chronic infection there taxing your immune system.

I know you are very worried and that is understandable. I think if you keep pushing forward dealing with one issue at a time, you will get through this quicker than you imagine and you will be ok!!!

Please continue to keep us in the loop ~'.'~
Bryanna

Thanks again. I am having the consult today but another question. Is extraction of 11 painful? I have heard that it's the toughest tooth to pull although my dentist said the root doesn't look as long as most. I am asking because even though I have been awake for the last 3 extractions which took about 2 minutes, this scares me and maybe I'd be better off with iv sedation. What has your experience been with your patients? How long does it usually take and do you feel any pain? Another question is can the resorption on the wisdom tooth just stay that way forever and never need to come out? Third questions, what do they give you to temporarily put in the place of a tooth like 11 that shows, while you're healing and have to go outside and not look like a jack-o-lantern :-(

Hi Sandy,

The eye teeth or incisors, teeth #11 and 6 can have long roots. However, an oral surgeon or a dentist with alot of oral surgery experience can remove those teeth without a problem. No it should not hurt.

Our eye teeth, 6 and 11, are considered the cornerstone of our upper arch and it is important to replace them temporarily during the healing phase of the extraction and then permanently once the area has healed.

Temporary replacement can be a removable partial denture that either has just that tooth on it or that tooth plus any other missing teeth on the top with exception to the wisdom teeth. Permanent replacement once the area has completely healed could be either another removable partial denture or a dental implant (depending on the health and stability of the bone) or a multi unit fixed bridge.

Your wisdom tooth....... If your wisdom tooth is causing root resorption on your second molar, then it should be removed. This type of resorption will progress and you will eventually end up losing the second molar as well. Is that where the resorption is located??

How did your consult go today?

Bryanna

hi , can someone help me please, i had my right lower mouler extracter over a week ago, its still sore, my teeth next to the wound both hurt, my gum still has a whole in it. i cant eat on it as of yet, i checked it every day and it does not look like its healing. i have been using a mouth was 4 after dental. to gegin with it was white on top of whole bt i believe thats where it was healing, bt now its just a whole. what should i do. as i am living on pain killers at the moment. thanks.

Hi duane28,

It is not uncommon for the adjacent teeth next to the one that was extracted to feel sore or achey for a couple of weeks after the tooth was extracted. HOWEVER, your description of the hole and the pain sounds like you may have a dry socket. This condition too could cause the adjacent teeth to hurt or feel sore.

A dry socket needs intervention from your dentist. I would suggest that you make an appointment as soon as possible for him to check it out to determine if it needs to be treated.

A note about rinsing....... the only thing you should be rinsing with is warm salt water, NOTHING ELSE. Mouthwashes contain alcohol and this will cause a dry socket to occur. Herbal rinses will irritate the wound and can cause a delay in healing resulting in a dry socket as well.

I hope this information is helpful to you..... please let us know how you are doing.

Bryanna