Pain 6 weeks post crowb lengethning and extraction
 

Sorry if this is a bit long but I am looking for advice. A few years ago I had a crown put on the 2nd molar from the back on the bottom. In March of 2014 my dentist suggested I get a new one bc it didn't look good. She tried to put it in on but I was in great pain. I had 2 root canals and took clindamycin for infection. After the temp was put on it had to come off the same day due to intense pain. After waiting for the gums to heal the new crown was finally put on with permanent cement. Fast forward to Oct. It came off and I went for gum lengethning surgery. I was in so much pain I went to an oral surgeon who pulled the tooth. He said I had an infection and I went on 2 more rounds of antibiotcs. I also developed terrible dry socket almost immediately. A covering doctor packed the site and the os packed for about 2 weeks post extraction. The os says the site is healing but I cannot eat on that side at all and I am highly sensitive in that area. I have pain in that area, pain that goes down in my jaw and neck. Pain gets worse with cold weather. Also the site seemed to finally start to grow over from the side near the cheek but has stopped growing. From the outside the area looks pink and healthy. I'm about 6 weeks out from the surgeries. Should I get a 2nd opinion or continue to be patient in pain?

Welcome Cc83. :Wave-Hello:

Hi Cc83,

I am in the dental field and can offer you some information here. So sorry for my delay in replying to you.

First let me inform you that the crown work, root canal therapies and crown lengthening procedure were heroic efforts, not healthy or helpful just heroic, to retain a very infected tooth. None of those procedures could in any way have cured the infection brewing in that tooth. As ridiculous as this sounds, dentists are educated to "retain" teeth, even those that are infected. So unfortunately, in performing all of those traumatic procedures, further damage and inflammation was caused to not just the tooth, but the bone around it. On top of that you developed a dry socket which was to be expected given the degree of trauma in that area.

There is a good possibility that as this site heals, you will have quite a bit of bone loss. During the healing you can experience referred pain in the adjacent teeth or up into the jaw... ear.. etc. At any rate, this type of dental situation will take a very long time to heal. But it needs to be monitored periodically, every 6-8 weeks for a few months, with an xray to be sure that there is no recurrence of infection.

I would avoid eating on that side of your mouth and especially avoid eating anything that requires a lot of chewing. Your jaw bone is trying to repair from a lot of trauma and it needs to rest.

If it is at the 6 week mark, I would go in for an evaluation and a post op periapical xray.

Hope this information is helpful to you.
Bryanna








She tried to put it in on but I was in great pain. I had 2 root canals and took clindamycin for infection. After the temp was put on it had to come off the same day due to intense pain. After waiting for the gums to heal the new crown was finally put on with permanent cement. Fast forward to Oct. It came off and I went for gum lengethning surgery. I was in so much pain I went to an oral surgeon who pulled the tooth. He said I had an infection and I went on 2 more rounds of antibiotcs. I also developed terrible dry socket almost immediately. A covering doctor packed the site and the os packed for about 2 weeks post extraction. The os says the site is healing but I cannot eat on that side at all and I am highly sensitive in that area. I have pain in that area, pain that goes down in my jaw and neck. Pain gets worse with cold weather. Also the site seemed to finally start to grow over from the side near the cheek but has stopped growing. From the outside the area looks pink and healthy. I'm about 6 weeks out from the surgeries. Should I get a 2nd opinion or continue to be patient in pain?[/QUOTE]

Reply to Bryanna
 

Thank you Bryanna. It was very helpful. I still do not eat on that side at all. While the pain has lessened I still cannot have any food or liquid touch the site. I am going to my os on Tuesday. I will ask him for that xray. I know that diagnosis cannot be done over the Internet but does it sound like I have a jawbone infection? I asked my os about my jaw bone and he said there's no way to know. Also my last xray was the day of the extraction. Should I have already had an xray? Should I see another type of doctor regarding infection bc my os seems very uninterested in my case.
Thanks again.





She tried to put it in on but I was in great pain. I had 2 root canals and took clindamycin for infection. After the temp was put on it had to come off the same day due to intense pain. After waiting for the gums to heal the new crown was finally put on with permanent cement. Fast forward to Oct. It came off and I went for gum lengethning surgery. I was in so much pain I went to an oral surgeon who pulled the tooth. He said I had an infection and I went on 2 more rounds of antibiotcs. I also developed terrible dry socket almost immediately. A covering doctor packed the site and the os packed for about 2 weeks post extraction. The os says the site is healing but I cannot eat on that side at all and I am highly sensitive in that area. I have pain in that area, pain that goes down in my jaw and neck. Pain gets worse with cold weather. Also the site seemed to finally start to grow over from the side near the cheek but has stopped growing. From the outside the area looks pink and healthy. I'm about 6 weeks out from the surgeries. Should I get a 2nd opinion or continue

One more question
 

Bryanna,

Is it possible that the sensitivity is the last molar, the one with the deep filing and the crown. If it is I plan on getting it extracted. Is tooth sectioning a surgical way to get a tooth removed without one straight pull? I am concerned about getting dry socket again.

Hi Cc83,

I think that area of your mouth has been through so much trauma and infection may or may not be a contributing factor. Anytime a tooth is extracted there is a risk of developing a necrosis in the jawbone this is referred to as osteonecrosis, osteomyelitis, NICO or cavitation. This possibility is elevated if the tooth extracted had been root canaled due to the abundance of bacteria that resides in and around root canaled teeth. Sometimes this can be detected on a dental radio graph, other times a CT scan, and other times only be means of a small surgical intervention into the site.

If your OS is not interested in further evaluation of your case, then yes, see someone else. I personally do not recommend dental practices that are rely solely on insurance money as they tend to be less interested in the patients care and often not as skilled as someone in private practice. Sorry, but that's the name of that game :/

Bryanna



[QUOTE=Cc83;1109135]Thank you Bryanna. It was very helpful. I still do not eat on that side at all. While the pain has lessened I still cannot have any food or liquid touch the site. I am going to my os on Tuesday. I will ask him for that xray. I know that diagnosis cannot be done over the Internet but does it sound like I have a jawbone infection? I asked my os about my jaw bone and he said there's no way to know. Also my last xray was the day of the extraction. Should I have already had an xray? Should I see another type of doctor regarding infection bc my os seems very uninterested in my case.
Thanks again.

Cc83,

It is possible that the last molar is ticked off from all the trauma that has occurred in the area in front of it. Make sure that the xray you have done shows that tooth in it's entirety. Have the dentist take 2 periapical xrays explaining that you want the full length/width of the last molar and the extraction site to be seen on the xray.

Yes, tooth sectioning of a molar for extraction is actually less traumatic to the jaw bone because the dentist is able to luxate (dislodge the tooth from the bone) in 2 pieces rather than one. Depending on the case, this is often preferable over removing the molar tooth in it's entirety.

Dry sockets occur for various reasons. Most often it is due to the malformation of the blood clot or the clot had become dislodged. It is important that the surgeon debride the extraction site thoroughly and get a real good blood flow going as this helps with the healing.

If you are hesitant about using that OS, please seek someone else.

Bryanna





Is it possible that the sensitivity is the last molar, the one with the deep filing and the crown. If it is I plan on getting it extracted. Is tooth sectioning a surgical way to get a tooth removed without one straight pull? I am concerned about getting dry socket again.[/QUOTE]

Thank you
 

Thank you Bryanna. I went for a second opinion and got the X-rays you suggested. The last molar is fine and the bone beneath the extraction site looks good as well. He said it would just take time for the sensitivity and pain to go away. I just am finding it hard to deal with all this pain and sensitivity. The k you again for your advice.

Cc83,

As I said, that area of your mouth has been through so much trauma in a short period of time. It would be normal for it to take several weeks if not longer for it to really calm down. In the meantime, make sure you brush and floss thoroughly to keep things healthy and be mindful of what you are eating so that you can avoid over working your jaw muscles.

Keep us posted!
Bryanna

Last week I went back to my os and he said he will keep seeing me until I am pain free. He said that I still have exposed bone and that is why the area is so sensitive. It is now 2 months post op and I was in so much pain today I was crying. Also the other side of my mouth is starting to ache bc basically I have been using only that side to eat since March. I am also getting bad headaches. I go back to the os in 2.5 weeks.