Hi Bryanna: trouble 2 weeks after wisdom tooth extraction.
 

Hello Bryanna and all,

I was googling the troubles I've been having since my Wisdoom tooth was extracted; and I found this site. I read several of Bryanna's posts and I'm hoping she or others can help.

Here are my details:
-29 years old
-In good health. Recent physicals good.
-Occasional drinker but not since the extraction. No tobacco products but occasional marijuana.
-No medication

Exactly 2 weeks ago I had 1 wisdom tooth removed on the lower left side. Prior to the extraction it was painless and not abscessed or anything. My dentist wanted it removed he said because "it is impacted and could be trouble down the road." So after an X-ray or two I went into an Oral Surgeon to have it done.


The extraction was difficult, I was awake with local novocaine to numb it. It took 45 minutes to remove the one tooth. With much sawing and cracking to the tooth to bits. Finally they did dissolvable stitches and sent me home.

I was put on Omoxicillin and Vicodin and told come back in a week. The bleeding took 12 hours to cease.

I went back a week later. More X-rays, still some pain. He found and removed a bone chip but said the clot wasn't big enough to fill the socket. He said he was glad to see it was not dry socketed or infected, but wanted to pack it with this clove packing to help my pain and fill the exposed socket so he packed it for 4 days. I went back again and he said it "looked good come back later this month" and he gave me more Vicodin which makes me woozy.

So now here I am 2 weeks post extraction. I don't have pain like before... However the teeth next to extraction site are tender if I chew on that side, and I have to keep flushing out my socket with some tenderness still in the gums. Also the packing he had in made the socket LARGER which I thought was weird.

Furthermore the tooth directly next to the empty socket is SENSITIVE to hot and especially cold, because its base is so exposed deep in be socket. Also the socket doesn't seem to be closing much. I feel another sharp piece I am pretty sure is another bone chip. It feels like the other bone chip did.

Is all of this normal? I feel like what was a painless tooth has turned into a nightmare. I wish I never had it removed and Im just so upset.

I would appreciate any advice.

-Kev

Hi Kev,

Your situation is fairly typical. Lower impacted wisdom teeth can be a bit of a PITA to remove as they sometimes get locked into the bone. It is also typical for small bony fragments to come out as the site is healing. These are actually pieces of the jaw bone that splintered during the surgery. These usually pose no harm and either come out on their own or the surgeon removes them if they cause inflammation, infection or pain.

What are you irrigating the socket with? You should only be using warm salt water and use only gentle pressure with the irrigation syringe. No mouthwash what so ever as the chemicals and alcohol in it can prevent the site from closing all the way. And never use force with the syringe.

I know you think why did I do this in the first place since it wasn't bothering you before you had it done. Well if this tooth was positioned in a way that it was (or could have been) damaging to the second molar, then it was wise to remove it. It is typical for the other teeth in that quadrant to feel sore to chewing and for the second molar to be sensitive until the area heals closed. There was quite a bit of bone manipulation during the removal of that wisdom tooth and the nerves and ligaments in that quadrant are upset about all of that. So they will calm down. The sensitivity in the second molar may be due in part to gum recession. If that doesn't subside completely then your dentist may be able to cover any exposed root surfaces after the extraction site has healed.

Hope this is helpful to you. If you feel the site needs to be rechecked by the surgeon for any reason, don't hesitate to do so.

Also... refrain from smoking (anything) or drinking alcohol until the site closes over completely :)

Bryanna

Hi Bryanna,

Thanks so much for the reply, I think its neat you help out so many folks here.

I have been irrigating it with warm salt water using a syringe they gave me. I normally use alcohol free mouthwash, but since the extraction I have been diluting it 50/50. I will stop however and just do the warm salt water gargles and syringe going forward after brushing. (Currently using sensodine)

Yes the base of the tooth next to the extraction site is exposed and the Surgeon says this is the cause for sudden extreme sensitivity. He said tissue should grow to cover it, but I don't see any tissue growing around the base of that tooth and it doesn't appear to have progressed or desensitized. He said he might have to do a tissue graft to cover it if tissue doesn't grow over the base.

I'm worried how little my tissue growth has progressed.

He also said there is normally a little nub of bone between teeth and gum tissue between teeth, but since my impacted wisdom tooth was literally sideways there was not tissue or bone between the wisdom tooth and the now exposed molar. He said bone should grow next to the newly exposed tooth and tissue should cover it. I sure hope so!! It's so sensitive to cold especially.. Even breathing through my mouth on a cold day causes the sensitivity to flare... So as long as Im not eating or breathing I'm OK :p

Do you know how long the neighboring teeth on that side will hurt to chew with? (I've been mostly chewing on the other side)

Hi Kev,

Thanks for your warm reply to me. Very appreciated :)

The angulation of the wisdom tooth had actually deteriorated the bone that normally is found in between the teeth. New bone and tissue will form there, but it may not be adequate. It is a wait and see situation. The sensitivity should lesson but it may not go away completely without some intervention. Again, wait and see. Using sensodyne toothpaste or prevident fluoride toothpaste (rx from your dentist) on that area may be helpful in reducing the sensitivity.

As for the length of time before that quadrant calms down... every one is different. It heals continuously so that is a good thing, right?! It is bes to avoid eating on that side so as to give those teeth a rest. Soft foods however, are okay to eat on that side. Whatever you feel you can tolerate.

Hope this was helpful to you. Check back with us soon...

Bryanna

Thanks again,

I'll be sure to come back an update on how things turn out.

I noticed this morning the sharp bone chip is gone, I suppose it worked its way out in my sleep. So that's good!

I still can't believe how sensitive my molar is though! Oddly enough when food debris collects in the socket while eating the sensitivity goes away. I guess this is because the food debris acts as a barrier to cold liquids stopping cold from touching the exposed root. Of course after each meal I flush out the socket with warm salt water to keep it clean... so the sensitive pain returns.

I sure hope my bone and tissue grows quickly to provide a natural barrier for my now exposed tooth root.... Because Ouch!

Update: (and a question)

Hey Bryanna!

I went to my dentist yesterday for my sheduled 6 month cleaning which came up by coincidence. (This was my regular dentist, not the Oral Surgeon who took out the wisdom tooth 3 weeks ago. I am scheduled for a follow up with the Surgeon in 1 more week.)

After the cleaning was done by his assisitant he came in to look at things. He said he was surprised at how much of the root was exposed below the "Crown" and "Neck" of this molar next to the socket. He said this exposure was the reason for the sudden sensitivity pain in that molar. I asked him if he thought normal bone or tissue would eventually grow to cover this newly exposed part of the root and he said "no, I dont think so." The socket is still open and I am keeping it clean, but the way the tissue is closing it doesnt appear to be growing towards the exposed root this molar. It looks more like to socket is collasping in on itself and slowly closing.

This is a bummer. I think this means once the socket fully closes my root will still be left exposed on this molar next to the extraction site. The sensitivity hasnt gotten any better either, infact I feel its gotten worse. :(

When I see the Oral Surgeon next week, Im going to ask about a tissue graft to cover the root. He had mentioned something about it before, and I'm worried it might be the only way to correct this sensitivity. But if thats the way to fix it than I want it done, the sooner all of this is over the better. Also I'm not too keen on my root being exposed forever if I do not get a tissue graft. That cant be good for the long term health of the tooth.

Also, I wanted to ask...... is it normal to still be experience tender pain when chewing with that tooth after 3 weeks? This "tender pain" is seperate from the sensitivity pain to hot/cold but is affecting the same molar. This pain only occurs when pressure is applied ontop of that tooth while chewing.

There is no pain when my mouth is at rest.

The sensitivity pain is an 8-of-10 when hot/cold touches that root. And the tender pain is a 3-of-10 when chewing. All of my other teeth, gums, and tongue feel fine. So it's just the one tooth that still hurts me.

Thanks in advance for any input/advice, gosh I just wish this was over :(

-Kevin

Hi Kevin,

Yea, like I said the wisdom tooth was up against the second molar which either prevented bone growth in that area or the bone deteriorated. The new tissue looks like it is collapsing because the bone level is very low there. When you see the oral surgeon ask if he is going to put in a bone graft as well as harvested tissue. Sometimes they do both.

In cases like yours, it is very normal for that second molar to be sensitive/tender to chewing. The tooth is not being supported properly in the bone which hopefully will get better on it's own or after you have the graft done. Does that tooth have a large filling or crown?

Bryanna

No, that tooth has not had work. Looks pretty good too if it was tender and sensitive!

He did mention grafting, I think he even might have said bone in addition to tissue. But I'm not sure, I guess I'll find out next week.

Whose bone are talking about? Lol

Does he transfer my bone and tissue? Where does he take it from?

Hi Kevin,

Well it's not my bone :)

A synthetic calcium material can be used or sterilized bone granules from a cadaver source. You could use your own bone but that is not always recommended. The tissue would be taken from someplace in your mouth... perhaps your palate. The surgeon will explain all of that to you in detail.

Please let us know what he says....

Bryanna

Hey Bryanna,

I hope you're doing well.

I just got back from the Oral Surgeon. I explained how I was still having sensitivty pain to hot/cold. And also how when I chew with that tooth it hurts when the pressure of chewing is applied to the tooth. He said he understood the 2 distinct types of pain I was still having. He asked if the pain when chewing was sharp or dull/achy and what food set it off. I said it didnt seem sharp more achy and chewing softer foods is OK, but crunchy things or steak mean more firm pressure is applied and thats when I feel the chewing pain. And obviously anything cold sets off the sensitivity pain.

It has been exactly 1 month since the original wisdom extraction.

He patiently listened to my symptoms, and went over my Xrays again and examined my mouth again. He tapped my teeth, used his mirrors, and had me bite this "carbon copy" paper to check where my teeth meet. He kept patting me on the shoulder and genuinely seems to feel bad about the trouble Im having.

His diagnosis was that this tooth had the root and "pulp" inside the tooth traumtized during the extraction. And this was causing the pain when chewing. He said the sensitivity was due to the small bit of exposed root where the wisdom tooth and tissue had been.

I asked him if he thought this tooth might have been fractured since it was next to the wisdom tooth that was extracted, but he said no, he said he did not see any fractures on the X-ray or during examination. He said other than the pulp trauma and exposed root the tooth seemed healthy.

He said there are 2 types of pulp trauma. One type heals and the other type is permanent and would require a root canal. He said he thinks the pulp in my tooth will settle down over the next month and that he didnt think any permanent damage was done to this tooth. (Im hope he's right!!!)

Now he is sending me back to my regular dentist to have 2 things done: The first is a liquid gel will be applied to the exposed root to "desensitize" it untill tissue can naturally grow to cover it. The other thing is to have this tooth filed down ever so slightly to releive the pain from pressure when chewing. He said after having these 2 things done he wants me to come back in 1 month to see him.

When I go back to the oral surgeon in 1 month he is hoping the pain when chewing will have subsided, and he is hoping enough new tissue will have grown around the exposed root to defend it from hot/cold naturally. If not he said he will be doing a bone PLUS tissue graft, but usually he only has to do that with people in their 50's and older. Since I'm 29 he thinks enough tissue will regenerate and he will only do the graft if all else has failed...

-Have you heard of the 2 types of pulp trauma he talked about? Where one type heals and another is permanent?
-Is it possible if this tooth was fractured below the gum line he could miss it in X-rays?
-Is there any other advice or questions I should be sure to ask next time I see him?

Thanks again for all your help. Having this discussion with you has made me feel more informed before going to see him and a little less frustrated with the situation. Take care!

-Kev

Hi Kev,

Once again thank you for the kind words.... really thoughtful of you ~'.'~

I agree with most of what the oral surgeon has told you with the exception of doing a root canal if that nerve dies in the tooth. You also have the option of removing that tooth if it should die which means avoiding chronic infection in your tooth and jawbone. Just thought he should have informed you of that is all.... :)

<<Now he is sending me back to my regular dentist to have 2 things done: The first is a liquid gel will be applied to the exposed root to "desensitize" it untill tissue can naturally grow to cover it. The other thing is to have this tooth filed down ever so slightly to releive the pain from pressure when chewing. He said after having these 2 things done he wants me to come back in 1 month to see him.>>

THE DESENSITIZING GEL IS A TOPICAL APPLICATION THAT DOES NOT LAST LONG. BUT IT MAY BE TEMPORARILY HELPFUL. ALSO APPLYING FLUORIDE DIRECTLY TO THAT SENSITIVE AREA DAILY MAY BE HELPFUL UNTIL THE GUM GROWS BACK. FILLING THE TOOTH DOWN TAKES THE PRESSURE OFF OF IT WHEN YOU ARE CHEWING. IT ONLY HAS TO BE REDUCED MINIMALLY TO BE AFFECTIVE. ALSO AVOID CHEWING ON IT AS MUCH AS POSSIBLE, ESPECIALLY HARD OR CHEWING THINGS. THAT ALONE WILL CALM IT DOWN.

<<When I go back to the oral surgeon in 1 month he is hoping the pain when chewing will have subsided, and he is hoping enough new tissue will have grown around the exposed root to defend it from hot/cold naturally. If not he said he will be doing a bone PLUS tissue graft, but usually he only has to do that with people in their 50's and older. Since I'm 29 he thinks enough tissue will regenerate and he will only do the graft if all else has failed...>>

YOUR ORAL SURGEON IS FUNNY..... AGE ALMOST HAS NO BEARING ON THIS SORT OF THING UNLESS YOU HAD RECEDING GUMS TO BEGIN WITH.... WHICH CAN OCCUR AT ANY AGE. HE WAS BASICALLY PUMPING UP YOUR EGO... WHICH IS OKAY, IT'S A MALE THING ;)

<<-Have you heard of the 2 types of pulp trauma he talked about? Where one type heals and another is permanent?>>

YES, OF COURSE. ANYTIME A TOOTH IS HIT, DRILLED, PI**ED OFF, THE PULP INFLAMES. WHEN THE "TRAUMA" IS ELIMINATED, THE PULP COMES DOWN.... PROVIDING THE "TRAUMA" IS NOT CONSTANT FOR ANY LENGTH OF TIME. THAT IS WHY I SAY TO AVOID CHEWING ON IT AS MUCH AS POSSIBLE.
IF THE PULP BECOMES PERMANENTLY INFLAMED, THEN THE NERVES START TO DIE OFF IN THE TOOTH AND THERE IS NO RETURN. IT IS EITHER ROOT CANAL OR EXTRACTION. AND YOU KNOW WHICH ONE I WOULD CHOOSE ;)

<<-Is it possible if this tooth was fractured below the gum line he could miss it in X-rays?>>
YES.

<<-Is there any other advice or questions I should be sure to ask next time I see him?..

FIRST, STOP CHEWING ON IT. WHEN YOU SEE HIM, IF HE SUGGESTS DOING A BONE GRAFT JUST DISCUSS YOUR MATERIAL OPTIONS WITH HIM SO YOU CAN MAKE AN INFORMED DECISIONS.

Keep us posted..
Bryanna

Hi Bryanna,

Just a quick update.

Unfortunately I'm still having pain when chewing with the molar next to my wisdom tooth extraction site. It's the same dull aching pain in just that one tooth and its only when chewing.

I am also still having sensitivity to temperature with that tooth as well.

The socket where the wisdom tooth was is mostly closed now, but the root of this molar next to it is still exposed which is what leads to the temperature sensitivity. If anything cold touches that molar I pay a very dear price... OUCH!

I go early next week to have my regular dentist "file" it down a tiny bit. I guess this will releive some of the pressure when chewing on that side which will hopefully mean I will finally chew pain free. But I dont think this will help the sensitivity issue.

On March 7th I go back to the oral surgeon.

Wish me luck!

I hope to enjoy chewing again someday!

Hi Kev,

The reduction in the occlusion may help to a certain degree while chewing but no it will not do anything for the sensitivity :/

If there is only a small area of root exposed on that tooth, then your dentist may be able to put a tooth colored filling over it. This would protect the root and prevent the sensitivity. Depends on the individual circumstances. Ask him when you see him next week.

Thanks for checking in.... keep us in the loop!
Bryanna

Hi Kev,

I read each of your thread and experience and I am undergoing the same excruciating pain. My oral surgeon today said that there is nothing that can be done regarding the pain. Can you please tell me how did it go for you?

Hi Bryanna,

Can the filing stay snug on side of the tooth? Would it not come off?

Hi danin,

It is common practice to place white colored dental fillings on the sides of a tooth. Often the area is located along the gum line where there is some gum recession and some root is exposed causing sensitivity.

The area to be filled is roughed up with a drill to help give the filling some retention. They usually last for a few years before needing to be replaced.

Bryanna


[QUOTE=danin;1040455]Hi Bryanna,

Can the filing stay snug on side of the tooth? Would it not come off?

Time to wait
 

Hi Bryanna,

Thank you for your quick and kind response. My surgery took place on Dec 4th, how long should I wait before considering any options such as the side filling that you mentioned or tissue grafting? It hurts every time something cold or very hot touches that last molar and drives me miserable. The dentist said that this is something that cannot be fixed and I'll have to live with it.

Hi danin,

It is usually okay to do the filling next to the extraction site once the gum tissue closes over the hole.

If your tooth is that severely sensitive and your dentist is dismissing it..... then it might behoove you to see a different dentist :)

Bryanna

Pain is 90% gone
 

Hi Bryanna,

Thank you for being so kind and helpful for everyone who asks you in desperation. I'd like to simply update and let you know that as time is passing by (in my case 3 months), the holes are healing up fine and the sensitiveness is gone by almost 90%. For the 10% I simply feel it, but it doesn't hurt. I would like to thank you once again and hope my experience gives someone hope who was in my shoes 3 months back.

Similar Symptoms
 

Hi Bryanna,

I found this thread while looking up reasons for my recent symptoms. I am a 19 year old female and I just got two of my wisdom teeth (bottom ones) removed at my normal dentist on March 3rd 2015. They were impacted and causing me pain on the left side. It's been 8 days since extraction (which my dentist said went well) but I started to experience additional pain 3 days ago. I'm not sure of what is causing the pain, but it is affecting the first molar, not the molar next to the wisdom tooth but the one after. There is only pain on the left side, and that is also the side that was experiencing pain before extraction under the assumption that the wisdom tooth was damaging the neighboring teeth. The tooth that feels pain has been heavily worked on in the past and has 2 large metallic fillings. It has had history of cold sensitivity in the past but never to this extent.

The past two days the pain was on an off, mostly occurring when I ate or drank anything, but today it has been in constant pain, and is unbearable. I am scheduled for a post op check up in 3 days, but it would make me feel better if I could go to my dentist with some knowledge as to why I'm feeling pain.

here are the symptoms.
1. Throbbing and pain when blood rushes to head
2. constant dull aching pain
3. high sensitivity to both hot and cold
4. pain when chewing even when not chewing on the molars.
5. pain when pressure is applied

I have some ideas as to why it's hurting. I think there might be a fracture on the tooth which is causing the pain. I can see a hairline crack extending horizontally on the tooth, which seems abnormal for a tooth crack. I am not sure if it has always been there or just recently appeared after the surgery. Another theory is that there was nerve damage from the application of needles to numb the surrounding area. I needed quite a few.

I would just really like to know if these seem like likely causes for my pain or if there are any other reasons that I don't know of and what kind of treatments, if any, there are.

I really hope I don't need to go through another tooth extraction and that this is just a side effect from the wisdom tooth removal that will subside with time.

-Tab

Hi Tab,

When a patient is reasonably comfortable for the first few days after the extractions and then develops pain after that, it often indicates a dry socket. The pain with a dry socket can cause other teeth to hurt. I am not sure if that is the cause or a contributing factor to what you are experiencing in your first molar. But if the pain becomes steady and/or gets progressively worse, or you develop swelling or a fever, do not wait to see the dentist, get in asap.

Regarding the restorations and possible crack on the first molar.. metal mercury fillings deteriorate over time which causes openings to occur that allow bacteria to get in underneath and around the filling. It is also typical for teeth with these fillings in them to fracture because metal fillings do not bond with the tooth like white composite fillings do, instead they act like a wedge in the tooth. So over time, the tooth surrounding the metal filling becomes weak and is prone to fracture.

The symptoms you describe on that tooth are typical of tooth nerve pain. Not neuralgia type pain from an injection. This could mean that the fillings have open areas....could be decay underneath the fillings.... could be an irritated nerve or beginnings of infected nerves in the tooth, could be the tooth is fractured... etc.

The tooth needs to be evaluated by the dentist with at least one xray to determine if there is decay or an infection brewing. The dentist should also check for a fracture, he can do that with a bite stick. Just tell him your symptoms and he will do the xray and the fracture check.

Hope this info is helpful to you. Please keep us posted.

Bryanna



.

Hello again,

I just came back from the dentist and my doctor said the sockets from the wisdom teeth removal are healing well and look to be in good condition. He gave me a syringe to flush out any debris from the hole and they should close up within the month.

I notified him about the pain I was experiencing in my first molar on the left side and I got an X-ray. Turns out it was infected since the mercury filling hadn't never been replaced and was installed a long time ago (he said he doesn't even know how long ago haha). That's what was causing all the pain and sensitivity.

I was prescribed antibiotics and 600mg Motrin for the pain. I'm going to have a root canal preformed on the 21st, I hope this will solve my pain issues for good!

Thank you for the replies and insight, I'm really glad that I don't have a dry socket or any other serious problems concerning my wisdom tooth extraction. Hopefully the root canal procedure will go smoothly and painlessly!

Sincerely,
Tab

Hi Tab,

Glad to hear the oral wounds are healing. It is very important to be very gentle when using the irrigation syringe. Only use warm salt water or plain warm water in the syringe. If you use anything else to irrigate with you will slow down the healing.

Regarding the issue with the tooth that is hurting you.... Just to help clarify what a tooth infection really is so you can understand what is going on more clearly. Tooth infections do not show up on a dental xray until the bacteria has spread from the tooth into the periodontal ligament or jaw bone. That means that the infection is not new it is something that was present inside of the tooth for quite some time. Also, most tooth infections typically have no symptoms until the infection has spread. This infection might have been visible on the xrays that were taken prior to your recent extractions. Did your dentist mention anything about that tooth to you prior to today?

Also, a tooth does not become infected because a mercury filling was not replaced. They become infected because either a piece of the filling broke off or the filling was deteriorating and bacteria was getting in and decaying the tooth underneath the filling. The decay does not happen suddenly and either problem is visible both clinically and on dental xrays quite some time before the decay occurs.

There is a lot of information on this forum about root canals. If you are curious about learning more about them, just skim through some of the threads about root canals. If you have any questions, please feel free to ask them here.

Bryanna

Hi Bryanna,

I have been using mild salt water to clean out the holes, they're actually quite small since the stitches were in places for almost two weeks. There was some bad tasting fluid coming from the right side, but after using the syringe it has gone away. My dentist said the fluid was not a problem and would go away with healing.

Thank you for clarifying that, I had no idea. The tooth had been bothering me for a while but I thought the sensitivity was only coming from the fact that the filling is quite large and close to the nerves. I actually hadn't been to the dentist in 3 years until I got my wisdom teeth removed haha, shame on me.

My dentist did not mention anything prior to my visit on saturday. He showed me the X-ray of my infected tooth and my untrained eyes couldn't really see anything, but he said there was an infection. Well I have no clue what's going on... I guess the infection has spread.

I'll be sure to do some sifting around in the root canal forums.

Thank you so much for all of your help and for just being here and doing such a kind thing for all these people looking for help.

Tab

2 year update
 

Hey everyone,

I just wanted to come and update my post I originally made 2 years ago.

I see a couple people stumbled across my post through Google searches and had similar issues.

I am happy to report that the sensitivity has completely dissapearred and the pain when chewing has completely dissappeared as well.

But boy.... did it take a while!

The dull aching pain around the extraction site when chewing firm or crunchy foods took about 3 months to subside. Now it never hurts.

The hot/cold sensitivity was really bad for the first few months after the extraction. During the following summer I remember it only bothered me occasionally, and only if something was REALLY cold.

For the last year I have had zero discomfort, I seem to have healed 100%.

Also the socket where the wisdom tooth used to be kind of shrunk and closed up. Now it is a smooth healthy pink tissue sort of shallow divot.

I do still have to be careful to clean behind that tooth next to where my wisdom tooth used to be. But no biggie.

My advice for anyone who finds themselves in a similar situation is be patient, keep the extraction site clean until it smooths over, don't smoke for 2-6 weeks after extraction, and USE FLOURIDE RINSE. That helped a lot. I remember in the months following the extraction I would brush and floss and then hold FLOURIDE rinse inside my mouth over the whole area for several minutes before spitting it out and going to bed.

Hope everyone else who has this issue heals faster! It feels so much better not to worry about it now.

But boy... it sucked at the time :/

Thanks again to Bryanna, I hope you've been doing well.