Extreme swelling post extraction?
 

Hi Bryanna,

Paranoid patient here. So, first, follow-up. The dentist said the "short crown" was likely due to my gums being more swollen when he placed it due to the lupus. It touched the gums when he placed it. He's wants to give it another month or two, and then said he will replace it free of charge if it still isn't right.

So, I had my extraction Monday. It was my first molar on my lower left, and the roots remaining from a previous second molar extraction, plus placing 2 implants. The extraction was really tough-I have very, very strong bones. He had to use the hammer/chisel thing for a good 10-15 minutes total, and take the tooth out in like 7-8 pieces over the course of an hour and 15 minutes or longer. I was up all night in pain despite having oxycodone (I take Vicodin for my lupus, so it's not strong enough for post surgical pain). It was the worst dental procedure I've ever had-the oral surgeon said it was a very, very hard extraction. He hates root canals (one of the reasons I like him) and was saying that anytime a tooth has had a root canal they're a nightmare to get out. The tooth was extracted because there was a crack in it, and I didn't want to wait until it hurt.

So my question is, I'm at about 36 hours and my cheek is HUGE! I'm nervous that something is wrong because it's never been this bad after dental work. I don't have signs of an infection-no warmth or fever, no discharge (except a little blood), and I'm on antibiotics. I have also had limits on what I can take anti-inflammatory wise, so I can only take around 6-8 Advil in 24 hours, so it can't really take down the swelling fast enough. He wanted me in this one anti inflammatory, but my lupus docs shot him down.

Is this normal? When should I worry? Luckily, I have all week off work to recover.

Thank for always sharing your knowledge, I appreciate it.

Hi socasusie,

You are not paranoid......... ..... just protective of yourself and you know your limits better than anyone else. I can relate to that completely ;)

The swelling does not surprise me. This is typically seen in patients who have had the extent of oral surgery that you have had. Just to warn you... it may get a bit worse before it gets better. With that said....anytime over the next 3-4 days if you develop severe or different pain, a fever, or hives call the oral surgeon. If you develop swelling on the inside of your mouth (tongue, throat) consider that an emergency. If the current swelling remains the same for another two-three days and then starts to subside, that would be normal. If at the end of 4 days it has not changed, call the oral surgeon.

Drink plenty of water.... water.... water. Keep flushing your system out. Eat soft nutritious foods, take your vitamin supplements and your probiotics.

Do not apply ice at this stage. You could apply a warm MOIST heat pack to that side of your face 3-4 times a day. Not dry heat.... moist only. Sleep with your head elevated so the blood doesn't pool in your face as that can cause more swelling.

You are so brave for taking all of this one at one time. I understand the reasons for it..... but it is still brave!

It's good that you are home and able to rest. Find a good book or pretty magazines to get lost in... just chill and take care of yourself.

Keep us posted.......

Bryanna

Thank you so much-I will, do all that you say. The pain is steadily getting better, that's actually why the swelling freaked me out. I will up my water intake!

Yeah, I'm hoping to start a new job so I really didn't have much choice on the timing. But just think, I'm now "caught up" on the emergencies, so after this I can focus on what to do to address all my root canals. I'm toying with the idea of a quadrant at a time to address them all, but haven't decided how to proceed. The good news is that my oral surgeon seems to understand and dislike root canals as well. I only have 13 root canals left to address.....

Ps-do you have any thoughts on metal free crowns vs porcelain fused to either base metal or gold?

Hi socasusie,

OMG... 13 more root canaled teeth to go!! You poor thing! I would bet that your health affliction is connected (to some degree) with those teeth!! Wouldn't it be great if your health improved once they were all removed!

Quadrant dentistry is often a wise plan for many reasons but mainly because it allows the quadrant to heal at one time rather than a little piece here and there. If you could manage to do that, that might be ideal for you.

Bryanna

Yes, I am in favor of metal free crowns and bridgework if at all possible.
Generally with implants, the crown will have a metal substructure. But you could speak to your dentist about other options and he can discuss that with his dental lab.

Bryanna

Thanks Bryanna-yep, I can't help but think they contribute. Although auto immune diseases run in my family, I can actually trace mine getting intolerable back to the 2–3 year period when I started getting all my root canals. So, while I don't think root canals caused my lupus, I do think it's what threw it over the edge.

Let's be honest, finding an oral surgeon who can support removing teeth with root canals is half the battle. And only 2 of those teeth are left on the bottom, the rest are on top, so really I'm making some actual progress.

Thanks for the info on the crowns-I actually did metal free for the last 2 implants. They are solid zirconium (which I know it technically metal, but not the same way) but since the opposing teeth are already crowned with porcelain crowns, I'm not as worried about it wearing them down. I just wasn't sure it was worth the extra money. I glad to know it was.

Finally, I've doing moist heat since your comment. The hard swelling when I touch my jaw has already fine down by like 30%. Woo hoo!

Thank you again for always making me feel better!

Hi socasusie,

You are very welcome :) Glad to hear that the swelling is subsiding. Continue to do what you are doing.

I am so glad that you have done your research and have chosen to make the changes to become healthier. I know that can be a difficult and expensive journey.... but it is so worth it :)

You mentioned autoimmune diseases. Here is a book that is truly eye opening ..... by any chance have you read the "Autoimmune Epidemic" by Donna Jackson Nakasawa?
http://donnajacksonnakazawa.com/autoimmune-epidemic/

Glad that your oral surgeon is honest with you about root canals. ALL oral surgeons know the pitfalls of endodontic therapy. But many of them are reluctant to say too much to their patient for fear that it might ruffle the feathers of the referring dentists. Hopefully one day that will change!

Bryanna

Hi Bryanna, I had a root canal a few years ago and it became infected so it needed to be retreated. Along with the retreatment the endodontist found that the tooth beside it also needed root canal therapy. Now the endodontist has found that the original tooth with the root canal needs to be extracted and the other tooth needs to be retreated. I have a little bump on thr roof of my mouth and when I push on it I feel a slight pull on my gums. I'm wondering what this is and how to treat it. Is it serious? How much longer until it becomes serious?
Thank you in advance.

No, but I'll check it out. The fact that auto immune diseases are off the charts is indicative of an issue. Not only that, but they are getting more and more severe and destroying lives when they don't outright kill someone.

Well, don't forget my oral surgeon is in Mexico, and he owns the practice. The restoring dentist is his employee, and he also bought the lab and employs them (they do lab work for other dentists too). He's the one who decided they would redo the crown for free. Cost wise, it's not so horrific-he generally tries to throw things in, like bone grafts for me free of charge-but I pay in time instead. Culturally, am appt means nothing. I waited 4 hours for my surgery Monday, but he does a good job,so it's the trade off.

I think it's ironic I had to leave the country to find a dentist/surgeon that admitted that root canals are not the way to go. When he was talking about why the extraction was so horrible, and it was, and basically just said that root canals are a nightmare, on many levels. Funny, his practice does root canals-they employee an endodontist part time- so I think he still fears patients freaking at the "root canal is bad" conversation, and patients aren't open to hearing extraction is the better option. He cares about health-for example he said I don't need a deep cleaning because I don't have deep enough pockets, the bleeding was because of the lupus or the meds, not disease.

For me, it was a weight off when a dentist said root canals are on "borrowed time" because it started clicking-all my root canal teeth were falling apart, and they all kept getting abscesses. Why would "healed" teeth have such horrific infections? If the infection was cleaned out, why would the tooth have such a bad infection that it elevated the tooth to hit before any other tooth? That's a lot of inflammation!

Curious though, do you think some people can luck out and have a single root canal not destroy their health? Or do you tend to think its a ticking bomb, that at some point will go off? I sort of have a theory that root canals didn't do as much damage 50-75 years ago when we weren't surrounded by chemicals at every turn-meaning it was the only stressor on their body so it wasn't so traumatic. Now, our bodies are surrounded by physical and emotional stressors, so cumulatively we don't stand much of a chance.