Excruciating pain starting 6 weeks after wisdom extraction
 

Hello. So my spouse had a top wisdom tooth extracted about 6 weeks ago. Everything went fine. Ever since he has has pain but the dentist had said its not fully healed but there are no issues, so everything seems on track. He has been taking 400-800 mg ibuprofen since it was pulled. Well about a day and a half ago it got ALOT worse. It's now a throbbing pain that is worse when he lays down. He was not able to sleep last night but for an hour here and there. Ibuprofen is not working at all. Went to dentist today, they took xrays and did a full exam and said he doesn't see any issues. Gave him a script of penicillin to see if that helps. Earlier this afternoon he started taking half 10mg percocet and it's helped a bit, but not much. This evening since trying to sleep had to give him a whole one spread out and he is still crying out in pain. Any idea what could be going on?


I have been scouring the internet for the past 2 hours trying to find information on what may could be going on with my spouse. Found some problems similar but none have been solved or exact. Wanted to see if I could get any help here. Thanks for reading.

Hi dnd1980,

Your spouse should consult with an oral surgeon. They will take a panoramic radiograph which will show the mouth in its entirety as well as his sinus , etc. He may have a communication into his sinus which may be infected and inflamed. General dentists are not as knowledgeable with this sort of thing as an oral surgeon would be.

A waring about the long term us of ibuprofen. This medication is not intended to be used in high doses for long term. It can cause life threatening circuclatory problems with the heart and damage can occur in the stomach, kidneys and liver.

Also if he is a smoker.... he needs to seriously consider stopping. The toxic chemicals in cigarettes can prevent the surgery from healing properly. It can also cause or contribute to a sinus communication resulting in infection and pain.

I hope this information is helpful.

I will call to see if he can get a referral to an oral surgeon. We do not have insurance, so this was a sliding scale place. I'm hoping the antibiotics start working because he is not really able to function. He has had to call off from work.

Normally he doesn't take pain medicine but with the pain recently, he hasn't really had a choice. I warned him about the effects so he had stopped taking it for a week or so and tried Tylenol. Then it started getting worse so back to the ibuprofen and now stronger medicine.

He has never smoked, so that is not an issue at all.

dnd1980,

Tylenol long term is also not a wise alternative to ibuprofen. Both meds can cause various problems and toxicity.

I understand that you are trying to keep the cost down, however, it is in his best interest to go to an oral surgeon who is in private practice and not tied to any particular HMO insurance. He needs to get properly evaluated and treated accordingly.

All the best.


QUOTE=dnd1980;1087559]I will call to see if he can get a referral to an oral surgeon. We do not have insurance, so this was a sliding scale place. I'm hoping the antibiotics start working because he is not really able to function. He has had to call off from work.

Normally he doesn't take pain medicine but with the pain recently, he hasn't really had a choice. I warned him about the effects so he had stopped taking it for a week or so and tried Tylenol. Then it started getting worse so back to the ibuprofen and now stronger medicine.

He has never smoked, so that is not an issue at all.[/QUOTE]

I wonder if he could have a sinus infection? I had a great oral surgeon, who happened to also be an MD. If he doesn't offer any help, your husband may need to see a neurologist.

[/QUOTE]

Hello again. So this has been an ongoing thing. The pain was manageable for a bit, but ended up coming back extremely severe on Friday. Between Saturday and Monday we went to the ER twice and dentist once. BF did not sleep a wink for 3 days until last night. Dentist had no clue said maybe sinus, and gave referral for oral surgeon. First ER doc said infection, second said Trigeminal Neuralgia. neither did much. Only gave pain pills that did not work. Finally gave him something from an older prescription that put him to sleep. Went to oral surgeon, first said Trigeminal Neuralgia and was going to give referral to neurologist. before we left the older dr and attending walked by and they asked his opinion. He actually took his time to test and x-ray multiple times and talk to BF. He thinks tooth #18 is dying and is sitting on a nerve and leaking something into the nerve in the lower jaw which is causing all the facial pain. He put some shot into the nerve and the pain went away for several hours. We still have to go back to see an Endontist and then get a root canal. So my question is does this sound like it could be the issue? One tooth for all this severe pain to where BF was crying and ready to give up. I have the xray slides and ct scan to show next dentist, but the appointment is a week away and im still freaking out about the other drTrigeminal Neuralgia. Thanks

Hi dnd1980,

<<<He thinks tooth #18 is dying and is sitting on a nerve and leaking something into the nerve in the lower jaw which is causing all the facial pain. He put some shot into the nerve and the pain went away for several hours. We still have to go back to see an Endontist and then get a root canal. >>

TOOTH #18 IS A LEFT SECOND MOLAR. THIS TOOTH IS NO WHERE NEAR HIS SINUS. THE "LEAKING" FROM THIS TOOTH IS BACTERIA AS THE TOOTH IS INFLAMED AND MOST LIKELY INFECTED. IT IS IMPORTANT TO KNOW THAT THE DIAGNOSIS NEEDS TO BE ACCURATE NUMBER ONE AND SECONDLY A ROOT CANAL IS NOT GOING TO CURE THE PROBLEM WITH THIS TOOTH OR STOP THE LEAKING OF BACTERIA. IT WILL ONLY SERVE TO PROLIFERATE THE PROBLEM. THE ONLY WAY TO ATTEMPT THE INFECTION FROM SPREADING FROM THIS TOOTH FURTHER INTO THE NERVES AND BONE, IF IT IS AN INFECTED TOOTH, IS TO REMOVE THE TOOTH.

It is my opinion based on all of your posts that your BF has several dental issues going on at one time that are causing various problems to occur all at once. It's like a symphony, once it starts the whole gang joins in.

Long term dental problems like oral infections in root canaled teeth, decayed teeth, periodontal disease, poorly extracted teeth... these are all contributing factors to TN. So the longer the dental problems go on, the more likely he is to end up with some form of neuralgia.

On top of this, the amount of antibiotics and pain meds that he has been on has definitely screwed up his immune system and he is in a toxic state. This will cause any problem to become exacerbated.

I may have mentioned this before or perhaps he's already had this ....... he needs to have a comprehensive oral exam and full mouth series of x-rays along with a panoramic x-ray. All of his dental findings need to be evaluated, a comprehensive treatment plan needs to be established and the dental work needs to be done. It is not beneficial to just treat what is hurting at the time if there are other problems brewing. Again... think about that symphony......

I hope what I have offered you makes sense and he gets the help and relief he needs.

Bryanna





Hello again. So this has been an ongoing thing. The pain was manageable for a bit, but ended up coming back extremely severe on Friday. Between Saturday and Monday we went to the ER twice and dentist once. BF did not sleep a wink for 3 days until last night. Dentist had no clue said maybe sinus, and gave referral for oral surgeon. First ER doc said infection, second said Trigeminal Neuralgia. neither did much. Only gave pain pills that did not work. Finally gave him something from an older prescription that put him to sleep. Went to oral surgeon, first said Trigeminal Neuralgia and was going to give referral to neurologist. before we left the older dr and attending walked by and they asked his opinion. He actually took his time to test and x-ray multiple times and talk to BF. He thinks tooth #18 is dying and is sitting on a nerve and leaking something into the nerve in the lower jaw which is causing all the facial pain. He put some shot into the nerve and the pain went away for several hours. We still have to go back to see an Endontist and then get a root canal. So my question is does this sound like it could be the issue? One tooth for all this severe pain to where BF was crying and ready to give up. I have the xray slides and ct scan to show next dentist, but the appointment is a week away and im still freaking out about the other drTrigeminal Neuralgia. Thanks[/QUOTE]

[/QUOTE]

Thank you for your reply. They did not mention that 18 was near the sinus. That was what at one point they thought it was when they thought the pain was coming from the upper wisdom tooth extraction, but the dental surgeon ruled it out. We went back to the regular dentist today since we could not wait to get this fixed since it is so bad. He did more xrays and said that the tooth is infected and sitting on a nerve and thought a root canal would fix it. He started the root canal today and cleaned it out i guess. Will insert post on next appointment. He also mentioned the molar next to it needs to be removed, but that will be done at a later time.

We have done a full oral exam with this dentist and have been getting all of the problems fixed. Unfortunately its all done one at a time. This issue started after all the work was already happening. In fact this tooth had a large filling done within the last 6 months. I don't know when exactly because he has had multiple fillings. Do you think the root canal will at least stop the excruciating pain he has been having for now? On our next appointment we can maybe ask for xrays and when it shows as still infected ask him to take it out. Our main concern is not being able to function or sleep due to the pain. It's been the worst 5 days of my life and it's not even my pain. Just watching what he is going through and not knowing what to do.

Hi dnd1980,

I understand that he has several dental issues going on at the same time. Very difficult to deal with and the constant pain is certainly debilitating.

What your dentist has obviously not informed you of is that the root canal is NOT going to cure the infection. The symptoms, the pain, may subside temporarily but it will flare up again as the infection will still be present. A root canal procedure does not remove all of the infected nerve tissue because there are hundreds of tiny canals that are not visible and not accessible. So the infection continues to brew in those canals. The only way to attempt to remove the infection is to remove the source of the infection which is the tooth.

Also there is obviously little tooth structure left if they are putting in a post. Posts cause teeth to fracture and it is common for decay to occur around the post. This tooth is not healthy and will never be healthy.

The xray that will be taken in a week or so of this tooth will not indicate the severity of the infection unless it is large enough to have caused bone loss. So if that has not occurred yet, the xray will not be of diagnostic use as it will not show the infected nerve tissue that still remains in the tooth. I am sorry that your dentist did not inform you of this information.

I am sorry that your BF has had so many dental problems. I know he just wants to be out of pain. But there is so much more to his situation than he realizes and he will continue to have pain and infection as long as he retains infected teeth.

I can only offer you the information that his dentist has not. I can only hope that sooner than later his dental problems are over and he feels well again.

Bryanna







Thank you for your reply. They did not mention that 18 was near the sinus. That was what at one point they thought it was when they thought the pain was coming from the upper wisdom tooth extraction, but the dental surgeon ruled it out. We went back to the regular dentist today since we could not wait to get this fixed since it is so bad. He did more xrays and said that the tooth is infected and sitting on a nerve and thought a root canal would fix it. He started the root canal today and cleaned it out i guess. Will insert post on next appointment. He also mentioned the molar next to it needs to be removed, but that will be done at a later time.

We have done a full oral exam with this dentist and have been getting all of the problems fixed. Unfortunately its all done one at a time. This issue started after all the work was already happening. In fact this tooth had a large filling done within the last 6 months. I don't know when exactly because he has had multiple fillings. Do you think the root canal will at least stop the excruciating pain he has been having for now? On our next appointment we can maybe ask for xrays and when it shows as still infected ask him to take it out. Our main concern is not being able to function or sleep due to the pain. It's been the worst 5 days of my life and it's not even my pain. Just watching what he is going through and not knowing what to do.[/QUOTE]

This sentence is very interesting and I mean that in a positive way:
"Long term dental problems like oral infections in root canaled teeth, decayed teeth, periodontal disease, poorly extracted teeth... these are all contributing factors to TN. So the longer the dental problems go on, the more likely he is to end up with some form of neuralgia."

I'm not sure what I personally think of such things, but I surely see it as plausible! And many dentists won't entertain the possibility. There is much confusion out there. I do wish dentists would study TN seriously since so many TN patients seem to arrive at TN after visiting the dentist. The ADA must be a very "interesting" organization and I do NOT mean THIS in a positive way. :(

I did not have problems with a top tooth, which surely must make things even more complicated. I had problems with a bottom tooth. I had some preventive dental work done. I did not have pain originally. Something went wrong. I ended up in pain after simple dental work. I was given a lot of pain meds and antibiotics. Someone suggested a root canal. This, was a waste of time. The pain worsened. More antibiotics and pain meds. A dentist pulled my tooth and put in a graph. The pain worsened and I got a fever that wouldn't go away until I took the graph out.

In short, every dental professional I saw made my situation worse. Finally, I saw an oral surgeon who was also an MD. If you can find someone like this, go to him or her.

He told me that I needed to stop seeing dentists and start seeing a neurologist at this point.

My life has been turned upside down. I just spent about two weeks in a flare....lots and lots of pain. I'm overjoyed today, as I have a reprieve.

I've had my TN diagnosis for over a year now. I take several meds for it and am learning,what causes flares and am trying to cope. It has hurt me physically and psychologically. However, on the positive side, I appreciate a good day like no one would believe.

It would be ideal if you could find an oral surgeon with a medical degree like I was blessed with. But, also seriously consider seeing a neurologist with at least some background in TN if things don't start improving relatively soon.

As an experiment and using extreme and utmost caution, you can rub a little low level capsaicin cream on the outside of his face where it hurts the most. Dilute it with a little hand cream. Don't use in the mouth...but outside on the skin. If it is too close to the eye...forget it....don't do it. Rub in thoroughly. He shouldn't wear glasses at this time. See if it reduces the pain a little. Nerves usually quiet down a bit when exposed to capsaicin.

Very warm heating pads sometimes helps my TN pain a little, but don't do this with capsaicin on the skin.