Tooth Extraction and pain in adjacent tooth
 

I had broken a tooth (no.5 on the upper left) on a popcorn hull three months back. I had gone to the dentist who advised a root canal and a crown. There was no other problem or infection.
I had had root canals before, but this was the most painful ever. He had done the root canal and put on a temporary crown, and the pain was bad. I had gone back twice, but each time it was dismissed as reaction to temporary crown filling material, was assured it will be better once the permanant was in place. Well, the permanant was placed and two weeks later the gum was swollen, and the tooth was very painful.

After much dilly dallying they admitted that the root canal was not done proper, so they have to extract the tooth, and do an implant. I was in so much pain and was willing do anything to get rid of the pain.

They extracted the tooth two and half weeks back, it was healing well, Now I have a pain in the tooth adjacent to it ( number 4). Its not sensitive to heat or cold, but pains when I bite. Sometimes there is burning pain leading upto my nose and sinuses...
Went and got an x ray, and dentist assures there is no cavity or decay, and must be due to overbite ( have an overbite not corrected in child hood.. am 39 now) and the fact the missing tooth must be making the overbite worse.
Last week I had very bad pain in the jaw and ear joint on that side, and the dentist had said it must be due to eating only on one side.
Now the pain in jaw has lessened a little, but its the adjacent tooth thats worrying me now. Is it possible there is something wrong in this tooth and that does not show in the xray ? Should I go for a second opinion ?
I am not in my home country.. other wise I would have gone to my regular dentist for help.. I googled a lot but did not have an answer..
I don't know whether to worry or not, or that I have become paranoid because they had messed up my tooth in the first place .. Please help !

Hi lotta,

Being away from home with a tooth problem can be very difficult. Having said that, if you are under alot of stress, you may be grinding your teeth which could cause a tooth to hurt or ache. Grinding your teeth could also cause discomfort or pain in the muscle near the ear.

Anytime we have a tooth removed, the bite shifts a little. Some teeth cause more shifting than others and it really depends on the individual. Our teeth are meant to bite against other teeth. Sometimes the removal of one tooth makes the bite more exaggerated on another tooth which could be one thing that is happening here. Do you plan on having that tooth replaced with an implant or bridge?

Sometimes there is a fracture in a tooth that does not show up on an xray. That would cause the tooth to hurt and possibly be sensitive to temperature. Sometimes the tooth next to the extracted one becomes sore or achey for a while because it was moved during the extraction. In those cases, the tooth usually calms down on it's own.

There could be any number of things going on with that tooth. If there is no pathology present, no swelling or oozing of pus from the gum then until you can pinpoint what it is, you may have to tough it out and become very aware of what you do that sets off the pain. Once you get back home, see your regular dentist for an xray and evaluation. In the meantime, anti-inflammatory OTC meds can be helpful to reduce the inflammation.

I'm sorry you are dealing with this....... please keep us posted on how you are doing.

Bryanna

Bryanna,
Thank you so much for your quick reply.

In answer to your question, yes I am getting an implant on that tooth, they extracted it and the dentist filled it with what he called " Bone Powder" .. I assume it was some calcium compound, to help the bone grow. He said he will put in an implant next month. After reading all that can grow wrong with the implants.. yes I was stressed out. Actually I have a LOT of problems with my teeth ever since I was a child, knocked my front tooth out when I was 10, for which I have a bridge - lot of cavities filled, and some root canals and crowns. I really regret not having looked after my teeth when I was young.
When this tooth was not a good thing to have got a root canal in the first place.. and got a rootcanal, which was wrongly done.. I was suffering for past three months, eating soft foods, eating on one side only...on top of that, there was a lot going on my work front too. So I guess I could be grinding my teeth in my sleep. I had this problem few years back when I was under stress, my jaw ached and my dentist back home said I might have bruxism.( I think thats what it is called).
I will be going back home may be in 4 months, may be in 6 months.. can't say because of my job, have to leave when they say I have to. That brings it to my second question :
My dentist says after placing the implant next month, he will finish the crown 2 months after the implant, so that I can go home ( in case I have to in 4 months).. I read other threads where you said it is better to wait longer periods. Do you think it will be ok for me to have the implant soon ? Or should I wait.. which of course might be a problem if my job requires me to leave ?
I think this stress is more for me than anything else..
As far as the pain is concerned - if I am busy and don't think too much about it, it seems fine..
Thank you for your time, and reading so patiently through the long post.
I was going through the threads yesterday, and I really appreciate the way you take so much time to answer everyones' questions !

Hi Lotta,

Your description of the problem with that tooth indicates that there was indeed an infection brewing if not at the time of the root canal, definitely after the root canal was done and the permanent crown was placed. The swelling and pain are associated with infection. So that in of itself means that the bony socket where the tooth was had not been healthy prior to the extraction. This means that the bone has already been traumatized by infection and then again by the surgery to remove the tooth and then again with the bone graft because it now has to accept this foreign matter and heal solidly and healthy.

Anytime a tooth is extracted at least 50% of the bony socket is lost for good. The bone graft will eventually fill in about 35 to 40% or more of that lost bone. However, ALL areas of the jawbone irrelevant of whether a bone graft was put in or not will take at least 3-6 months to heal solid enough to place an implant. Implants that are placed sooner than that have a higher failure rate. The bone actually takes up to about a year to fully fill in, but generally 3-6 months post extraction is enough time to put the implant in and then the bone continues to heal and become one with the implant.

To surgically place the dental implant means to disturb the bone again. This means there should be a another healing period of about 3-6 months after the implant surgery BEFORE the implant crown is put on. If the crown is put on before the implant has integrated with the jawbone, the implant can fail because it has not had adequate time to intergrate with the bone.

I know you are feeling rushed to get this implant over with...... but if it is done too soon the likelihood of infection and failure is greater than if you wait.

I know this is alot to absorb...... if I need to clarify anything or you have other concerns, please don't hesitate to ask.

Bryanna ~'.'~



(QUOTE=lotta;502728]Bryanna,
Thank you so much for your quick reply.

In answer to your question, yes I am getting an implant on that tooth, they extracted it and the dentist filled it with what he called " Bone Powder" .. I assume it was some calcium compound, to help the bone grow. He said he will put in an implant next month. After reading all that can grow wrong with the implants.. yes I was stressed out. Actually I have a LOT of problems with my teeth ever since I was a child, knocked my front tooth out when I was 10, for which I have a bridge - lot of cavities filled, and some root canals and crowns. I really regret not having looked after my teeth when I was young.
When this tooth was not a good thing to have got a root canal in the first place.. and got a rootcanal, which was wrongly done.. I was suffering for past three months, eating soft foods, eating on one side only...on top of that, there was a lot going on my work front too. So I guess I could be grinding my teeth in my sleep. I had this problem few years back when I was under stress, my jaw ached and my dentist back home said I might have bruxism.( I think thats what it is called).
I will be going back home may be in 4 months, may be in 6 months.. can't say because of my job, have to leave when they say I have to. That brings it to my second question :
My dentist says after placing the implant next month, he will finish the crown 2 months after the implant, so that I can go home ( in case I have to in 4 months).. I read other threads where you said it is better to wait longer periods. Do you think it will be ok for me to have the implant soon ? Or should I wait.. which of course might be a problem if my job requires me to leave ?
I think this stress is more for me than anything else..
As far as the pain is concerned - if I am busy and don't think too much about it, it seems fine..
Thank you for your time, and reading so patiently through the long post.
I was going through the threads yesterday, and I really appreciate the way you take so much time to answer everyones' questions ![/QUOTE]

Thank you - you are very helpful. Yes.. I think I understand what you mean.
I can only hope that my work lets me stay for that period of time. Otherwise, I don't know what else I can do... only other option seems is to get the implant done here and the crown in my home country ? I don't even know if its possible. Otherwise, I have to wait till I get to my country.. which I don't even know when, in three months time or six months. Six months may be too much to leave the extracted site open ..

Or is it better to get a bridge ? I asked the dentist, he said since the other two teeth were fine, and an implant will cost the same as a bridge with two teeth on either side.. and its better for me to have an implant.
Should I change my mind and have a bridge done instead ? then it would be cutting the teeth on either side.. and dentist already said its better to have implant...

This is too confusing, I know... sorry to be such a terrible patient !
I think for me, now that they messed up one tooth, my faith in them is shaken. I am not even sure they will do a good job on the implant. Its because I don't have insurance, and they are one of the more affordable dentist is why I have gone to them ( they have good recommendations)..
but then...now when I said I will be going back to my home country.. will they do a shoddy job since any way I will not come back to them ? What if the implant fails ? what should I do then ?
First instance, he had said that the implant will take six months in all. Then when I said I might not be here for so long, he said " oh, may be then we can do it sooner for you". So... I don't know !

Any way, thank you so much for your kind and patient responses ! God bless you !

Wow lotta what a problem! I'm glad to hear you are not in much pain. I agree with you I am amazed reading these threads how patient and polite Bryanna is with everyone.
I'm looking forward to her answer I'm thinking of an implant to but reading what can go wrong scares me. There is a local dental college that can do it on the cheap but not sure cheap is the way to go, but how can you really know who's going to do a good job? A bridge is almost equally scary as two more teeth could be damaged at least in my mind. Anyway I was under the impression you could get an implant done at anytime so why the rush? Is it because your bite is off so much? Or did they say sooner is better? I'm off to the dentist Tuesday for a consultation hoping I'm not blowing more money.

Good luck with your teeth. I never knew how important they were till they started hurting.

Pam