Expert: J.R. Strecker, B.S., D.C. - 3/15/2008

Question
Dr Strecker,

I am 8 weeks post wizdom teeth extraction and have had terrible complications on the RHS side in my recovery and am still in considerable pain. The tooth was taken out quite roughly, and I suffered an infection and dry socket in the fortnight following - suffice to say the pain has been quite chronic and despite the meds it is always there.

I was wondering whether ultrasound/accupressure would be useful in the area to help bloodflow and the healing process - I realise it won't fix it but wondered whether it would provide assistance.

Someone who i have spoken to who experienced nerve damage as a result of a tooth extraction mentioned that the ultrasound helped significantly, and I am obviously willing to do anything which will facilitate an environment which will help the process.

The pain is debilitating and it is taking over my life - work, sleep has been affected terribly, and despite visiting my GP and another Oral Surgeon for a second opinion, I am quite keen to seek an alternative opinion.

Cheers
Steve

Answer

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Hello S.,

I’m sorry to hear about your problems.  I remember having my wisdom teeth pulled when I was 16.  I’m sure my experience was several times less traumatic and dramatic as yours, and still, even my experience was not a fun one, so I can understand your pain.

In answer to your question, I probably would not put any therapeutic ultrasound on you.  For one, it is too close to your brain.  But I might consider it if you had tried other alternative therapies first, but only because of empathy for your pain.  I think there are better options first.  It’s tough because that area of the body has very little muscle with very tiny structures.  If there is still inflammation, then you should be icing the area of pain for 20 minutes on, 40 minutes off, wrapping the ice in a thin towel so you don’t burn the skin of your cheek.  If the inflammatory period is over, you should be using heat – again, 20 on/40 off.  And acupressure is a great concept.  It may help for any associated myofascial pains as a result of procedure, but I don’t think it will help much for the problem itself.  That’s just my opinion, though.  Instead, of all my recommendations that I think will help you the most is acupuncture.  I’m not sure where you are, but acupuncturists have different training in different states.  For example, California has some of the most rigorous training standards (3-4 year graduate program), while other states will license a practitioner after a dozen weekend seminars if they are already a chiropractor or medical doctor.  So do your best to find an acupuncturist who really knows what he/she is doing.  I truly believe this will provide the most dramatic pain relief.  

You could call around to some of the local chiropractors in your area.  Some will have therapies for TMJ that they might be able to use on you.  Just explain your situation and ask if they have any physiotherapy to help the healing.  You might especially find help from an interferential unit.  This will be safer to use on the face, rather than ultrasound.

There are other natural supplements, such as wobenzym and turmeric, which will help with the inflammation and healing.  I don’t take many anti-inflammatory supplements since I’m generally pretty healthy so I don’t have personal experience myself, but there are some people that swear by wobenzym.  You should also be on a high-grade multivitamin and a fish oil supplement as well (to further help with inflammation).  1000 mg of Vitamin C is also a good idea because this helps collagen fibers (which make up the tissues of your body) heal.  Tissues don’t heal well if you’re deficient in Vitamin C.  You may need to start at 500 mg of Vitamin C the first few weeks before bumping up to avoid any possible diarrhea.  It’s harmless, but make sure you are drinking lots of water, too.  Please check these recommendations with your doctor.

I’m also an expert for the Headaches & Migraines section on this website.  There is a dentist, Dr. Scherr, answering questions with me in this topic.  Here is the link: http://www.allexperts.com/el/Headaches-Migraines/  Being he is a dentist, maybe he has some additional advice to provide that is of some help.

Best of luck!!

Dr. J.R. Strecker, D.C.