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Dentistry/extreme pain and swelling

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Question
My wisdom teeth just have the tops of their heads showing. However the one the bottom left has been cause me extreme pain for about 3 days. I have tried Advil and Orajel to deal with the pain, but they do nothing, and now the left side of my face is swollen. Dentists have told me they can not do anything about the wisdom teeth till they are fully through; however this pain is keeping me up all night, and I can not chew food because of this pain. Please I need advice on what I can do to help manage the pain till it passes.

Answer
Hi Rebecca and thanks for your question.

You almost certainly have a condition called pericoronitis, which simply means an infection around the emerging crown of a wisdom tooth - and I know from experience how painful it is.  If the condition is left unmanaged and untreated, it will resolve itself in about 7-10 days. Remember just to make sure that your oral hygiene is optimal, even though the area is painful and salt/bicarb rinses can be very beneficial in aiding healing - 1 teasp of salt and 1/2 teasp bicarb dissolved in 1/2 glass of warm water and rinse out your mouth at least 5x/day and after each meal.  This ensures optimal pH of your mouth which keeps the pathogenic, or harmful, bacteria at bay.

Ideally, to facilitate the area returning to normal, your dentist should have prescribed you a course of antibiotics, to reduce the active infection around the wisdom tooth.  It is never advisable to have a tooth removed when active infection is present, because of the risk of spread into the blood stream or adjacent areas. But once the infection has cleared up, you could make an appointment to get the offending tooth/teeth extracted, either by your dentist or with a referral to an oral surgeon, possibly even under general anaesthetic if you so wish.  Don't be fooled once the pericoronitis has healed and you are pain free, because if left untreated, it will return in a few months, usually affecting the lower wisdoms more than the top because of the greater limitation of space in the lower jaw for the tooth to erupt into normal alignment, which causes a flap to gum to overly the emerging crown of the tooth and due to occlusal or biting trauma from the opposing teeth and food being trapped underneath, it becomes infected.

I hope this helps and wish you all the best in resolving this problem and your pain speedily.  Take care.

Kind regards
Dr Craig Peck

Dentistry

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.

Experience

I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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