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Dentistry/Ligament damage to tooth


QUESTION: Just over 2 weeks ago I was eating an olive - it felt like I had hit a pitt but they were free from pitts and there was not one there. The pain was excruciating, but settled a little over night. I started taking ibuprofen and paracetamol to keep the pain down and was only eating on one side of my mouth, the slightest hint on that side and the pain sends me through the roof.  I made an emergency appointment with the dentist. Who did all sorts of tapping and freezing to establish whether there was any nerve exposed. But there was no real pain whilst he was doing it. I said the worst thing was, when I tried to eat and he agreed that the offending tooth was a bit loose and that I probably bit too hard and ground it on a lower tooth.  He said the ligaments were damaged and that it would take 4 - 6 weeks or so to settle properly but to eat only soft foods for 3 - 4 weeks.  He also told me to take ibufrofen, if I could for a few days to help it settle.  It's two weeks now and i'm still taking ibuprofen and not supposed to because I'm on warfarin, but the pain is so bad even when i'm not eating, as soon as the ibuprofen wears off.  I also take paracetamol but on its own that doesn't last long as a pain killer.

There was previous history with this tooth, I had seen another dentist at our surgery a couple of months ago because I kept getting food stuck up into the gum, my regular dentist had left in the past few months. This dentist took an x-ray and told me there was something abnormal about the tooth and that it was cracked up through the middle of the tooth. He told me to wait until my new dentist arrived and get him to talk over treatment with me. I saw the new dentist a couple of weeks later and he said there was no crack in the tooth, just a tiny area that he could fill on the edge that would stop the food getting up into the gum.  He did this, but it was a little painful afterwards and when I saw him a couple of weeks later for a routine 6 month check up, I mentioned it but I also had sinusitis at the time so he said it was probably that causing the pain in the jaw and give it time and it would go after the sinusitis went.  I did think it might have settled down for a few days, but then the above episode with the olive happened and now I am not sure whether there is something more wrong with this tooth than he has assessed(perhaps the crack the original dentist mentioned)or whether it is what is expected with ligament damage. The tooth is still a bit loose but not like it was. But my whole jaw hurts, top and bottom and i notice each time I close my mouth just the rows of teeth touching top and bottom around that area don't feel right and cause a real ache even under the effects of ibuprofen.

Is all this normal for ligament damange or does it sound like there is more wrong?

ANSWER: Thank you for your question and I'm sorry you are in this pain.  I agree there is something more wrong and it sounds like you might have some bone loss or periodontal disease in the area.  Since the tooth is loose it indicates expanded ligament or perhaps more but I am not sure without an x-ray or examination.  I am very certain that your first dentist is right and that the tooth is cracked through the center, if it were simply ligament damage it would have improved by now but it has not.  I think you're probably going to need an extraction

Dr Karmen

---------- FOLLOW-UP ----------

QUESTION: I rang the dentist and insisted on an emergency appointment. He didn't agree that the tooth had always been cracked back to when the original dentist said it was. he told me it was impossible to tell from x-rays that a pre-molar is cracked.  He then took it out but had a lot of difficulty, it took 45 mins. He was very proud that he had achieved it without any bleeding as I am on warfarin. He said I would be fine now and would be able to bowl that night.

An hour later the anaesthetic wore off and the pain set in at such an excruciating level I had to call my GP. I had to be prescribed heavy painkillers as I cannot take codeine. I was prescribed tramadol.  this made me ill after 2 doses and I was sick for 24 hrs and the pain still persisted, then the bruising started to come out and extended under my chin as well al half way up my face. the pain extended up into the forehead giving me constant headache and earache. My teeth either side were also loosened. My face felt tender all round my sinuses.

I have done everything I was told about salt mouthwashes. It is now 2 weeks since the extraction. The bruising has almost subsided, the pain is almost gone but I still have trouble eating on that side, partly because the wound has not completely healed but mostly because the other premolar next to it still feels odd, it feels like it has dropped and it looks longer than all my other teeth, I don't remember it being like this before. I have for about a week been experiencing infected sinus nasal drip.

3 questions:-
a) is it normal for the next tooth to drop and still feel loose like this, 2 weeks later?
b) Is it possible that the sinus drip is also infection caused by the extraction?  
c) A trainee dental nurse friend was shocked by everything that has happened, she saw the terrible bruising and pain I was still in 4 days after and suggested that I change dentist. I'm not sure what to do - is all this normal?

I am SO sorry tjis is happening to you.  It is not normal for a tooth to drop at all.  The sinus drip probably was not caused by the extraction but it might be related to the overall knfection.  Please go see another dentist preferably an oral surgeon as soon as possible.

Dr Karmen  


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Thomas Karmen


All general dentistry questions, especially those related to fixed prosthetics. Endodontics, Periodontics, and implants, minor oral surgery I can't answer much about othodontics nor advanced treatment of carcinoma nor deep tissue surgery nor osseous surgery such as jaw reduction or advancement.


DDS In general practice and consulting with having done some lecturing for local dental societies.

ADA and Florida Dental Association and Iowa Dental association

DDS degree

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