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QUESTION: I just wanted to clarify that I am not sure this is an infection because my cheek is not swollen although my gums might be a bit but it is negligible and probably continues from the root surgery.

So I only have pain that is really intense but no swelling or fever.

ANSWER: Senevene - Again, as I answered in the other question, I need to know exactly what was done.  I do suggest that you immediately begin the warm salt water rinses for 2-3 minutes, 4-5 times a day to reduce any possible infection.  

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

QUESTION: Dear Doctor --

Sorry if my email was a bit confusing, I was in a lot of pain yesterday. Here is a better description: I had an infection in at the root of the tooth which was not my own (see attached image) and the doctor did an apical resection (their term) to remove the infection. In the picture I attached you can see the tooth before the procedure. The scan now shows that a part of the root was removed and you can see where the bone is missing (I don't have a picture as I just had a scan yesterday at the dentist). In your words: the root was removed but the crown is still there.

As I said in the other message, I was doing well until the stitches were removed. The day after and the weekend to follow I was in really bad pain. Yesterday, on my way to the dentist, I almost fainted too, I was very dizzy and my heat heated up immediately and I was sweating a lot. This passed in about 10 minutes. I am not sure what that was, maybe exhaustion from the continuous pain, as I had not taken painkillers for two days fearing they would make me very numb and drowsy.

The dentist in NL was not sure what had happened -- he checked where the painful area was, and it is along the area where the surgery was done, in that part where the bone is still reconstructing. He said my gums look OK and the wound is healed from the outside so all he can think of is an infection and he gave me more amoxicilin and paracetamol with codeine as painkiller. Today I will contact a surgeon at a medical centre, but I still have no clue what possibly cound have happened.

The problem is that I did the surgery in my home country, Albania, where it is cheaper (but I went to a good clinic there) and now I am in The Netherlands, where I live.  Moreover, I was recovering just fine until I went for stitches removal and the other filling procedure that I had done here.

I have read about the salt and water treatment but it is really painful: I don't know what the water and salt does but it is the only thing that hurts. The chlorhexidine does not hurt at all, it actually helps with the pain. While the salt and water is slightly painful even when I am on painkillers. Should I still do it?

I am sorry I can't be more clear than this and I hope the picture will help you understand the treatment I am talking about.

Senevene -  that you for getting back to me and explaining that you had a surgical procedure done, called an apicoectomy. Usually once the root tip is removed and the doctor seals the end of the root, pain is gone.  The fact that you are having pain, may indicate that the sinus, laying above that root might be inflamed.  If the doctor does not get you better quickly, you should probably have an oral and maxillofacial surgeon to evaluate the pain you are having.  I wish you well and hope you feel better soon. If the pain continues you definitely will need a surgeon to evaluate your situation.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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