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QUESTION: Dear Doctor --

I have had severe pain in my gums after my doctor removed the stitches from a root resection after 8 days from the surgery. Following the surgery I had the normal swelling and some pain but it seemed everything was fine and I was steadily progressing. I had done the surgery at another dentist and I had to have the stitches removed from my usual one.

I went to the doctor to remove the stitches and he told me that my gums were a bit sensitive but nevertheless, he removed the stitches and did not prescribe anything else for after. In addition, he worked on another cavity on the same side of the mouth (upper right). I felt some pain after stitches removal but then felt no pain during that day and carried on normally.

The following day a very bad pain started, which has continued over the weekend, progressively increasing. I was in such a pain that I had to go to the emergency on Sunday to get something because I had taken so many ibuprofens I was feeling dizzy and panicky.

The emergency doctor told me that your gums look a bit inflamed and prescribed a chlorhexidine mouthwash, which I am using now. It improved my pain yesterday after I used it, but the pain continues on today.

I have a meeting with the dentist today and I fear that he will blame the other dentist for this problem -- although I went into his office without an infection and I came out with one. I say this because on the day my dentist removed my stitches he was very angry at me for going to another doctor (cheaper) and I feel like he was a bit violent in removing the stitches, which could have caused the wound the revive.

Based on what I explained, could you give me an idea of what might have happened to my gums and why is it that  I have this terrible pain? It feels like I might as well not have had the root resection surgery at all -- it is a similar intense pain.


Thank you and hope to hear from you soon,
S.

ANSWER: Senevene - I am questioning a little what you mean by root resection.  Do you mean that the root was removed and the crown of the tooth is still there or do you mean that the crown was removed and the roots were left?  I ask you that because different doctors name their procedure different that others.  If you could get back to me and tell me exactly what was removed and what is left at the site, I could better help you.  

Just so you know, if the crown of the tooth was removed and the roots left, this is a procedure that has become more common with doctors who are not very skilled and often leave infected roots.  

So get back to me and describe exactly what was done and I will try to give you a more distinct answer and advice.

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QUESTION: Dear doctor,

Here are the most recent pictures of my tooth after the procedure (the dentist just sent them to me today).

Hope to hear from you soon,

Answer
Senevene -  There is definitely the proximity to the sinus I stated in the other response.  I cannot tell if that is the problem, but it definitely pays to have it examined.  The fact that the warm salt water makes it more uncomfortable tends to indicate a continuation of an infection.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

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.

Experience

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

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

Education/Credentials
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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