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QUESTION: Hello,
It's been 7 months for me already since I had my upper right wisdom tooth pulled. It took three or four shots just to deaden my mouth. I was told that I had an unusually large wisdom tooth the reason it was so hard to pull. And mean he wrestled with that tooth. While pulling the wisdom tooth the dentist cracked or chip the tooth in front of it. Every time I think that it's getting better it flares up again as if it takes on different shapes of swelling and pain. The three teeth in front from where the wisdom tooth was pulled hurts. It fill like pus is in it sometimes, like fat against the side of my tongue. I still fill the print of the needle mark by the third tooth  Each day my gum takes on a different form of swelling and throbbing. I haven't been able to chew on that side for 7 months now. I've been told by people that it may take up to several months to heal. But this just don't seem right. Especially with the cracked tooth I got that I didn't have until the dentist pulled my wisdom tooth out.

ANSWER: Dear Ava and thanks for your question, which I am answering from the question pool.

Firstly, let me express my condolences with your dilemma and I agree, 7 months is a considerable time to have pain and discomfort.  I would go back to the practice where the surgery was originally done and explain your situation again - if you don't get any success with the dentist who treated you, then ask to see one of the other associated or even the principle dentist at the practice.  I feel that a thorough examination with X-rays of the area is vital in order to firstly diagnose where the pain is coming from, but also to evaluate the integrity and health of the 3 teeth in front of the extraction site - especially the tooth which was damaged during the extraction.  Without a diagnosis, no treatment can be planned and it remains a big mystery.  The examination should be able to identify any signs of infection or isolate reasons why infection is still present (if in fact it is).  The possibility of sinus involvement must also be cancelled out because the roots of the upper wisdom's often have direct contact with the floors of the maxillary sinuses and a fracture to the walls/floor of the sinuses could explain the chronicity of your symptoms.  the vitality of the damaged tooth must also be tested because if the nerve was damaged during the extraction, this tooth would require a root canal treatment.  In fact, all 3 teeth on the affected side should be tested for vitality owing to the difficulty of the extraction. My advise, it not to leave this any longer - you have obvious pain which is not resolving itself which indicates some form of pathology.

Bare in mind, though, that this pathology could be co-incidental to the extraction and could have an unrelated cause, so stay open minded but make sure you get the answers you need in order to put this to rest and carry on enjoying your life (and food) again.  Also, the unforeseen and often unpreventable damage to adjacent teeth during any extraction, is sadly a complication for any such procedure.  Sure, as clinicians, we do all we can to avoid this this and to minimize any damage when it does occur, but every extraction is different and the technique used is greatly dependent on the specific circumstances for that tooth.  I can promise you whole heatedly that no clinician would ever intentionally cause any patient undue or excessive pain.  So your case is less about placing blame and more about diagnosing the root cause of the problem and treating if effectively. i hope this helps and wish you a speedy resolution of this problem.  Take care and best of luck further.

Dr Craig Peck

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

QUESTION: Aug. 2012 my wisdom tooth was pulled resulting in cracking the tooth next to it that was fine before the procedure.

March 2013 finally after complaining that the pain never goes away and after another x-ray the dentist discovered

& removed the broken tooth which had totally split in half while still in the gum. This broken/split "completely in half"

tooth had been in my gum for 6 months after trying to convince the dentist that something wasen't right.

From 2013 until now 2015 the hole never closed completely resulting in swollen gum, soreness, pain, tingling

numb lips, dizziness light headedness and constant hearing my pulse beating in my right ear. I wonder now if there

could still be a small piece of that tooth left inside the hole in my gum the reason it won't heal or close completely.

March 25, 2015 my primary doctor has now diagnosed me with an ear infection, high blood pressure and borderline

diabetes. After over four weeks I now still have the light headedness and dizziness all day everyday since March

along with the symptoms I already had. I now think that my primary doctor's diagnosis were cause by my dentist

because I found this information over the Internet about my problem and they are all my symptoms since the dental

procedure:




Severe tooth infections that spread to the ear nerves.

Causing:

1. Damage to the labyrinth

2. Inner Ear Issues

3. Middle Ear Infection

4. Ear Canal Infection

5. Loud Heartbeat sound in ear

6. Swimmer’s Ear

7. Dizziness or Vertigo

8. Gum Tenderness

9. Gum Swelling

10. Face Swelling

11. Throbbing Gum Pain

12. General Discomfort

13. lightheadedness

14. Anxiety & Inability to Sleep

15. Chronic Anemia

16. Diabetes

ANSWER: Hi Ava and thanks for your question.

Please accept my apologies for my rather late reply.  I noticed that you did message me some ago about the same problem and my response is as valid now as it was then.  Additionally, I would suggest that you get a consultation with a maxillo-facial oral surgeon to get the clarity on all your questions, considering the length of time your symptoms have existed.

Kind regards and take care.

Dr Craig Peck

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

QUESTION: Thank you so much Dr. Peck. I saw a new dentist on may 11 2015. They took two different x-rays and an ultra cam screening. They gave me a copy of the maxillo-facial oral surgeon referral form, two days worth of antibiotics and said that I'd be contacted in a couple of days. It's been 19 days now. I haven't been contacted by them yet. I've even called the emergency number on the form just to get an automatic service saying that "their busy with other callers, call back later. Then I even faxed the form myself describing my situation, still no one has contacted me yet. So I called the new dentist to ask if he could prescribe me more antibiotics until I get the call for the appointment. But he tells me that it's out of his hands and against the law once he refers me and there's nothing else that he can do. Well after that initial shock that he don't care how long I'm going to be in pain I talked to my primary doctor about it because my primary doctor had been giving me antibiotics for the ear infection in the first place and he prescribe me enough for 2 weeks. I thought that the new dentist was going to be my primary dentist giving him the right to prescribe me more antibiotics within the law. This is just how my mom died not being taken seriously until her problem turn into cancer and killed her at the age of 59 and she had good insurance and they when sued. I've instructed my children that if this happens to me that they are to take full action in making them pay. By the way the dentist that cause this problem, his office is no longer there. He's gone. I've became permanently disabled at 24 years old In 1980 because of a botched up surgery. My calcium glad was accidently removed during a thyroid surgery causing me to have to take 30 pills each and every everyday for the rest of my life. I was too young to know what to do then and when I finally realized it was a malpractice result it was to late to do anything about it. I have high respect for doctors and the good that they do. I just don't have any for those that make mistakes leaving one to suffer while they go on with their lives thinking that they're just suppose to forget about me and my suffering that they caused. That surgery put me on Medicaid the disrespected insurance. I never had the chance to afford the respected insurance which is why I'm being mistreated this way. I apologize for such a long email but for some reason I just felt the need to share this with you. Thank You So Very Much For Your Patience. Bye.

Answer
Hi Ava and thanks for the follow-up.

You are more than welcome and so sorry to hear about your misfortune but try and stay positive and focused.  I would strongly suggest that you find a new dentist who is dedicated to maintaining and improving your oral health and one who you feel has your best interests at heart. Best of luck and take care.

Kind regards
Dr Craig Peck

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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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