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Dentistry/Pain and complications following a jaw bone graft


A bit over a month ago I had tooth #2 extracted (due to root resorption) and a cadaver bone graft placed in the socket. Ever since the procedure I have been in pain. The first 10 days the pain was very strong, and after that it subsided but it is still there. The pain is not focused in the graft site, rather it radiates almost throughout the right half of my head. The affected sites include:
(a) the vein on the right temple
(b) the right ear
(c) the right eye
(d) the vein in the middle of the right half of the mandible (external to the mandible)
(e) the right lymphatic node under the tongue
In addition to the persisting but manageable pain, I have developed periodic dizziness and an upper respiratory infection that seems to be concentrated in the right half of my head. For instance, the right nasal passage is blocked while the left one is totally clear.
How can you explain this response to a bone graft? My oral surgeon said I was doing fine as far as the graft site is concerned (no local infection, gums healing well), and that my symptoms are "very rare". However, being an analytical person, I would like to understand what is going on. In particular, I need to know how to prepare for a period of misery if I need another such procedure in the future.
Thank you for your time.
Jacek Kostyrko

Jacek - Of course, without examining you I cannot be completely sure, but from your description of the pain you are suffering through, a fairly common complication seems to have occurred.  I sort of question why your surgeon did not think of the obvious.  The locations of your pain; the ear, eye under the tongue and the temple are common sites of pain subsequent to extractions when the jaw muscles go into spasm.  Just like a muscle spasm elsewhere, these spasms can cause pain.  With the loss of teeth the bite can often go out of balance and that can precipitate a muscle imbalance and muscle spasms.  My suggestion is quite simple to start with.  Immediately begin a strict regimen of warm salt water rinses on both sides of your mouth for about 3-5 minutes 4-5 times a day.  Do this daily and you should notice an improvement within 3- 5 days.  It will not completely cure then, but slowly it will resolve.  

If resolution is not complete, the doctor may need to give you a muscle relaxer.  So my impression of what is occurring is based on your description of your symptoms.  Please get back to me in a few days and let me know how your are feeling.

The only other cause would be from a sinus inflammation from  the extraction if the surgeon perforated the sinus during the treatment.  That should be considered if healing is not progressing with the warm salt water rinses.


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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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