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Dentistry/extreme facial, sinus, and ear pain

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Question
About 6 weeks ago I broke a wisdom tooth. No pain, just sharp. A few weeks after that I felt like I had abscess or major cavity on the right side of my face,  i went to ER, they gave me norco and antibiotics.  The next day i went to the dentist, after finding out my work had changed my dental, which gave me no relief. The dentist said it was tmj, but that i had inflammation by the wisdom tooth. And prescribed tylenol 3. Over the next few days i realized the norco and Tylenol didn't do anything,  the pain was extreme, my entire upper and lower jaw, ear, nose,  forehead,  sinuses. I've since determined its not tmj, i did muscle relaxers,  anti anxiety meds, and a mouth guard at night with no relief.  I switched to ibuprofen and a hot moist corn pack and finally had a bit of relief.  I truly believe the wisdom tooth cutting into my cheek/tendon is the root of all evil. The inflammation goes away after several days, and then something irritates the skin  (peanuts,  spicy foods,  etc), and I'm back to square 1. I can't have the wisdom tooth surgically removed until October when they fix ny insurance.  Is there any way the dentist can grind the sharp pieces down temporarily?  I currently have no nerve pain in the tooth itself.  The dentist I saw was in one of those multi dentist practices and didn't appear to care what i had to say. I'm a nurse, not stupid. If you can give me any ideas for temporary relief i would appreciate it.  I tried at home temporary filling but the clove taste made me so nauseousi couldn't stand it, due to a medication I'm on (saxenda for weight loss). I bought a expensive mouth wash today specifically designed for mouth sores and a numbing cream that is supposed to heal mouth sores as well. The numbing doesn't do a thing obviously.

Thank you
Sara

Answer
Sara -  without examining you directly it is a little difficult for me to be completely sure, but it sounds like, from your descriptions, your problem might be from the muscles of your face becoming inflamed.  This is a common problem and is often associated with wisdom teeth.  The jaw muscles as an instigator for facial pain is often misdiagnosed.  Simple minor inflammation of teeth can precipitate inflammation of the jaw muscles.  There are three main areas of pain caused by muscle inflammation precipitating spasms and pain.  The areas of the muscles are from muscle attachments from in front of the ear to the bottom of the jaw.  From in front of the ear to the temple region and to the jaw in the mouth behind the teeth.  All of these when the muscles are in spasm cause pain that can be severe.

Well what can be done.  There are a different causes pushing the muscles into spasm.  The stability of the bite and an overclosure of the bite is important to be evaluated by a skilled and knowledgeable dentist.  Often dentist look over these problems, until the muscle spasms occur.  Initially a simple and very effective approach to reduce pain is to take warm salt water and rinse you mouth with it.  A simple rinse is not good.  You have to concentrate the water inside your mouth on both lateral sides in the mouth.  Rinse for 3-5 minutes 4-5 times a day.  Make sure to keep te water warm.  

Any change to the muscles won't happen before 5-7 days after you begin and then only minor changes.  Once the muscles begin to relax, then a dentist can properly evaluate your bite to insure that it is balanced. At that stage the imbalances that are probably present can be adjusted and corrected.  So it is important that your dentist is knowledgeable about dental occlusion to properly correct the pains and most likely the causes.

If you have additional questions, feel free to contact me again.  

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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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