Dentistry/Sensitivity in adjacent tooth after extraction
QUESTION: Hi. Two weeks ago I had tooth #18, lower molar, extracted due to a failed root canal. The extraction was easy and I was given amoxicillin for the infection. This past week, tooth #19 started hurting in a sensitive way, aching and feeling some pressure as well. Its uncomfortable pretty much all the time but gets exacerbated by drinking, eating, air hitting it and brushing teeth. Biting pressure does not increase pain. I went back to the oral surgeon and he said everything was healing fine even though the socket is not closed over yet and #19 looks fine on x-ray. He suggested that the root tip can get exposed with teeth adjacent to the extraction site and perhaps this was causing my pain and it should resolve in a few weeks. My dentist agreed and put a desensitizer on the tooth on the newly exposed side after she blew air on it and I had a lot of pain that lingered. I've had teeth extracted in my upper jaw before and never had this problem. Is the lower jaw different? What's your opinion? Thanks!
ANSWER: Julie - Any tooth adjoining another one can expose the root of the adjacent one during an extraction. Once exposed, the symptoms like you are going through occur. Your surgeon is correct about it will heal as the socket heals. It is important to be aware and stay away from the foods that stimulate the pain.
This situation can occur with any two teeth next to each other. It will get better, but it can take a few weeks. It doesn't matter if it is an upper or lower tooth. When an adjoining one is extracted, the root of the adjoining tooth is now exposed to the environment that was previously not stimulating discomfort.
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QUESTION: That makes sense. It started to feel a bit better but today it cane in worse. I'm hoping it will just clear up. Can it get worse after improving?
ANSWER: Julie - if the pain continues or gets worse and your dentist does not give you a solution or treatment it might be a good idea to find another surgeon near you for an evaluation. I hope the pain resolves, but if it continues or gets worse, an oral and maxillofacial surgeon might need to treat the tooth next to the extraction or the bone.
If you have additional questions, feel free to contact me again.
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QUESTION: Thank you for your answer. It was a lot better and got worse so went back to dentist and she said it could take a long time. She didn't really know why except something is irritating the roots perhaps. She said to make sure I'm not clenching my teeth. Anyway it improved again and was better for about 4-5 days and now it's painful again. It is not sensitive to cold. Ice cream was fine. Swishing salt water made it worse. It is a deep ache type pain that throbs. The tooth socket from #18 is still not closed over after 4 weeks. It is better though. Any thoughts on why this doesn't just stay better? What could I be doing to irritate it? Does this sound typical for this problem? Thank you.
Julie - Of course without a visual exam it is a little difficult, but with the failure of the socket to completely close by four weeks, it usually indicates that there is an area of the bone in the socket that may not be getting the oxygen and nutrients it needs to heal. This is called a necrosis of an area of the bone. Again, I cannot be sure, but you need a skilled and knowledgeable board certified surgeon properly evaluate the area.
There are treatments available that can induce oxygen into the bone, but the doctor prescribing this treatment, called hyperbaric oxygenation, needs to be able to properly diagnose the existance of poor healing due to necrosis.
Again, as I have said before, seeing a board certified oral and maxillofacial surgeon is probably appropriate.