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About Joel S. Teig, DMD, FABOMS
Expertise
I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 DMD

You are here: Experts > Health/Fitness > Surgery > Oral Surgery > dry socket and facial paralysis

Oral Surgery - dry socket and facial paralysis

Expert: Joel S. Teig, DMD, FABOMS - 11/5/2009

Question
QUESTION: I got my 2 lower impacted wisdom teeth extracted my an oral surgeon 1.5 weeks ago. 2 days post extraction, I started getting excruciating pain on one side and called the surgeon as I KNEW something wasn't right. It was sharp and stabbing, throbbing pain. He refused to see me as it was a saturday of the long weekend. He prescribed me another kind of antibiotic(I was on penicillin already)and told me to keep taking narcotics to get me through the 3 day long weekend. I suffered through it, almost comatosed. Turns out, both the sockets were dry and he packed them in the office - which was excruciating to fix. He told me if in 24 hours it wasn't improving, he would see me...if it improved, he wanted to see me in a week. The first few days were improving, but now, for about 3 hours out of a day I get sharp pains in my ears and along the lateral side of my jaw. I usually put a hot compress on it and take tylenol and within a few hours,it goes away. The packing was done 5 days ago. Is this normal to have pain like this this long afterwards? Also, he injured my nerve on the one side and my chin and side are still frozen, along with my bottom teeth. I feel lots of tingling and almost like a rubber band is snapping against my skin...my teeth also 'ping' regularly. Is this a sign of healing of the nerve?? THank you for your time in reading this. I am at a loss, and also have small children to care for, which I am finding difficult to do.

ANSWER: Shelley - First of all, the fact that you are having any sensations, such as tingling, is a good sign and the nerve should come back, but you should know that it can take a few months.

The sharp pains you are getting in your ears and the side of your jaw could be from the dry sockets and you may also be having jaw muscle spasms. The recurrent pain means you should not wait the week and see the surgeon earlier. He probably needs to repack the sockets with the dry socket medication. The hot compresses are not a bad idea to relax the muscles that are in spasm. You can also rinse your mouth in the far back on the sides for a couple of minutes, 4-5 times a day with warm salt water to also relax the muscles.

So contact the doctor tomorrow and get in to see him. I hope you feel better soon.

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

QUESTION: I got my sockets packed a few more times and now they are re out. The pain is subsiding and I think I am doing ok. Am flushing with salt water with a syringe and keeping it clean. Taking advil when necessary.The holes that are left are HUGE so I have no choice but to flush it out. Is that normal? The biggest issue I have now, is that my adjacent remaining teeth- the last 2 or 3 teeth on the one side- are slightly painful when I bite down. I am now not quite 3 weeks post surgery. Is this normal? Will I ever be able to eat again?The surgeon said I didn't; ever need to see him again about this, but if I had issues I wanted to be dealt with, I can see him this week if I like. Does this warrant a visit to him// Should he do any tests or procedures for this problem?? Thank you...I am tired of mush. Cannot even eat soft cauliflower. My baby eats more solids than I do.

ANSWER: Shelley - The discomfort you are feeling in the adjacent teeth could just be from the inflammation of the dry socket. Until those sockets fully heal, those teeth might be a little sensitive. What I just said is true, unless your bite has been altered from the extractions and now you are biting harder on those sensitive teeth.

I think you should still be seen. If you are having pain, the surgeon should not be releasing you. That is my philosophy - no releasing until pain free.

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

QUESTION: I had to cancel my followup appointment as our household got the flu and we were on quarantine. The dental sensitivity is gone and has been for about a week. But now, I have excruciating pain with cold or hot fluids or sweet foods. - the pain seems to be radiating from the site of extraction - and only on one side- the troubled side. Even taking my syringe of warm salt water is so painful...such a sharp pain- which lasts about 20 minutes afterwards. This wasn't the case for the last week or so. I was able to drink hot coffee- in fact it soothed the area. And flushing it out with salt water was never an issue. I have an appointment with my surgeon tomorrow, but looking for some education beforehand. I am feeling like he sloughs my dental issues away and could care less. I need information before I fall through yet another crack. Thank you kindly.

Answer
Shelley - It is a little difficult for me to tell you if the pain is from the extraction socket or the teeth in front of the socket. It could be either, but seeing the surgeon is important to better define the cause. I hope it is something simple that the surgeon can help you with.

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