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Oral Surgery/Problems following wisdom tooth removal.


Last Monday I had my lower left wisdom tooth removed under local anaesthetic. It was a very difficult extraction, and it took my dentist 40 minutes to extract the tooth, which was laying horizontally and imbedded around bone. I also have TMJ on the side the tooth was located, so the whole extraction was very uncomfortable. My dentist checked the site after extraction, stating it 'looked ok' and did not feel the need to prescribe antibiotics, and I was just advised to take warm salt water rinses. He also put one dissolvable suture in to close the wound site. The first two days following were very painful and my face and area of my neck below my jawline were very swollen. I did as instructed - salt water rinses and applied ice packs to my face and neck. I also took as much Ibuprofen and paracetamol as I possibly could, as the pain was constant. By day 3 I felt somewhat better - the swelling in my face had reduced, but remained in my neck. The pain had decreased very slightly, however by the following morning (day 4) I was awoken very early with unbearable pain that had me crying, despite maximum painkillers. My face had swollen once again also. As I had taken the max amount of meds I could, I obtained some diclofenac and clove oil from the pharmacy, used both and the pain settled a little. Today, day 5, I have felt better overall, but the painful neck swelling remains constant and the last few days I have had a metallic, foul taste in my mouth. My throat also hurts, as does my ear. All of this time since the extraction, I also cannot open my mouth wider than an inch or so, but I do not know if this is due to the TMJ, is par for the course after an extraction, or is due to any infectious process that may be occurring. I attempted to see my dentist a few days ago, but he is not working again until next week. I have not had any temperature, but am concerned that I could be sitting on an infection here, without treatment. I am a nurse myself by profession, and just suspect that something is not right. The most distressing part for me is that I cannot even inspect the extraction site myself, as I cannot open my mouth. I am at the end of my tether, and to be honest, regretting the extraction at all. Any advice is hugely appreciated.

Deborah - Of course, without examining you I cannot be completely sure, but from your description you definitely are suffering from spasms of the jaw muscles.  In addition, with the pain and foul taste, there is definitely an inflammatory condition, like a "dry socket" occurring in the extraction socket.  This process is not infectious, but it can produce significant pain.  You need to be seen by a dentist, preferably an oral and maxillofacial surgeon to evaluate and reduce the inflammation.  You cannot put this off or the inflammation will increase, producing more pain.  

So find an oral and maxillofacial surgeon to examine the area.  Do not wait.  Get this done soon.  In the interim keep rinsing with warm salt water for 2-3 minutes, in the area of the extraction, for 4-5 times a day.  I really wish you well and hope you feel better soon.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


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.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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