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Oral Surgery/Still having socket pain after tooth extraction

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Question
Hello, I am concerned about pain after having an extraction and bone graft. I had tooth #19 removed 4 weeks ago, after 4 months of continuous pain, preparation for a crown, and a root canal which didn't help. The tooth was supposedly fractured, but there was no evidence of this on x-ray, and the endodontist did not see a fracture when the root canal was done. A bone graft was done the day of extraction to prepare for an eventual implant. The socket still hurts quite a bit even after extraction. When I have called the dentist's office, the tech tells me that this pain is normal, but I'm not so sure. Am I just being impatient with the healing process, or do I need to insist on seeing the dentist?

Thank you for your help.

Answer
Ann -  you are absolutely correct to doubt the presence of the pain this long.  First of all, if the tooth being extracted was painful, a bone graft should not have been placed after the extraction.  Pain needs to be gone before a graft placed.  Why-because it could be inflammation or infection in the area and in either situation a graft should not be placed. A bone graft needs the area to be healthy.  

You need to have the dentist examine you.  If you do not get a result you are satisfied with, it might be best to have a board certified oral and maxillofacial surgeon examine you.  The pain is not normal 4 weeks later and the tech is the wrong person to even give a reason.  

It is possible after the extraction you developed an inflammatory condition called a dry socket and the graft was placed on it.  I cannot tell you, but there are a few reasons for continued pain and it needs to be evaluated properly.

By the way, you are not being impatient. The pain should be gone now.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired

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- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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