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Oral Surgery/Still having pain after tooth extraction redux

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Question
Hello Dr. Teig,

You responded to a question of mine back on 5/10/13, http://en.allexperts.com/q/Oral-Surgery-3405/2013/5/still-socket-pain-tooth.htm, regarding mouth pain I was having after an extraction and bone graft. I am still in pain, after returning to my dentist, going to an oral surgeon, being referred to a neurologist, seeing two other dentists and being referred to yet another oral surgeon.

It turns out that I did not and do not have an infection, and my bone graft has taken just fine. The neurologist and the oral surgeon tell me my symptoms do not fit for trigeminal neuralgia. The best answer I can get from anyone is that it's "atypical pain". The neurologist put me on Gabapentin, which seems to be helping some, but the pain is still severe. I am at my wit's end, the pain makes it very difficult to sleep at night. Do you have any ideas regarding what sort of specialist might be able to give me better answers? I've already talked to a psychiatrist and he assures me that this is not psychsomatic! It is, however, leading me to be very depressed.

Thank you for your help.

Answer
Ann -  This is a very difficult question to answer.  If is not neurological in origin the only other cause of pain when there is no infection could be a lack of oxygen to the area.  It could like when we sit in a position too long and our food falls asleep.  The discomfort is due to decreased blood flow  and a secondary lack of oxygen to the area.  I am not a specialist in this problem, but I wonder if a treatment, called hyperbaric oxygen treatment, might help.  This procedure increases the oxygen throughout the body  and should help.

I don't know the experience of your doctors in hyperbaric oxygen, but it is a benign treatment and might help.  Let me know of the outcome.

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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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