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Oral Surgery/Removal of tooth 31


QUESTION: On Wednesday morning I had 31 removed by an excellent oral surgeon. He gave me the impression everything went well and he didn't need to see me again.
It's now been three full days at 9:30 this morning. I've continued to have pain from tbe get go.
He gave me tylonel 3 to take. I've been taking 2 ibeprofen and one tylonel 500 mg for the pain. Today I took one of the pills he gave me, but it didn't really last long.
I'm 71 years old. I've been diligent in doing the salt water rises.
He put in something that was supposed to help with the clotting.  How long woukd be normal to have this continued pain?
I had been in pian for over 4 weeks when I had it removed.
What are your thoughts?

ANSWER: Cherie -It is not normal to have the type of pain you are expressing.  I have a couple of questions for you that can help me diagnose what might be happening.

Do you have a bad taste in your mouth?  Do you have bad breath?  I ask those two questions because if they are present, the blood clot in the socket where the tooth was may have or is breaking down.  This could produce a condition called a dry socket.  The pain can be intense.  I is now about 4 days and if the pain is still intense, you should see the surgeon immediately or have another surgeon examine you to rule out a condition called a dry socket.  In that condition, the blood clot in the socket has broken down or is breaking down.  The bone within the socket becomes inflamed.  

You need to be examined by the surgeon as soon as possible.  In the interim, immediately begin a regimen of warm salt water rinses in the area of the extraction for 1-2 minutes, 4-5 times a day.  Most important is to have the surgeon examine you.  

If for some reason the doctor is unable to examine you, you need to see another oral and maxillofacial surgeon.  I hope you feel better soon or the doctor helps you.  If you have additional or another question feel free to contact me again.

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

QUESTION: Thank you so very much for answering my question.
I have been doing the salt water rinses since the day after the extraction. I don't spit but let it roll out of my mouth.
I don not have any bad taste in my mouth or bad breath. I had a dry sockett about 25 years ago and I don't think this is one now.  It throbs though. Tbe oral surgeon put a collegon plug or something in to prevent any issues, I remember how intense the pain was from the dry sockett.

I just keep praying this starts to get better. I've had to stop the ibeprofen as it's causing me to swell underneath my eyes. I have always had a sensitivity to ibeprofen, and normally can only take it for one or two days.  It is the only thing that seems to help with one tylonel over the counter 500 mg. I've tried to only take this twice a day, but there have been some days leading up to tbe extraction I had to use it three.

I've only taken two of the tylonel 3 pills, one yesterday morning and one this morning. They don't seem to do anything but take the edge off.  I've eaten only soft foods and brush my teeth immediately after eating followed by the salt water rinse. I've taken vitiman C to help with healing.

I just feel so bad as I have been in pain since a crown prep on this tooth, which the dentist said if it continued to bother me I needed a root canal. I decided to have it removed, and the decision didn't come easily.  If you are able to email me directly I will tell you the rest of this story. I don't want to post it.  Again, thank you so very much for taking the time to answer me.

Cherie -  There is a possibility that the collagen plugs might be the cause of the pain.  The pressure of the collagen or collection of bacteria from saliva could be inflaming the socket.  It is five days since the extraction; at this stage of healing an inflammation in the socket could be the cause of your discomfort.  I know you are rinsing the socket, but I suggest you increase the rinsing to 5-6 times a day for about 3 minutes each time.  The warm salt water helps to reduce inflammation so try to increase the rinsing.  I hope you feel better soon.  If no better soon, get back to the doctor to examine it.

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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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