Dr. Robert Thein's Implant Dentistry Blog

I just had an extraction yesturday. I was suppose to have a root canal, but the tooth was fractured and infected and so an extraction was recommended. The dentist told me that I should have very little pain, if any at all. However, I am in severe pain. My left jaw is too sore to touch. All around the area of the extraction is extremely painful and I can’t talk with out feeling pain or open my mouth. Is this normal? Thanks for your time.
- Leslie from Pennsylvania

Leslie,
Some tooth extractions can be traumatic enough that you can have serious pain afterward. The pain you’re telling me about doesn’t sound abnormal, except for one thing, and that is what your dentist told you. You’re having a much different experience from what your dentist led you to expect.

I don’t know if the difference comes from a lack of experience of your dentist in predicting what to expect afterward or if there is something wrong, like the infection has gotten deep into the tissues. Dentists are smart, when they give post-operative instructions, to paint a picture of a worst-case scenario, so that you won’t worry when that happens. But it sounds like you are experiencing problems way beyond what your dentist was expecting. I would recommend you call your dentist, tell him or her what you are experiencing, and address the problem. It may need a return visit to the office, or it may be that you just need some prescriptions for pain medications and possibly antibiotics.

Other links: read about dental implant surgery.

I won a smile makeover through a local TV station and a local dentist office. You had to submit a letter (about 100 words or less) stating why you should win. I ended up going in to their office as a finalist and received a full set of x-rays and a consult for free. About a week or so later, they contacted me to let me know that I had won. The value of the prize is around $7,000.00- 10,000.00 and after talking to this dentist at length about my teeth he said that he thought my best plan of action would be to get 4 implants total to anchor the denture on. He went over the x-rays with me and showed me the roots of all my top teeth are infected (having pockets of infection around the root). As for my bottom teeth, 10 of them could be saved, but would need lots of work. Of the 10 they are 4 front teeth, 2 eye teeth and the two others past the eye teeth. He did say that it would be up to me to keep those, but that if I did I would have to get partials to replace the molars that need extracted and the molars that have already broke off (2 on each side). I am 29 years old and have not been able to afford to go to a dentist (I have no dental insurance) in many years prior to this.
Thank you,
Amanda from Kentucky

Amanda,
I tend to be suspicious about contests where you win things like this out of the blue, but the prize sounds like a marketing project for this dental office—an opportunity for them to get radio exposure, so it does sound legitimate.

When you have a lot of teeth extracted at age 29, then sometime in your 40’s you’re going to be a dental cripple. I could tell you stories of people who had their teeth out when they were young, and now they need bone grafting and dental implants, at a cost of four to eight times what you’re paying—more than they can afford—because their jawbone has shrunk to almost nothing and they can’t hold any teeth. They don’t eat normal food any more, so their health suffers, and they don’t go out in public because their teeth slip around and fall out. Don’t let that happen to you.

Read our page about facial collapse for more information about this.

Especially on the lower – that’s where it’s the hardest to hold a denture. I’d save whatever lower teeth you can.

Four implants on the upper would help prevent a good part of the facial collapse on the upper. So I think that would be reasonable.

And then, if you save these teeth, most people, and even a lot of dentists, don’t fully appreciate that it’s the snacking all day long that really ruins your teeth. No matter how much you brush, if you’re snacking on pretzels or raisins or sipping soda often during the day, you’re feeding a constant decay attack, regardless of how much you brush. To get your dental work to last, keep your eating to your regular three meals a day and then maybe a couple of snacks, and you’ll be amazed at how well your teeth hold up. When you limit that frequency of eating to about five or six times per day, no more, you get very few cavities if any.

And if you get removable partials, be sure to at least rinse your teeth EVERY TIME YOU EAT ANYTHING, no matter how little a snack. Excuse yourself to the rest room, take your partial out, rinse it off, and rinse out your mouth, and put it back in. The clasps and attachments and bars collect food particles and you will get cavities every place they touch your teeth if you don’t do that.

You’re lucky to get a chance to fix your teeth. Good luck with your treatment plan.

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I had a tooth extracted 6 days ago. Yesterday, I went back in to the dentist because there was a sharp edge poking out at my tongue, and I couldn’t chew, talk, or swallow without pain. My dentist ground down the edge a little. It still bothers me, but it’s tolerable.

Will this go away in time as he says? And how long will it take before it feels normal?

Thanks,
James in Massachusetts

James,
Yes, having sharp edges of bone after an extraction is fairly common, and your body will smooth it out as it heals, over the next few weeks.

There is a reluctance of dentists to remove any more bone than necessary after an extraction, because they want there to be as much bone in the ridge afterward as possible, so I can understand your dentist’s reluctance to trim your sharp edge any more than necessary to enable you to be reasonably comfortable.