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Pain in other teeth after extraction

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Unread 08-24-2011, 09:28 AM   #1
prwier
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Default Pain in other teeth after extraction

Hello - I had a root canal in tooth #15 4 months ago. When a dentist when in to do a new filling, sje said it was too deep and sent me straight to an endodontist ,who did the root canal. Since that day, I had pain when biting on that tooth. Permanent crown did not help. Shaving it down so it was out of occlusion only helped until the tooth started moving down again and could be bit upon. There was only pain on biting. After a CT (no abscess) and several rounds of antibiotics, the tooth was extracted by an oral surgeon last week on the assumption that it had a micro-fracture which could not be seen on xray. Regular dentist x-rayed the other upper left teeth right before and found no problems with them. She did see inflammation of the PDL around the bad tooth.

When the tooth came out, there was no "obvious fracture" but a long dark line running the vertical length of the tooth, which the oral surgeon said was probably a "micro-fracture." It was a simple extraction - tooth out in about 2 minutes, no digging. The extraction socket still has the clot and is healing, i do saline or peridex rinses several times a day.

However (and here's the problem), since the extraction, i have sensitivity/some pain when biting on all the other teeth in the upper left. Oral surgeon said it may be PDL inflammation, normal surgery trauma, etc and give it time. if it doesnt improve in time, he said I may need to see a neuro @ possible nerve damage from the root canal. I have a history of sinus infections, but am on a 2-wk course of clindamycin.

Sorry for the long story. The question: Is it normal to have biting pain in the neighboring teeth a week following an extraction?

Thanks much-
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Unread 08-24-2011, 06:19 PM   #2
Bryanna
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Hi prwier,

The simple answer is yes. It is common to have pain in teeth adjacent to the extracted one for several days to a few weeks post op. If it goes on longer than that or you develop a fever, then you would need to be re-evaluated.

To offer you a peek into the big picture based on your description.....

Tooth #15 was not healthy due to the deep cavity. You may or may not have had symptoms from that cavity but all cavities are small to large infections within the tooth structure. The decay causes inflammation and irritation not only to that one tooth but to the nerves that are shared by all of the teeth in that quadrant. It's like having an infected splinter in your finger....... before you know it, the whole finger, even the hand hurts.

In addition to the cavity, drilling into a tooth as well as doing the root canal procedure will always cause trauma and inflammation. FYI... when the PDL is inflammed or widened (PDL is the periodontal ligament), this indicates that the tooth is severely traumatized and/or infection is brewing. So not only had this tooth been overly traumatized but the surrounding area and teeth were feeling the affects of all of this work as well. Take it one step further and extract the tooth.... more trauma to the surrounding nerves and blood vessels.

Unfortunately, this is the chance we take when we get a cavity... that's why it's a good idea to have them fixed when they are small. Sometimes we don't even know we have a cavity until it hurts... so we depend on our dentist to diagnose them at the onset. I'm hoping I have explained this ok......does that make sense to you?

Bryanna







Quote:
Originally Posted by prwier View Post
Hello - I had a root canal in tooth #15 4 months ago. When a dentist when in to do a new filling, sje said it was too deep and sent me straight to an endodontist ,who did the root canal. Since that day, I had pain when biting on that tooth. Permanent crown did not help. Shaving it down so it was out of occlusion only helped until the tooth started moving down again and could be bit upon. There was only pain on biting. After a CT (no abscess) and several rounds of antibiotics, the tooth was extracted by an oral surgeon last week on the assumption that it had a micro-fracture which could not be seen on xray. Regular dentist x-rayed the other upper left teeth right before and found no problems with them. She did see inflammation of the PDL around the bad tooth.

When the tooth came out, there was no "obvious fracture" but a long dark line running the vertical length of the tooth, which the oral surgeon said was probably a "micro-fracture." It was a simple extraction - tooth out in about 2 minutes, no digging. The extraction socket still has the clot and is healing, i do saline or peridex rinses several times a day.

However (and here's the problem), since the extraction, i have sensitivity/some pain when biting on all the other teeth in the upper left. Oral surgeon said it may be PDL inflammation, normal surgery trauma, etc and give it time. if it doesnt improve in time, he said I may need to see a neuro @ possible nerve damage from the root canal. I have a history of sinus infections, but am on a 2-wk course of clindamycin.

Sorry for the long story. The question: Is it normal to have biting pain in the neighboring teeth a week following an extraction?

Thanks much-
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Unread 08-24-2011, 08:20 PM   #3
prwier
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Hi - thank you for the reply, excellent explanation.

If the pain doesn't go away in a few weeks, what might be wrong (and more importantly, how might it be fixed)?

After the root canal, that tooth hurt when biting or even when pushing up on it with a finger or tongue. The pain in the other upper left teeth is different now; not painful with a tongue push, but painful when biting down (gently or hard) against the lower teeth. If i bite just the right way, the pain seems to shoot up my cheek towards the eye. Does that suggest anything in particular? Or do I really need to "wait it out"?

Also, I had a baby 5 months ago (right before the root canal) and am still nursing. Not sure if that has anything to do with anything, but thought I'd let you know so you have more of the picture. I also had shingles about 1.5 months ago over the right (other side) eye, that was treated with antivirals.

When it rains, it pours.

Thanks much-


Quote:
Originally Posted by Bryanna View Post
Hi prwier,

The simple answer is yes. It is common to have pain in teeth adjacent to the extracted one for several days to a few weeks post op. If it goes on longer than that or you develop a fever, then you would need to be re-evaluated.

To offer you a peek into the big picture based on your description.....

Tooth #15 was not healthy due to the deep cavity. You may or may not have had symptoms from that cavity but all cavities are small to large infections within the tooth structure. The decay causes inflammation and irritation not only to that one tooth but to the nerves that are shared by all of the teeth in that quadrant. It's like having an infected splinter in your finger....... before you know it, the whole finger, even the hand hurts.

In addition to the cavity, drilling into a tooth as well as doing the root canal procedure will always cause trauma and inflammation. FYI... when the PDL is inflammed or widened (PDL is the periodontal ligament), this indicates that the tooth is severely traumatized and/or infection is brewing. So not only had this tooth been overly traumatized but the surrounding area and teeth were feeling the affects of all of this work as well. Take it one step further and extract the tooth.... more trauma to the surrounding nerves and blood vessels.

Unfortunately, this is the chance we take when we get a cavity... that's why it's a good idea to have them fixed when they are small. Sometimes we don't even know we have a cavity until it hurts... so we depend on our dentist to diagnose them at the onset. I'm hoping I have explained this ok......does that make sense to you?

Bryanna
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Unread 08-24-2011, 10:34 PM   #4
Bryanna
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Hi prwier,

Congratulations on your new baby!!

Time and dissipation of symptoms would indicate that the pain is linked to the trauma and inflammation. If the pain gets worse or starts all by itself without chewing, then the teeth would have to be re-evaluated. The fact that #15 hurt after the root canal could indicate a fractured tooth, however, it is common for root canal teeth to hurt to some degree because they are inflamed and infected. So those symptoms are typical.

The shooting pain can be indicative of a nerve issue or sinus inflammation. That tooth may have been very close to you sinuses. If so, then that has to heal also. Was there any mention of a sinus exposure or perforation??

I would suggest that you try not to bite or chew on that side of your mouth for a week or so. See if that helps at all. That entire quadrant is upset and chewing on those teeth may be adding insult to injury.

Just a thought.........has your dentist checked your bite to see if you are hitting on that side more so than the right side? I ask that question because you had a crown placed on #15 and had some additional bite adjustments to try and ease up the bite on that crown. Perhaps the dentist adjusted the bite to fit that crown and now that the tooth is gone, the bite may be off. If that's the case, then you would have pain when chewing on that side and another bite adjustment may be helpful. He could check the occlusion very easily to tell if that is a problem or not.

I wish I could be more specific... but I would refrain from eating on that side and also see the dentist to check the bite. Then give it a few weeks to calm down... if it gets worse in that time frame, see your dentist for further evaluation.

Hope that was helpful!

Please keep in touch.......
Bryanna






Quote:
Originally Posted by prwier View Post
Hi - thank you for the reply, excellent explanation.

If the pain doesn't go away in a few weeks, what might be wrong (and more importantly, how might it be fixed)?

After the root canal, that tooth hurt when biting or even when pushing up on it with a finger or tongue. The pain in the other upper left teeth is different now; not painful with a tongue push, but painful when biting down (gently or hard) against the lower teeth. If i bite just the right way, the pain seems to shoot up my cheek towards the eye. Does that suggest anything in particular? Or do I really need to "wait it out"?

Also, I had a baby 5 months ago (right before the root canal) and am still nursing. Not sure if that has anything to do with anything, but thought I'd let you know so you have more of the picture. I also had shingles about 1.5 months ago over the right (other side) eye, that was treated with antivirals.

When it rains, it pours.

Thanks much-
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Unread 08-25-2011, 03:33 PM   #5
prwier
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Hi - thanks for the reply.

Good suggestion, I will try avoiding that side altogether. Which isn't difficult on a primarily liquid diet. That tooth was very close to the sinuses, but the oral surgeon said that there was no perforation; his explanation was that there is never perforation or exposure with a simple extraction (yank only, no digging). Is that true?

I am on 2 weeks of clindamycin on advice from my regular sinus doctor, she tells me that this would cover any leftover gum/socket infection as well... true? is there a better choice of antibiotic that would cover both teeth and sinuses (and safe for nursing)?

As to the bite.. all adjustments were done by filing down the crown, which was removed along with the tooth. However, my teeth come together oddly on that side - very poor bite. if we think that's a factor, I can ask my dentist to take a look in a month or so after the calming-down time.

Thank you-

Quote:
Originally Posted by Bryanna View Post
Hi prwier,

Congratulations on your new baby!!

Time and dissipation of symptoms would indicate that the pain is linked to the trauma and inflammation. If the pain gets worse or starts all by itself without chewing, then the teeth would have to be re-evaluated. The fact that #15 hurt after the root canal could indicate a fractured tooth, however, it is common for root canal teeth to hurt to some degree because they are inflamed and infected. So those symptoms are typical.

The shooting pain can be indicative of a nerve issue or sinus inflammation. That tooth may have been very close to you sinuses. If so, then that has to heal also. Was there any mention of a sinus exposure or perforation??

I would suggest that you try not to bite or chew on that side of your mouth for a week or so. See if that helps at all. That entire quadrant is upset and chewing on those teeth may be adding insult to injury.

Just a thought.........has your dentist checked your bite to see if you are hitting on that side more so than the right side? I ask that question because you had a crown placed on #15 and had some additional bite adjustments to try and ease up the bite on that crown. Perhaps the dentist adjusted the bite to fit that crown and now that the tooth is gone, the bite may be off. If that's the case, then you would have pain when chewing on that side and another bite adjustment may be helpful. He could check the occlusion very easily to tell if that is a problem or not.

I wish I could be more specific... but I would refrain from eating on that side and also see the dentist to check the bite. Then give it a few weeks to calm down... if it gets worse in that time frame, see your dentist for further evaluation.

Hope that was helpful!

Please keep in touch.......
Bryanna
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Unread 06-01-2014, 07:17 PM   #6
nienna777
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Hi again!

I was doing a little more research on some symptoms I was experiencing after having my molar extracted, and to my surprise, this forum came to my aid once again!! I was so relieved to see not only a very thorough explanation of why we are feeling this pain, but also to know that someone else had experienced the exact same thing!!

Just wanted to express how grateful I am, again, to have this resource here, to comfort my mind and not call my dentist every 5 minutes
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