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Tooth Extraction Site is Sensitive to Warm Food

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I had a wisdom tooth extracted. Everything seemed to go fine. It was a bit achy, but the type of achy I assumed you would expect with a tooth extraction. A week later I needed to shovel some snow. The achiness grew after that. Now, it is another week later and the spot is still hurting and it is hurting when I have warm or hot food. The extraction site looks healthy, but this later development has me worried. A friend thinks it is because I did not replace the tooth. Could that be the problem? My dentist didn’t mention needing to replace the tooth, though.

Evelyn

Dear Evelyn,

Woman holding her cheek needing a tooth extraction.

While you would want to replace almost any other tooth which is extracted, a wisdom tooth does not need to be replaced. The achiness does not bother me, especially after exertion. The sensitivity to warm or hot food is more concerning.

Sometimes after a tooth extraction the root to an adjacent tooth can be exposed, which would lead to sensitivity. If a tooth is sensitive to cold, it generally is not something to worry about. Heat, however, is another story. If the pulp of a tooth begins to die. This gives off gases. When something warm enters the picture, the gasses expand, but have nowhere to go. Hence the sensitivity.

I think it would be a good idea for you to see a dentist to have the adjacent teeth looked at as a precaution. Most dentists leave room in their schedule for urgent dental appointments. It’s always easier if things like this are attended too sooner rather than later. The longer things sit, the more invasive the solution ends up.

If there is a chance that your adjacent tooth ends up extracted, which is not very likely but stil possible, you will want to replace that tooth. If you don’t the other teeth will shift or tip into the open space. That can throw off your bite and even lead to TMJ Disorder. Just as a means of giving you information, the best tooth replacement available is a dental implant.

This blog is brought to you by a friendly Kalamazoo Dentist Dr. Susan Dennis.

Does My Tooth Still Need to Get Extracted?

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I had a tooth that was hurting me on 10/7. My dentist prescribed antibiotics for ten days. It started feeling better right away. It still feels better. But, I’m scheduled for a tooth extraction in two more weeks. Is it really necessary to have the tooth extracted if I don’t have any pain? I’m not fond of the dentist so I wouldn’t mind avoiding the extraction if I can.

Eloise

Dear Eloise,

Woman holding her cheek needing a tooth extraction.

I’m very glad you wrote. If the tooth was infected then, it is infected now. The antibiotic will help calm your infection down but is unable to get to the source of the problem. Eventually, because of that, the infection will flare back up. It was good that your dentist prescribed the antibiotic. However, he or she should have scheduled your treatment for while you were still on the medication. That way the tooth is calm and more easily treated.

The first thing I would do is call the dentist and ask for enough of an antibiotic to get you to the tooth extraction and a few days after that in order to proceed safely. I’m curious as to why your dentist is recommending the tooth not get a root canal treatment. That would allow you to save your tooth. Unless it is too far gone to be saved, that would be the better treatment. If it is more a matter of your dentist not liking to do root canal treatments, then they can give you a recommendation for a good endodontist, which are root canal specialists. If the tooth is too far gone, than the tooth extraction will be the next option.

As for you not being keen on the dentist, you are not alone. Many patients have dental anxiety. The good news is that there is a solution. I would have your work done by a sedation dentist. There are different levels of sedation. For easy work, you could have nitrous oxide. For more extensive work you can have oral conscious sedation. In fact, that is so strong that you could sleep through the procedure if you wanted to.

This blog is brought to you by Kalamazoo Holistic Dentist Dr. Susan Dennis.

Dentist’s Negligence Keeps Costing Me Teeth

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I am fastidious with my oral health care. I brush and floss twice a day and go in for dental checkups three times a year. I always ask him after each appointment how things are going and he says things are fine. Three appointments ago, he told me that he had a tooth under watch. Then, the next appointment, he told me the tooth was too far gone and needed to be extracted. When I asked him how that could happen if it was just under watch and he said that my teeth fall apart faster than most. I asked about the rest of my mouth and he said it was fine. Surprise, surprise. It wasn’t. Between appointments I had a filling fall out. He had me come in and looked at it. He told me the decay flared up and caused an infection. He recommended a root canal treatment. I agreed and scheduled the appointment. It was only a week later. Then, when I got there he told me it blew up too quickly again and this tooth now needed to be extracted. I honestly, don’t understand how he can keep missing these. I am so careful and am spending a lot of extra money because of what I feel is his negligence. Do you think I should ask for a refund for the extra procedures he cost me?

Cathy

Dear Cathy,

Man holding his cheek in need of an emergency dentist

Bear in mind that I haven’t examined you. However, based on what you’ve described your dentist is guilty of negligence. It’s rare for a tooth being watched to blow up so quickly that it needs to be extracted. A root canal treatment would make a little more sense, though even that isn’t common. It’s even rarer for a tooth to be diagnosed as needing a root canal treatment and then only a week later it is suddenly unsaveable. Combine that with the fact that your filling fell off and I am not thinking you are with the best dentist.

Getting compensation will be tricky. You would need images of the tooth while it was in watch status as well as when he said it needed to be extracted. I do feel he’s a little tooth extraction happy. The goal should be to save the teeth, though sometimes that is not possible.

I would find a great dentist, get everything looked at and fixed and then approach him about your concerns. Tell him if he’s willing to compensate you for some of the work which should have been preventable you will let it go. If he’s not willing to, then let him know you’ll be leaving frank reviews about your experiences.

I do hope your dentist explained to you the importance of replacing missing teeth when he extracted them.

This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.

Sinus Perforation From Tooth Extraction

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I had to have all of my upper teeth extracted. One of the teeth, a molar, perforated my sinus cavity during the procedure. First, my dentist did not even tell me that this was a possibility. Does this mean he messed up? Also, there were problems from that. I want to give you a sort of order of events and get your advice.

  • I wasn’t told until the next day that there was a perforation.
  • By the fourth day, there was cracking and popping. They suggested that I take Sudafed. That did not help.
  • That night I developed a fever of 102-degrees. The next day I called them and they phoned me in an antibiotic.
  • Over the next few days there was no change in my fever.
  • I went back and they removed some bone pieces and put me on a stronger antibiotic.
  • I’m two weeks out and I still have a fever and pain.

I’ve sort of lost faith in this dentist and don’t know what to do.

Micah

Dear Micah,

Man holding his cheek in need of an emergency dentist

Your dentist made several mistakes here and, in your place, I would insist that he pay for any subsequent treatment to get this fixed. If he gives you trouble, write me back because he could be in some legal trouble. The first thing I want you to do is see an ENT. You want to get this dealt with because at this point you’re in a situation that could easily turn into a dental emergency.

Before your dentist did any work on you, they should have provided you with a list of possible complications. While a sinus perforation with a tooth extraction is not a regular occurance, it is also not that uncommon, there are protocols, one of which is that he should have alerted you to it immediately. They also should have started treatment for the perforation the same day. There is a good post on another blog that outlines post-doctoral care of a sinus perforation. You can read that in its entirety here, however, I will quote the relevant parts below.

If the dentist suspects that the sinus has been perforated, he or she can ask the patient to blow their nose, and the dentist will see a bubbling of air in the socket. The typical treatment is to pack the tooth socket with a biocompatible resorbable sponge material called gelfoam, which accelerates the growth of tissue to cover the perforation. Or bone grafting material can be carefully placed in the socket. If it’s not too difficult, the dentist can also suture soft tissue over the tooth socket, which also helps accelerate that process. But if it would be too traumatic to move soft tissue to that position, that isn’t necessary. Then the dentist will instruct the patient not to blow their nose for a few days, to give that tissue time to heal without disruption. The opening then heals over with soft tissue, and then gradually over a few months’ time, new bone grows in the socket and the sinus membrane completely heals.

If the dentist has any question about whether any tooth fragments were pushed up into the sinus, he or she may refer the patient to an ear, nose, and throat specialist (otorhinolaryngologist) for an x-ray to check whether or not the sinus is clear.

Leaving a root tip of the tooth in the bone should not cause any problem. There is a tiny risk that it could cause an infection and later need to be removed, but there is a much greater risk, in this situation, associated with trying to remove it now, while there is an opening directly into your sinus.

The first thing I want you to do is get an urgent care appointment with an ENT. Don’t ask your dentist to recommend one. Pick one yourself. The ENT should be able to help you.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Serious Pain After Tooth Extraction

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I had a tooth extraction on an upper molar three weeks ago. I thought the pain would be gone by now. The mornings start out okay, just a bit achy, but by the end of the day it is throbbing so much that I want to cry. There is also some pain in my lower jaw and part of my cheek will go a bit numb. Is this normal? Can I do anything to make it any easier?

Myka

Dear Myka,

A woman in pain holding her jaw, needing an emergency dentist.

I am sorry for what you’re feeling. Some of what is going on with your tooth extraction is normal; others ar not. The part that is normal is the throbbing getting worse as the day moves on. This is because of increased blood flow from activity. Referred pain is also quite common, so your bottom arch hurting could be from that. However, what isn’t normal is the length of time. Any pain like this should be gone within the first week.

I want you to contact your dentist. My guess is that you have a residual infection. You don’t want this to turn into a dental emergency. I think your dentist would give you an antibiotic like Clindamycin until the pain is gone for several days.

Once your tooth extraction is completely healed, you will need to replace the tooth that you had removed. The best tooth replacement is a dental implant. It will be the closest thing to having a healthy natural tooth in your mouth again.

As for the numbness you are feeling, that could be from a nerve getting touched in the process of the extraction. That will get better with time. It is important that you communicate with your dentist what is going on. If there is a residual infection as I suspect, it will only get worse.

This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.

Swelling Worsened After Tooth Extraction

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I had an infected back molar. The area was already pretty swollen. My dentist said that a root canal treatment is no longer possible and that I would need to have the tooth extracted. I was disappointed, but went ahead with it. After the extraction, my dentist prescribed me amoxicillin in order to treat the infection. It’s been four days since then and the swelling has gotten worse instead of better. The same is true of the pain I’m in. In fact, the painkillers he gave me are practically useless. Now the area around the infection is almost the size of a golf ball. Is this normal?

Nikki

Dear Nikki,

A woman in pain holding her jaw, needing an emergency dentist.

It sounds like this antibiotic is not working for your type of infection. There are some infections that are resistant to amoxicillin. You need to report this to your dentist so that they can switch you to a different antibiotic. Your infection has gotten worse. Don’t put off calling because this is quite serious. In fact, I would consider it a dental emergency.

If a tooth is too far gone for a root canal treatment to solve the problem, then a tooth extraction is the right procedure. Did your dentist mention the need to replace this tooth?

It is not a great idea to leave an open space in your bite. If you do that, then the adjacent teeth will shift or tip into the open space. This will throw off your bite. When that happens, you risk TMJ Disorder. That can leave you with a lifetime of headaches and jaw pain unless you treat it.

The best type of tooth replacement is a dental implant. This is the closest to having a healthy, natural tooth in your mouth. There are other, less expensive, options if cost is an issue. Your dentist should provide you with all of your options. Once the infection is dealt with, you will want to keep that space open. Until you decide on your permanent replacement, you could get a dental flipper.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.