Help please? Do I need a dentist or just stronger painkillers?

[Gilbo]

Hi. Following a particularly violent extraction last week, of a broken, root canalled, third molar, which was then cut into 4 and gum cut to enable root removal and then stitched back up again, I am wondering what to do now? The extraction was Tuesday and now, six days later, I am still in intense pain, with no sign of it stopping or even beginning to recover! I would describe the pain as a continuous 'ringing' sensation, covering the whole left side of my mouth. The lovely big blood clot at the extraction site seems to have gone and is now just left with a white space, with maybe bits of bone and bright red bits (blood?) Having read on here about dry socket though, I'm sure I can't have that, as I don't have any bad smells coming out of my mouth and the painkillers that I'm taking (Co-Codamol, Ibuprofen), do eventually help a bit. My partner and I both have urgent appointments Monday and Tuesday elsewhere, so must go to those, with no chance of seeing a dentist until Wednesday at the earliest anyway. Am I just being a wimp? As I see people on here with really bad pain too. My head was thrown about in all directions and there was a load of drilling and other pulling about going on for half and hour, so is this six days still a little too early to expect any reduction of pain yet? Any help will be gratefully received, thank you!

 

[Gordon]

It sounds more like dry socket than anything else, they don't necessarily have a bad smell, it's usually the pain that's the main indication.
If you can't go to the dentist till Wednesday then you'll just need to stick to the painkillers I'm afraid.

 

[Gilbo]

Thanks Gordon. I was sure it wasn't as people seem to be saying that dry socket is unbearable pain, well I think it's just about getting to that point now, as it woke me up twice overnight. Yes thankfully the painkillers take the pain away just enough to get on with the day. Which is another thing they say on here, that no painkillers will even touch it! But you're more likely to know than them, so I'm very grateful for your wisdom, if you'll pardon the 'almost' pun.

 

[Mike]

I’d agree with Gordon, nothing else is likely to cause that level of pain 6 days later. Quick and easy job to treat at the dentist and according to most of my patients pretty much instant relief

 

[Gilbo]

Hello again. Can I just ask one quick question? I'm planning (hoping!) to get to the emergency dentist tomorrow, as one appointment has been cancelled. I just want to ask if dry socket can also cause a swelling? I've only just noticed that the inside of my jaw/gum area around the extraction site is quite swollen and very painful too. Or could that maybe be something else? Thank you again.

 

[Dr. Daniel]

Hi,

Unlike my colleagues, I am not that certain it is a dry socket. It sounds more to me like a secondary infection which is very common after a traumatic tooth extraction. If that is the case, antibiotics can help. If you have fever and malaise antibiotics is a must.
Now for some good news: whatever you have, it is most likely a self-limiting complication and will disappear. You should have gradual improvement (whether it is a dry socket or a secondary infection).

 

[Enarete]

Keeping my fingers crossed for you to get help asap, Gilbo! Keep us posted

 

[Gilbo]

Well I'm back. My emergency dentist didn't say whether it was dry socket or not, she just said 'well it could be', but then said that it was likely to be some kind of infection. She packed the socket with 4 or 5 bits of dressing? Unless she was doing something else? As well as cleaning the hole out. All of which was far more painful (eye-watering!) than just the basic, unbearable pain! I feel better now, although the pain is still mostly there, albeit now in a clove-flavoured variety! (She said this packing will slowly drop out over the coming days, hence the occasional burst of 'clove' and Christmassy 'mulled wine' tastes!) None of the 'instant relief' that Mike spoke of, but that's probably due to the infection. I'm also on 5 days worth (15 big tablets) of 400mg of Metronidazole, which I really hope works. It usually does, so fingers crossed. I'm just off to take yet another dose of painkillers, as the last one has worn off! I've found that I can't really take any more Ibuprofen, as it makes my heartbeat jump all over the place and is very disconcerting, especially as it was the best one to deal with the pain. so it's Co-Codamol and Aspirin all the way. I know you shouldn't take aspirin either, but it's the next best thing and doesn't cause me any problems.

 

[Mike]

Could have been a combination of dry socket with infection, the dressing should help dull the pain a bit and help kill true bugs and the ABs will do they rest.

No reason not to use aspirin if you’re usually OK with it, just wait until you’d be due your ibuprofen if you’ve already been taking it

 

[krlovesherkids777]

Gilbo,

I really hope that works for you too.. That sounds like a painful appt and I hope you will be getting some relief very soon...

 

[Gilbo]

Yes Mike, I think we're talking hit, nail, head there. With the two things and yes I've just replaced the Ibuprofen with the aspirins at the same times of day. Thank you too KR, as I was full of pain while she was treating the tooth, but knew it was 'for a good cause', so I was brave! It's not so bad now, as like Mike says, it's dulled the pain a bit and only digs in when the painkillers start to wear off. So things aren't looking too bad at the moment. I've always loved that 'group hug' emoji thing that you put on! I don't even have that many friends, but the ones I do have make up for it!

 

[Gilbo]

Sorry to be a pain, but I rather stupidly picked up my antibiotics from a local chemist who aren't really the best people to go to, but I was in pain and wanted to be sorted quickly. Of course, as usual, they have given me tablets that are about a foot wide and taste like poison when you try to take them! (Even cutting them in half doesn't help much!) I don't suppose it's possible (having somehow managed to take 4 so far) to exchange them for another brand/shape? Silly question that I think I probably already know the answer to, but I hadn't got tablets from there in a while and hoped things had changed! On another point. How on earth do you get used to a missing tooth? I maybe should have asked for a denture to replace it, but didn't realise that it would make that much difference. Thank you!

 

[Mike]

I think metro 400mg tabs are pretty big whatever brand unfortunately

You’ll get used to the missing tooth before too long, I had a lower molar removed a couple of years back and haven’t felt the urge to have it replaced!

Hopefully things are getting better for you

 

[Gilbo]

Thanks Mike. It's just that the gap left seems to be enormous, compared to the size of the extracted tooth and the single one remaining at the back is digging into my tongue and making me feel a little bit nauseous! If they'd taken that one out, I'm sure it wouldn't have been so bad. Anyway, thanks for your reply. I thought that might be the case (about the tablets). I'll just have to 'soldier on'! ?‍

 

[Mike]

A tip I once for was to try swallowing tabs with yoghurt rather than liquid, it worked quite well!

 

[Gilbo]

Thanks Mike, I'll give that a try! I sometimes use milk or a milkshake and that seems to be easier. Regarding the gap problem, It's a real pain. I've just been researching the best thing to do for missing teeth and everything seemed to suggest some kind of replacement. Everything from implants, to dentures (too late?) to bridges and even a kit to make your own 'temporary teeth' from! I don't know if I'd trust that last one?

I think a bridge may be the way for me to go, although I've just been reading about one lady who's had no end of problems with hers, so I don't know. Why I think I may need a replacement is, when I was a child, I asked my mum to let me have some braces made. She just said "Oh no, you don't want that, all the other children will laugh at you!" Well, I had big, sticky out teeth and they were already laughing, a lot! I asked her again a few times, but she always said no. I didn't realise you could still have them many years later, or I would have done so myself!

Anyway, long story short, my teeth, due to this are more narrow than usual and almost dig into my tongue, rather than the nice, wide smile ? that most people have. I've had to 'adjust' my top lip to hide my awkward bent smile ever since and now you can't notice the problem. But due to this, with this strangely large gap (it looks twice the size of the molar that was removed!), the two teeth around it are digging into my tongue, with the back one causing the most trouble and this strange feeling is making me very nauseous! I try to keep my teeth closed together and that helps a bit, but is uncomfortable.

I had a night guard made to stop bruxism many years ago and have tried that to cover the gap. But I think it's changed shape over the years. I tried softening it up in some very hot water and then fitted it. It doesn't help so much now and feels very strange and while wearing it, I sneezed and then had a strange taste. I took it out to find it was full of blood! So that's no good. If anyone can suggest what they think the best thing would be to fill this gap, I would be very grateful, as I don't think I'll get used to this gappy feeling, though if I do, it won't be for some time!

 

[Gordon]

Your original post says it was the 3rd molar? We wouldn't normally even consider replacing those. Are you sure that's the tooth you meant?

 

[Gilbo]

No, sorry Gordon. It's the first molar, having looked on a proper diagram. Someone was talking to me about all back teeth being classed as third molars and I (stupidly) believed him. I still have the second molar, which is the one digging into my tongue most, with the third molar obviously being a wisdom tooth! I had all four of those removed years ago. So if I had a bridge, it would be attached to the second molar and the second premolar. I'm now at the end of the third day (of five) on antibiotics and there has been no reduction of pain at all! The pain and swelling is mostly on the inside of my jaw, behind the teeth and inside the socket too I suppose. The packing my dentist put in on Wednesday has now gone and I am back to an empty socket. She said I wouldn't need to come back (unless I'm absolutely desperate!) as the Metronidazole should have done it's job by the end of Sunday. I think, because she was violently tugging and pulling me about in all directions, that that must be the cause of most of my pain? But it would be good if the pills helped to rid me of any infection that may be causing some/most/all? of this unending pain.

 

[Gordon]

I'd go back and get the socket checked again, it should be getting a lot better now.

One simple thing she could do would be to smooth down the inside edge of the 2nd molar on the tongue side to see if that helped your annoyance with it.

 

[Gilbo]

I may just do that Gordon. This is making me feel quite ill and I've even been looking into temporary tooth kits (those funny 'soak in water' bead kits that you can get), as I don't think I could put up with this for very much longer!