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Nerve damage after lower molar extraction?

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gadforever

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Oct 1, 2019
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4
Location
USA
NOTE: I apologize in advance for the length of this post, and flagrantly admit that I am venting all my troubles to you good people. Please forgive me.

So, I've spent the last two months agonizing over a tooth, and it seems that everything that could go wrong did go wrong, all the way up to what appears to be facial nerve damage. :(

Let me do a "quick" recap:

1) On August 1st, my lower left second molar, which had a very large, deep filling in it, broke, and the filling came out. I went to an emergency appointment at my dentist's office, as the nerve inside the tooth was practically exposed, but all she had time to do that day was...glue the broken part back to the tooth, filling included, as a stopgap measure.

2) A few weeks later, I went in for a regular appointment and had a core build-up and crown prep done, as the dentist said she didn't think the tooth needed a root canal. The temporary crown she gave me that day didn't fit quite right despite adjustments, and I spent the next four weeks in mild discomfort because I couldn't bite right on the tooth. But I wasn't in any real pain.

3) Finally, I got the permanent crown put on. And that was when things went from bad to worse. The tooth, which hadn't been sensitive at all while I had the temp on, suddenly got extremely sensitive to cold and to drilling--the dentist couldn't even adjust the occlusion without numbing me. Also, my gums around the crown got very sore. So my dentist then said that I needed to see an endodontist and discuss getting a root canal.

Interlude: By this point, I had been suffering from pain and/or discomfort in that tooth for almost two whole months, and I'd had several breakdowns involving copious amounts of crying because I was afraid 1) I had an infection/was going to get an infection and/or 2) I was going to end up bankrupt from all the money I had to spend fixing this tooth.

4) Reluctantly, I booked a consultation with the endodontist--only I didn't end up keeping the appointment. A few days after the final visit to my regular dentist, where she told me that I probably needed a root canal, the gum irritation and the occasional aching in the crowned tooth finally drove me over the edge. I called the oral surgeon who got my wisdom teeth out and asked if I could get an extraction done, but unfortunately, he was booked up a whole month in advance.

And here's where I made what seems to be a horrible misstep. I was so frustrated and anxious at this point that I found another local regular dentist who did extractions in office and booked an appointment...Obviously, you know where this is going.

5) I went to the appointment with the second dentist, who took one look at my tooth and immediately got angry--because it was obvious to him that my gums were inflamed because I was ALLERGIC to the freaking metal in the crown. I didn't even know that was a thing that could happen, and my other dentist never even warned me that could happen. She didn't offer me a choice of crown materials or anything. She just got me a porcelain on metal crown, and the metal contained nickel...which I am mildly allergic to. (So even if I had opted for the root canal, I still would have had to pay for a SECOND crown, because I was allergic to the original one.)

6) THAT right there pushed me over the edge. I was completely done with this freaking tooth, and I wasn't willing to spend thousands more dollars and weeks more of my time (most of it spent anxious to the point of tears) trying to save this stupid tooth. So I told the new dentist to extract the frigging thing.

Hoo boy, am I starting to regret that...

7) The dentist numbed me up, like usual, and I didn't notice anything amiss at that point. Then he got to the actual extraction, which turned out to be complicated, because there was so little tooth structure left that he couldn't get a good hold on the thing. It broke multiple times, and he ended up drilling it into pieces and digging the huge, curved root out of the socket with some triangular root-digging tool. Thankfully, I did not feel any of this, because I was numb.

Perhaps a little too numb...

8) Now we get to the crux of the issue. I'm a little over 84 hours post extraction, and over the last 24 hours, I've noticed some...odd things. For the first 48 hours or so, everything seemed pretty normal. The original numbness from the injection appeared to wear off, like usual. My jaw got swollen and stiff, like usual. The socket stopped bleeding, formed a clot, and then started forming granulation tissue, like usual. I've noticed that the extraction site appears to be closing up at a reasonable rate--it was a huge, gaping crater at first, due to the shape of mouth--and I don't seem to have developed dry socket.

So, what's the problem? Well, I've been having issues with weird numbness and tingling in my jaw and cheek, on the side where the molar was extracted. If I press down on the external area of my jaw right next to the extraction site, it feels the way it does when you're coming down from being numbed. It's not totally numb, and it's not quite tingly, but it's not quite normal.

Sometimes, the sensation spreads upward into my cheek or across my lips and chin. Sometimes, I get a weird sensation in my teeth and gums on the left side of my mouth. And best of all, sometimes, I get a sharp jolt of pain very deep inside my jaw that feels eerily similar the kind of jolt you get when the dentist accidentally jabs the needle directly into the nerve.

FINALLY, we get to my question. Assuming I don't have a stroke and die from the immense anxiety I've been suffering and continue to suffer as a result of this stupid tooth, what should I do about this apparent nerve damage? I don't have any total numbness anywhere, and most of the sensations come and go, and the nerve is clearly still in some kind of working order, judging by the intermittent sharp jolts. So, should I just wait it out and see if the, ah, "paresthesia" symptoms gradually resolve? Should I run back to the dentist and seek out steroids? Should I see a regular doctor about this?

Honestly, I've been dealing with this tooth for two whole months, and it's made me break down into tears more times in those eight weeks than I've cried in the preceding four years combined. And I just really want this to be over. Completely over. I never want to have to worry about this stupid tooth, or its empty socket, ever again. But at the same time, I can't ignore a potentially serious problem.

So...any advice? Any at all?
 
Gordon

Gordon

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FINALLY, we get to my question. Assuming I don't have a stroke and die from the immense anxiety I've been suffering and continue to suffer as a result of this stupid tooth, what should I do about this apparent nerve damage? I don't have any total numbness anywhere, and most of the sensations come and go, and the nerve is clearly still in some kind of working order, judging by the intermittent sharp jolts. So, should I just wait it out and see if the, ah, "paresthesia" symptoms gradually resolve? Should I run back to the dentist and seek out steroids? Should I see a regular doctor about this?

Wait and see. Doesn't sound like there is any permanent nerve damage, sometimes you get some weird tingling/pulsing sensations as things start to heal up.

It's not likely that steroids will help and a doctor wouldn't have a clue what to do about it, with all due respect to doctors (and my son is one) they know next to nothing about oral issues...
 
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MountainMama

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Messages
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I have had the exact same issue with dental surgeries on my top front tooth. The first was an apicoectomy and I had nerve damage. I was terrified it would be permanent, and I had jolts of pain, and yet my upper gums across both top teeth and the lateral incisor were completely numb even two weeks after surgery. The endodontist shrugged it off, saying the feeling may come back or may not, but may take months (she is a very no nonsense, straightforward person). She said the jolts of pain would go away eventually. It took three months, and the tingling feeling got a little more intense, then faded and everything was normal except on little area directly above the tooth, which didn't bother me at all.

Three weeks ago, I had the top tooth removed, and the oral surgeon had to go in and clean out remaining infection. I had the same issue again. This time my upper lip was numb as well. I couldn't move it at all. As I had experienced this before, I wasn't as worried. I asked the oral surgeon about it at my two week follow up, and he said parathesia (I think that is what he called it), is fairly common with any extraction or procedure that is complex or causes a lot of trauma, but it is rarely permanent. He said it could take months to feel normal again, though. It has now been 3 weeks, and my lip is back to normal, mostly, but the gums are still numb and I still get occasional twinges in the nerve.
 
G

gadforever

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Joined
Oct 1, 2019
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USA
Thanks, guys. I feel reassured about the nerve problems, at least. One other question though. Are there are any obvious early signs of infection? And by infection, I mean regular infection and not dry socket.

For the first couple days post-extraction, I was taking Tylenol, and I didn't notice much in the way of pain or swelling, just a bit of jaw stiffness and some mild aches and soreness. However, I stopped taking meds after that, and over the past two days, I've been noticing more symptoms.

I've heard that swelling and pain tends to be peak around day three to four, and then diminish from there. Is that true? Because my cheek and jaw do seem a little puffier than they did on the first two days, and while my jaw is not as stiff, I am experiencing more in the way of throbbing and aching pain in and around the extraction site (and deep down near the bottom of my jaw, where that big root had to literally be dug out of the socket).

My gum around the healing socket also feels a bit "tighter" than it did in the preceding days, and might be a bit more swollen/tender than it was in the first couple days post-extraction.

None of the pain is severe or unbearable, and none of it's persistent. I'm just getting some throbs and aches that I wasn't getting on the first couple days. (They started around the same time I noticed the intermittent tingling/partial numbness).

There's no obvious pus oozing from the extraction site. I don't have a bad taste in my mouth. My breath doesn't smell like death. I don't have a fever. And my lymph nodes aren't swollen.

Considering how traumatic the extraction was, and that I've recently hit "peak swelling time," are these mild to moderate throbs/aches and gum tenderness just normal healing? Would it be a lot more obvious if I had a burgeoning infection?
 
M

Mike

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Aug 24, 2019
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It sounds fairly normal to me especially given it sounds like it was a difficult extraction. I’d keep taking ibuprofen (if you can) as it’ll help the inflammation resolve. If concerned head back to the dentist but if you’re only in mild/moderate discomfort after 3 days it sounds like it’s going on the right direction :)
 
M

MountainMama

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I had an implant put in for my lower first molar, and had exactly what you were describing. I had swelling that got worse on day 3 to 4. There was throbbing as well. I actually went to see my oral surgeon, because I had been told you rarely have pain with an implant. I found out that he had to create a gum flap and shave off some bone that had a ridge on the edge. That was causing the swelling and the swelling was causing the throbbing. It was all due to the trauma. It did start to go down.
Another thing I noticed is as the numbness from the nerve damage on my front tooth went away, I actually experienced more pain that I previously couldn't feel. Nothing major, just soreness.
 
G

gadforever

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Oct 1, 2019
Messages
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Location
USA
Thanks again for the reassurances, guys. I'm trying to get my anxiety under control, but it probably won't go quietly to anxiety jail until most of the pain and soreness fades away and the socket largely closes.

My brain has been trying to convince me I must have an infection, because the two lymph nodes at the top of my neck--not the ones under my ears or the ones tucked under my chin--are ever so slightly swollen, with the one on the left being slightly more swollen than the one on the right.

Thing is, my luckless self developed a SINUS INFECTION the same day I got my tooth extraction, with perfectly explains the low-grade fever (<99.5), slightly swollen neck lymph nodes, sinus congestion, and ear popping I had for the first three days post-extraction. (Also, there's the fact that my left neck lymph node is ALWAYS slightly larger than the one on the right. It just is. And I've known this for years.)

But my anxiety keeps trying to tell me that the sinus infection was just masking my extraction infection symptoms, no matter how much logic I keep trying to apply.

-sigh- I've really gotta get my anxiety back under control. I was doing so well until this tooth broke, and then I just spiraled into a pit of despair. :(
 
M

MountainMama

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Joined
Jul 1, 2018
Messages
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Thanks again for the reassurances, guys. I'm trying to get my anxiety under control, but it probably won't go quietly to anxiety jail until most of the pain and soreness fades away and the socket largely closes.

My brain has been trying to convince me I must have an infection, because the two lymph nodes at the top of my neck--not the ones under my ears or the ones tucked under my chin--are ever so slightly swollen, with the one on the left being slightly more swollen than the one on the right.

Thing is, my luckless self developed a SINUS INFECTION the same day I got my tooth extraction, with perfectly explains the low-grade fever (<99.5), slightly swollen neck lymph nodes, sinus congestion, and ear popping I had for the first three days post-extraction. (Also, there's the fact that my left neck lymph node is ALWAYS slightly larger than the one on the right. It just is. And I've known this for years.)

But my anxiety keeps trying to tell me that the sinus infection was just masking my extraction infection symptoms, no matter how much logic I keep trying to apply.

-sigh- I've really gotta get my anxiety back under control. I was doing so well until this tooth broke, and then I just spiraled into a pit of despair. :(
I thought I was the only one. I have gotten a sinus infection after every extraction or surgery. I figured my immune system was working overtime.
 
G

gadforever

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Oct 1, 2019
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4
Location
USA
I thought I was the only one. I have gotten a sinus infection after every extraction or surgery. I figured my immune system was working overtime.
You're definitely not the only one. It made the first few days after the extraction a whole lot worse.

Something else I've also figured out. It seems that everything hurts a lot more at the end of the day than at the beginning. My extraction site throbs more. My jaw aches more. My gums hurt more. Is this just because I, well, use my mouth all day long and it further irritates my injuries?

If so, what should I do about that? I mean, I guess I can talk less. But I still have to eat and drink regularly. Do I just have to deal with it? :(
 
M

MountainMama

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Messages
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You're definitely not the only one. It made the first few days after the extraction a whole lot worse.

Something else I've also figured out. It seems that everything hurts a lot more at the end of the day than at the beginning. My extraction site throbs more. My jaw aches more. My gums hurt more. Is this just because I, well, use my mouth all day long and it further irritates my injuries?

If so, what should I do about that? I mean, I guess I can talk less. But I still have to eat and drink regularly. Do I just have to deal with it? :(
I am not a dentist, so I am just speculating, but I know exactly what you mean. It is the same for me. I was guessing a few things. Maybe because when we are up and active, the blood is pumping more, causing more blood through the area? I know I get the pulsing during the day when I am active. Also, like you said, moving the jaw when talking or eating. Having liquids over the area, etc. Those are my guesses.
 
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