Hello Dr. Hall,
I recently had my wisdom tooth extraction from a oral surgeon. It was on the lower left jaw. The oral surgeon told me that it was very much inside the jaw and he had to cut the bone to extract it. After the extraction I was having a severe pain in my ear and teeth so the oral surgeon put a dressing in it which immediately stopped the pain. After a week he removed that dressing and now again I am having pain sometimes in the ear, sometimes in a nerve that connects to head which causes headache and sometimes in the jaw itself.

Dr. Hall, I want to know that usually in this case how many more days will be required to heal up everything. I am waiting for the day that I don’t have pain anywhere above my neck.

Thanks,
Purva

Dear Purva,
It appears that you have a dry socket. I don’t know for sure without examining you, but that is what it appears to be. This is a frequent complication of the removal of a wisdom tooth.

What I would recommend is that you go back to the oral surgeon and have the dressing placed again. And I would ask the surgeon if he or she would be willing to give you a prescription for clindamycin–that could help this heal faster.

Healing time after dry socket varies. Usually it is better in a week, but sometimes it can take two weeks or maybe more.
– Dr. Hall

I had a wisdom tooth removed recently. I was told I may experience some nasal discomfort as my tooth had affected the sinus wall. Since I have had my tooth extracted, I can feel air travelling through my gum to where my tooth was and also I feel that my food may be able to travel through my nasal pasage. Is this normal and how long does it take to heal?
Thank you.
Joe in Alabama

Joe,
I’d report back to your dentist or oral surgeon what you’re experiencing. You have a perforation of your sinus from your wisdom tooth socket. It wouldn’t be accurate to call it “normal,” but it’s not uncommon. The roots of upper wisdom teeth can sometimes lie right against the sinus wall, and that wall can be very thin and can sometimes perforate very easily. I would ask the dentist to place something over the hole to help it heal faster. It will probably heal in a couple of weeks anyway, but you’re right that there is a risk there with it open. You have to be very careful not to blow your nose or put any pressure on that delicate membrane as it heals, or you’ll just keep rupturing it and it may take very long to heal. I’d rather see them pack the socket with gelfoam and slide a piece of gum tissue over the hole to help it heal.
– Dr. Hall

Dr. Hall:

I am 38 years old. My lower bottom wisdom tooth is part ways out, and the gum surrounding it is very very sore. It did get infected 2 weeks ago, and I was put on anti biotics. I have been off the antibiotics for a week now,and I am feeling alot of discomfort again. Is this pain because it is growing, or should I get it removed. I am deathly afraid of getting it removed. With reading the complications of getting them removed when you are my age, should I be concerned? Please contact me soon. Thank you.

Sandra in Saskatchewan

Dear Sandra:

You need to get this wisdom tooth removed, and the sooner the better.

What you have done by taking antibiotics without getting the tooth out is that you’ve helped create antibiotic-resistant bacteria in your infected wisdom tooth. If you keep doing that, you’ll end up with an infection that is impossible to control, and infections in this facial area are very close to your brain, so they can actually become life-threatening. And it’s impossible to get rid of this kind of infection with antibiotics alone

Yes, it would have been easier to have had them out when you were in your early twenties. But 38 isn’t all that old. They don’t start getting really difficult until you’re up in your forties or fifties. Get a competent oral surgeon, and you should be fine.

But brace yourself for their legal warnings about every little thing that could possibly go wrong. They have to give those in order to protect themselves legally. But the risk of doing nothing is truly your greatest risk at this point.

Meanwhile, I would recommend that you ask the dentist for a blunt irrigation needle and irrigate the pocket under the flap of tissue that surrounds the wisdom tooth with a gentle, warm rinse of a mild salt water solution, maybe with a little hydrogen peroxide mixed in to help bubble out the infected material. Do that after every time you eat, and it will help keep the infection temporarily under control for a couple of weeks until you can get it out, and that way you won’t be breeding antibiotic-resistant bacteria.

And get ALL your wisdom teeth extracted. If you have one infected tooth, the others will eventually get infected also. You’re lucky this is happening now rather than waiting until you’re fifty or something.

-Dr. Hall