Jaw pain years after wisdom tooth extraction

Jaw pain years after wisdom tooth extraction

Q1. I had my wisdom teeth removed two years ago and unfortunately experienced dry sockets. Since then, the area where one wisdom tooth was removed becomes swollen from time to time. When this happens, the area under my chin feels very sore to the touch, although the feeling usually goes away in a day or two. What could this be?

— Lisa, Florida

It's rare to experience problems from a wisdom tooth extraction much later on. The most common problem that occurs after such an extraction has healed is that a little piece of the root of the tooth that was inadvertently left behind starts working its way out of the bone and soft tissue. It feels very similar to a baby tooth growing in. Alternatively, a small piece of bone might break off during an extraction — without blood supply, it becomes a foreign object that works its way through the tissue. But either of these complications would normally occur in the aftermath of the extraction rather than two years later.

You need to seek the advice of a dental professional, preferably a periodontist or oral surgeon, who does this kind of work, and have him or her take an X-ray, either a CT scan or Panorex. The image should be not only of your teeth but also your jawbone. This will allow you to rule out any kind of infection, cyst, or problem at the extraction site that could account for the recurring swelling. It's possible that there's a problem with the tooth adjacent to the extraction socket. The tooth might have a cavity or need a root canal treatment, which would makes it feel as though it's affecting the socket area. Teeth are very close together, and often neither the patient nor the dentist can tell exactly which tooth is causing a problem.

Q2. Is it wise to remove wisdom teeth? What are the pros and cons?

In my opinion, wisdom teeth, or third molars, that grow into your arch with normal alignment and function should be left alone because they may become useful later in life.

However, wisdom teeth can grow into the arch in a poor position, causing:

  1. Bite problems
  2. Bone loss and pockets around other teeth
  3. Infections
  4. Decay

These problems are often the result of a jaw that is too small to accommodate the wisdom teeth as they attempt to grow into the arch. If these problems do occur, then the wisdom teeth should be removed if the person is in a generally healthy state. Wisdom teeth can also be a source of bacterial infections and cysts, and can cause problems in oral hygiene. Their removal, however, must be analyzed on a case-by-case basis.

A dentist who believes that all wisdom teeth should be removed is either not knowledgeable or misinformed, or has a personal preference in the matter. One must seek a dentist with good judgment to go over the pros and cons of extraction and determine whether your overall general and dental health warrants the removal of these teeth.

If a wisdom tooth is causing a problem for other teeth — whether your bite is involved or just the tooth adjacent to the wisdom tooth — and constant infections occur, then it is advisable to remove the wisdom tooth. It is also important to analyze the anatomy of the roots of the wisdom teeth to see if they are near a nerve that runs to the lower jaw. If the nerve is wrapped around the bottom of the roots, removal might cause long-term numbness. All of these factors must be taken into consideration in determining whether removal of the wisdom teeth is the best course of action.

Q3. My dentist recommends that my 17-year-old daughter have all of her wisdom teeth removed. She is not having any problems. Is this necessary?

– Donna, North Carolina

Third molars ("wisdom teeth") normally erupt around 18 years of age, but the eruption can range from 17 years to 21 years of age. Dentists have different philosophies regarding removal of third molars based on their experience in practice and the type of dentist they are, e.g. oral surgeon, general dentist, periodontist, orthodontist, etc.

I am a periodontist and for the most part, I favor saving teeth, even third molars. If there is pathology, decay, poor eruption pattern leading to bone loss, a cyst, or chronic infection, then I would agree there is a reason to extract third molars. Of course, there are some exceptions to all guidelines, so each situation must be handled individually.

Third molars that are preserved can help keep a patient's bite or vertical dimension of their face intact. They can act as a back abutment tooth for a permanent fixed bridge in places that implants sometimes can't be placed. And they are perfectly fine teeth to chew with as long as they erupt in proper alignment.

Premature extraction of third molars can be an option, but I would want to know what the justification is before I would agree with that plan of action. One can always seek a second opinion from another dentist if unsure. As a general rule, I would not perform pre-emptive extractions of third molars except on an individual basis. In other words, I would not do this to my patients or my children unless there was a clear indication for it.

Learn more in the Everyday Health Dental Health Center.


Why does my jaw hurt years after wisdom teeth removal?

Pain after wisdom teeth removal surgery is normal and will subside as the healing process continues. However, removing the lower wisdom teeth can lead to a condition where the muscles of the jaw contract, or tighten, called trismus. This can restrict the mouth from opening.

Can wisdom teeth removal Years later hurt?

Phantom tooth pain, also known as atypical facial pain or atypical odontalgia, is chronic and constant pain in your teeth or in an area where teeth have been pulled or extracted. You may have heard of a similar phenomenon when people with amputated limbs still feel pain where the limb used to be.

How do I know if I have permanent nerve damage after wisdom teeth removal?

Some of the signs of nerve damage after tooth extraction may include: Pain that doesn't fade after a day or two, post-wisdom tooth extraction. A tingling sensation that doesn't fade once the local anaesthetic has worn off. Numbness in your tongue, lip, chin, gums or teeth after the anaesthetic has worn off.

Can you get Pericoronitis years after wisdom teeth removal?

What is the outlook for pericoronitis? Once a tooth has been removed, pericoronitis rarely returns. In cases where a flap of gum tissue is removed, the tissue can sometimes grow back.