Persistent Pain and Swelling at Tongue Base After Wisdom Tooth Extraction

Pain at the right base of the tongue without any wounds, and there seems to be a lump?

Hello, doctor.
About three years ago, I had my lower right wisdom tooth extracted, and to this day, I can still fit a whole grain of rice into the extraction site.
I frequently experience pain and swelling in that area.
I have seen two dentists, both of whom said there is no issue.
The pain is quite variable; sometimes it is at the wisdom tooth extraction site, other times in the inner gum, at the base of the tongue, or in the throat, but it is always on the right side.
I'm not sure if this is related to the extraction, but both dentists have examined me and said the wound has completely healed with no problems.
I tend to be anxious and often touch my tongue, fearing I might find something abnormal.
However, I have carefully observed my tongue and found no external injuries or ulcers, and swallowing is not painful.
I am unsure if I am just overly sensitive or if there is something else going on.
Should I consider a referral to an ENT specialist? Recently, I feel as though there is a lump at the base of my right tongue, but it seems to move.
When I touch both sides of my tongue, I occasionally feel what seems to be a lump on the right side, but it also feels like there isn't one (the left side feels very soft).
I really don't know what to do, and I haven't found anyone online with a similar situation.

FIFI, 20~29 year old female. Ask Date: 2017/05/24

Dr. Zeng Guanghui reply Dentistry

In the above situation, it is recommended to consult an oral surgeon for a detailed examination to determine if there is any damage to the inferior alveolar nerve or the lingual nerve.

Reply Date: 2017/05/24

More Info

After a wisdom tooth extraction, persistent pain and swelling in the area can be concerning and frustrating, especially when it seems to linger long after the procedure. Your description of the symptoms—pain at the extraction site, discomfort in the gums, tongue base, and throat—suggests a few possible underlying issues that could be contributing to your ongoing discomfort.

Firstly, it’s important to understand that the healing process after a wisdom tooth extraction can vary significantly from person to person. While many individuals experience a relatively quick recovery, others may have complications that prolong their discomfort. One common issue is the development of a dry socket, which occurs when the blood clot at the extraction site becomes dislodged or dissolves before the wound has fully healed. This can lead to significant pain and may require additional treatment.

Another possibility is that the pain you are experiencing is related to nerve irritation or damage during the extraction. The lower wisdom teeth are located near the inferior alveolar nerve, which can sometimes be affected during the procedure. If this nerve is irritated, it can lead to sensations of pain that may radiate to the tongue, gums, and even the throat.

Additionally, the presence of a persistent lump or swelling at the base of the tongue could indicate a few different conditions. It might be a residual effect of the extraction, such as scar tissue or a small cyst that has formed. Alternatively, it could be related to an infection or inflammation in the surrounding tissues. Given that you have already seen two dentists who have not found any issues, it may be beneficial to seek a second opinion from an oral surgeon or an ear, nose, and throat (ENT) specialist. They can provide a more comprehensive evaluation and may be able to identify any underlying issues that were missed during previous examinations.

Your concern about being overly sensitive or anxious about the area is also valid. Sometimes, after a significant dental procedure, individuals can develop heightened awareness or anxiety about the healing site, which can exacerbate the perception of pain. This is often referred to as somatic symptom disorder, where psychological factors contribute to physical symptoms. Engaging in relaxation techniques or cognitive behavioral therapy may help manage these feelings.

In terms of management, if the pain is mild and manageable, you might consider continuing with over-the-counter pain relief medications as needed. However, if the pain worsens or if you notice any new symptoms, such as fever, increased swelling, or discharge from the extraction site, it is crucial to seek medical attention promptly.

In summary, while it is not uncommon to experience some lingering discomfort after a wisdom tooth extraction, the persistence and nature of your symptoms warrant further investigation. Consulting with an oral surgeon or ENT specialist could provide clarity and help address any underlying issues contributing to your discomfort. Remember to communicate openly about all your symptoms and concerns during your next appointment to ensure a thorough evaluation.

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