Persistent Pain After Wisdom Tooth Extraction: When to Seek Help?

Five days after the extraction of the lower right wisdom tooth, there is still pain?

Hello, Doctor.
My lower right wisdom tooth is horizontally impacted and completely covered by gum tissue.
After the extraction on October 9th, for the first two days, I only experienced significant swelling in my cheek without any other discomfort.
I may not have been very consistent with the ice packs, but starting on the third day, I began to taste a slightly sour and foul-smelling fluid coming from the area of the last molar.
Additionally, there is a hard lump in my cheek (though it appears bruised), and I haven't been applying heat.
Since the fourth day, I've been experiencing nerve pain in the two outer molars.
Today is the fifth day, and my cheek still feels like there are small hard lumps, and the foul-smelling fluid continues to drain.
The earliest I can have my stitches removed is on October 20th.
Doctor, do you think I need to seek medical attention sooner, or can I wait until my stitch removal appointment?

Ka Ka, 20~29 year old female. Ask Date: 2017/10/14

Dr. Zhu Guanyu reply Dentistry

Hello, based on your description, here are a few suggestions for your reference: 1.
Maintain a regular schedule and avoid staying up late.
2.
Eat a balanced diet and limit the intake of spicy and hot foods.
3.
Improve oral hygiene, especially ensuring that food debris does not get trapped in the teeth adjacent to the wound.
4.
Return for a follow-up examination next week.
Thank you for your message! Wishing you safety and health.
Sincerely, Dr.
Kuan-Yu Chu, Director of Dentistry, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/10/14

More Info

After wisdom tooth extraction, it is not uncommon to experience some degree of pain and discomfort. However, persistent or worsening pain, especially accompanied by unusual symptoms such as foul-smelling discharge or swelling, can indicate complications that may require medical attention.
In your case, you mentioned that you had a horizontal wisdom tooth that was completely encased in gum tissue, and while you initially experienced swelling, you are now noticing a foul-smelling liquid and a hard lump in your cheek. These symptoms could suggest an infection or a condition known as dry socket, which occurs when the blood clot at the extraction site becomes dislodged or fails to form properly, exposing the bone and nerves underneath.

The presence of a foul-smelling discharge is particularly concerning. It could indicate that food particles or bacteria are trapped in the extraction site, leading to an infection. The hard lump you feel may also be a sign of swelling due to inflammation or an abscess forming in response to infection.
Given that you are on the fifth day post-extraction and experiencing these symptoms, it is advisable to seek medical attention sooner rather than later. While it may be tempting to wait until your scheduled follow-up on October 20th, the risk of complications such as a severe infection or prolonged healing time is significant. Early intervention can help manage any potential infection and alleviate your symptoms more effectively.

In general, after wisdom tooth extraction, you should watch for the following signs that warrant immediate medical attention:
1. Severe or worsening pain: While some discomfort is expected, pain that intensifies or does not improve with over-the-counter pain relief should be evaluated.

2. Foul-smelling discharge: This can be a sign of infection and should be assessed by a dentist.

3. Swelling that does not subside: If swelling persists or worsens after a few days, it could indicate an underlying issue.

4. Fever: A fever can be a sign of infection and should prompt a visit to your healthcare provider.

5. Difficulty swallowing or breathing: These symptoms require immediate medical attention.

In summary, while some discomfort is normal after wisdom tooth extraction, the symptoms you are experiencing—particularly the foul-smelling liquid and hard lump—suggest that you should seek help from your dentist or oral surgeon as soon as possible. They can perform a thorough examination, possibly including imaging if necessary, to determine the cause of your symptoms and provide appropriate treatment. Early intervention can prevent complications and promote a smoother recovery process.

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