Tooth Pain and Swelling After Cavity Treatment

Cavity in the molar, with swollen and painful gums the next day?

Due to a cavity in the lower right first molar, the X-ray did not clearly indicate whether it had reached the nerve (I had already undergone two fillings).
Ultimately, the dentist decided to fill it and monitor the situation.
However, since I am very afraid of pain, I received anesthesia.
A few hours later, when the anesthesia wore off, my tooth hurt significantly, so I took an anti-inflammatory pain reliever (not prescribed by the doctor), which made it so that it only hurt when I bit down.
The next day, the gum near my wisdom tooth was swollen to the point that I couldn't close my mouth, and the tooth still hurt when touched.
My wisdom tooth has not erupted yet, but its growth direction is pressing against the front molar.
I am unsure if this is related.
Is this situation normal, or should I return for a follow-up? Thank you for taking the time to help me with my questions!

Jessica, 20~29 year old female. Ask Date: 2017/10/17

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Jessica,
Hello! As mentioned, the first lower right molar has a cavity that continues to cause pain even after filling, which may indicate pulpitis and could require root canal treatment.
The wisdom tooth presents a separate issue, showing redness and swelling, which may necessitate incision and drainage or extraction.
Please communicate further with your physician.
Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2017/10/17

More Info

Tooth pain and swelling after cavity treatment can be quite distressing, especially when it follows a dental procedure like filling or root canal treatment. Based on your description, it seems you are experiencing significant discomfort and swelling in the area around your lower right molar, which may be related to the treatment you received for the cavity. Here’s a detailed explanation of what might be happening and what steps you can take to alleviate your discomfort.

Understanding the Pain and Swelling
1. Post-Operative Pain: After dental procedures, it is common to experience some level of pain or discomfort as the anesthesia wears off. This pain can be due to inflammation in the tissues surrounding the tooth, especially if the cavity was deep and close to the nerve. The pain you felt after the anesthesia wore off is not unusual, and it can sometimes be more intense than the pain you experienced before the treatment.

2. Swelling: The swelling in your gums, particularly if it is significant, could indicate an inflammatory response or infection. If your wisdom tooth (or third molar) is impacted or growing in a way that it is pressing against the adjacent molar, it could contribute to the pain and swelling. Impacted wisdom teeth can cause discomfort and can lead to pericoronitis, an infection of the gum tissue surrounding the tooth.

3. Infection Risk: If the cavity was deep and the dentist was unable to fully clean out the decay or if bacteria were introduced during the procedure, there is a risk of developing an infection. Symptoms of infection can include persistent pain, swelling, and sometimes fever.

What You Can Do
1. Pain Management: It’s important to manage your pain effectively. Over-the-counter anti-inflammatory medications like ibuprofen can help reduce both pain and swelling. However, you should always follow the dosage instructions on the package and consult with your dentist if you have any concerns about medication interactions.

2. Ice Application: Applying a cold compress to the outside of your cheek near the swollen area can help reduce swelling and numb the pain. Use the ice pack for 15-20 minutes at a time, allowing breaks in between.

3. Salt Water Rinse: Rinsing your mouth gently with warm salt water can help soothe irritated gums and may assist in reducing swelling. This can also help keep the area clean, especially if there is any food debris.

4. Monitor Symptoms: Keep an eye on your symptoms. If the swelling persists, worsens, or if you develop a fever, it is crucial to return to your dentist. They may need to evaluate for possible infection or complications related to the treatment or the wisdom tooth.

5. Follow-Up Appointment: Given your concerns about the pain and swelling, it would be wise to schedule a follow-up appointment with your dentist. They can perform a thorough examination, possibly including X-rays, to determine if there are any underlying issues that need to be addressed, such as an infection or complications from the wisdom tooth.

Conclusion
In summary, while some pain and swelling after cavity treatment can be normal, significant or worsening symptoms warrant further evaluation. Your discomfort may be related to the dental work you had done, the status of your wisdom tooth, or a combination of both. It’s always best to err on the side of caution and consult your dentist if you have any concerns about your recovery. They can provide you with the most accurate diagnosis and appropriate treatment options to help you feel better.

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