Persistent Pain After Wisdom Tooth Extraction: What to Do Next?

Q: Persistent Pain After Wisdom Tooth Extraction: What to Do Next?

Hello： Ibuprofen can be continued. <br>After the quarantine ends, it is recommended to visit a medical facility for an X-ray to confirm if there are issues with other teeth, and to also check the healing status of the extraction site. <br>Sincerely, Dr. <br>Lin Chia-Yung, Departm

It has been nearly 20 days since my wisdom tooth extraction, but I am still experiencing pain?

Hello Dr.
Lin: I had my wisdom tooth extracted on July 26, and it has been nearly 20 days.
It was a horizontal wisdom tooth, and I had the procedure done at a major hospital's oral surgery department.
For the first five days after the extraction, I took antibiotics along with Acetaminophen 500mg and Diclofenac 25mg.
On the seventh day, I had my stitches removed, and the doctor said the wound looked like it was healing well.
When asked if I was still in pain, I said a little (later I realized this was because the pain medication was still effective at that time).
The pain medication was then changed to only Acetaminophen.
That night, I felt a lot of pain, so I went to a nearby dental clinic.
The dentist there also assessed that my wound looked fine and there was no dry socket, concluding that the pain might be due to insufficient pain relief.
I resumed taking Acetaminophen 500mg and Diclofenac 25mg, which helped alleviate the pain.
Due to work requirements, I was sent abroad and am currently in quarantine.
Before leaving, the clinic dentist prescribed some Amoxicillin 500mg for precaution, which I continued to take for about six days, along with Acetaminophen 500mg and Diclofenac 25mg.
After finishing the Acetaminophen, I took only Diclofenac, which also seemed to manage the pain, but I still experience pain when not taking any medication.
Now, nearly 20 days post-extraction, I still feel some pain if I don't take painkillers, and the effectiveness of the pain medication varies—sometimes it works well, and other times it seems less effective (I take it approximately every six hours).
However, at least I haven't been awakened by pain (during the first two weeks post-extraction, I would wake up in pain every morning).

I've seen many people say they feel better within one to two weeks after having their horizontal wisdom teeth removed, so I'm unsure why I'm still experiencing pain.
Is this situation normal? Currently, the teeth in front of the extracted tooth have become very sensitive (I feel a slight aching pain when breathing in an air-conditioned room), and after eating and brushing my teeth, the gums around several teeth also feel sore for a while.
Overall, I feel quite uncomfortable.

Since I'm in quarantine, I can't visit a dentist, and there is a lockdown outside, which makes me a bit worried about whether there is a problem.
I'm also running low on Diclofenac, but I have three boxes of Ibuprofen that I plan to continue taking.
If I still have pain after a month post-surgery, would it be necessary to go to a major hospital for a detailed examination? Or should I just buy generic medications (pain relievers and antibiotics) locally and continue taking them? (I don't speak the local language, and I'm also unable to go out due to the lockdown.) Thank you.

Niming, 30~39 year old female. Ask Date: 2021/08/13

Dr. Lin Jiayong reply Dentistry

Hello: Ibuprofen can be continued.
After the quarantine ends, it is recommended to visit a medical facility for an X-ray to confirm if there are issues with other teeth, and to also check the healing status of the extraction site.
Sincerely, Dr.
Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/08/13

More Info

After wisdom tooth extraction, it is not uncommon to experience persistent pain, especially if the tooth was impacted or if there were complications during the procedure. In your case, since you had a horizontal wisdom tooth extraction and are now experiencing ongoing discomfort nearly 20 days post-surgery, it is important to understand the potential causes and appropriate next steps.

Understanding Post-Extraction Pain
1. Normal Healing Process: After wisdom tooth extraction, the healing process can vary significantly from person to person. While many individuals may feel relief within a week or two, others may experience discomfort for a longer duration. Factors influencing this include the complexity of the extraction, individual pain tolerance, and the presence of any underlying dental issues.

2. Possible Causes of Persistent Pain:
- Nerve Irritation: If the extraction was close to a nerve, it could lead to prolonged sensitivity or pain in the surrounding teeth.

- Bone Healing: The bone where the tooth was extracted may take time to heal, and any disruption can cause discomfort.

- Infection: Although you mentioned that there was no dry socket, an infection can still develop in the surrounding tissues, leading to pain.

- Sensitivity: The adjacent teeth may become sensitive after the extraction due to changes in the bite or trauma during the procedure.

3. Medication Management: You have been using a combination of Acetaminophen and Diclofenac, which is a reasonable approach to manage pain. However, if you find that the pain persists even with medication, it may indicate that the underlying issue has not resolved.

Recommendations for Next Steps
1. Continue Pain Management: Since you have access to Ibuprofen, you can continue using it as needed. Ibuprofen is an anti-inflammatory medication that can help reduce swelling and pain. Ensure you follow the recommended dosage and do not exceed the maximum daily limit.

2. Monitor Symptoms: Keep track of your symptoms. If the pain worsens, or if you develop new symptoms such as swelling, fever, or pus, it may indicate an infection that requires medical attention.

3. Consult a Dentist: Given that you are currently in isolation and unable to visit a dentist, consider reaching out to a dental professional via telehealth if possible. They can provide guidance based on your symptoms and may suggest alternative treatments or medications.

4. Post-Isolation Care: Once you are able to leave isolation, it is advisable to visit a dental clinic for a thorough examination. A dentist may perform X-rays to check for any complications such as bone healing issues or infections that may not be visible through a simple examination.

5. Long-Term Considerations: If after a month you are still experiencing pain, it is essential to seek professional help. Prolonged pain could indicate a need for further intervention, such as additional imaging or treatment for any underlying issues.

Conclusion
While it is not uncommon to experience prolonged discomfort after wisdom tooth extraction, especially with complicated cases, it is crucial to monitor your symptoms closely. Continue managing your pain with over-the-counter medications, and seek professional dental advice as soon as you are able. Your health and comfort are paramount, and addressing any ongoing issues promptly can help prevent further complications.

Similar Q&A

Persistent Pain After Wisdom Tooth Extraction: What to Do Next?

I had my wisdom teeth removed in April, and the sockets still haven't healed. They often hurt, and I've had X-rays taken at the clinic, which showed no issues. I've been taking anti-inflammatory and pain relief medication. What should I do now? Sometimes the pain e...

Dr. Lin Jiayong reply Dentistry
Hello: If you have already had an X-ray taken at the clinic and confirmed that there are no issues, the most common cause of long-term pain after tooth extraction is dry socket. This condition is primarily due to poor blood circulation, which prevents the extraction site from hea...

Persistent Pain After Wisdom Tooth Extraction: What to Expect

Hello, Doctor. Last Friday (June 12), I had my lower left wisdom tooth (non-horizontal) extracted at a large hospital. The tooth was only partially erupted, with half of it still inside, so the doctor had to cut a bit of tissue during the extraction (the procedure took about 20 m...

Dr. Huang Tingfang reply Dentistry
Dear Mr. Wei-Yuan, Hello! Actually, everyone experiences different sensations after tooth extraction. As long as there is no infection, that is good. Applying ice packs post-surgery can help alleviate pain, while heat packs can reduce swelling. If you have any questions, please...

Persistent Oral Pain After Wisdom Tooth Extraction: What to Do?

Hello. I had my wisdom teeth removed around mid-February, and I felt that I was recovering well by early March. However, in early April, I started experiencing pain in my oral tissue. I have seen three dentists and an otolaryngologist, all of whom said there was no issue. The den...

Dr. Zeng Guanghui reply Dentistry
It is recommended to first consult a dentist to check for periodontal disease, apical periodontitis, or temporomandibular joint issues. If everything is normal but discomfort persists, consider whether it may be related to facial nerve or trigeminal nerve problems, and seek furth...

Persistent Pain After Wisdom Tooth Extraction: Is It Normal?

It has been seven days since my wisdom tooth extraction, and I still have stitches. The gums around the molar in front of the wisdom tooth have been persistently aching. Rinsing my mouth, coming into contact with water, or even gently pulling on it causes severe pain, and the nea...

Dr. Zeng Guanghui reply Dentistry
If you are still experiencing pain a week after having your wisdom teeth removed, it may be due to a large wound from the extraction or the removal of an impacted wisdom tooth, which can make it difficult to keep the wound clean and may lead to inflammation. It is recommended to ...