Persistent Head and Cheek Pain After Wisdom Tooth Extraction: What to Know

Q: Persistent Head and Cheek Pain After Wisdom Tooth Extraction: What to Know

Hello： If the pain persists for more than one month, it is advisable to consult a neurologist for a systematic evaluation (as the localized symptoms you described, such as nasal congestion, sinusitis, and the extraction site, have not shown significant worsening).

After having my wisdom teeth removed, I have persistent headaches and cheekbone pain?

Hello Doctor, I had my upper right wisdom tooth (non-horizontal) extracted on Monday (11/28).
I took the anti-inflammatory pain medication and antibiotics prescribed by the doctor for two days post-surgery, so I only experienced mild discomfort.
However, starting on the fourth day, I have been experiencing constant pain in my right temple and cheekbone throughout the day, along with mild nasal congestion.
The extraction site itself only has slight discomfort.
On the fifth day, during my follow-up appointment, the doctor said the healing of the wound looked good and prescribed medication for sinusitis, which alleviated the nasal congestion.
However, the pain in my temple and cheekbone has not improved; I feel pain almost continuously while awake.
For the past two days, I've been relying on Tylenol to slightly manage the pain.
I would like to ask if this condition could be due to injury to the trigeminal nerve and if I need to seek additional medical attention, or if this is a normal postoperative phenomenon.
If it is normal, how long does recovery typically take?

Polly, 20~29 year old female. Ask Date: 2022/12/04

Dr. Lin Jiayong reply Dentistry

Hello: If the pain persists for more than one month, it is advisable to consult a neurologist for a systematic evaluation (as the localized symptoms you described, such as nasal congestion, sinusitis, and the extraction site, have not shown significant worsening).

Reply Date: 2022/12/04

More Info

After wisdom tooth extraction, it is not uncommon to experience various forms of discomfort, including persistent head and cheek pain. Your experience of ongoing pain in the temple and cheekbone area, despite the extraction site healing well, raises several important considerations.

Firstly, the pain you are experiencing could be attributed to several factors. One possibility is that the extraction procedure may have caused some irritation or inflammation of the surrounding tissues, including the muscles and nerves in the area. The trigeminal nerve, which is responsible for sensation in the face and motor functions such as biting and chewing, can sometimes be affected during dental procedures. If the nerve is irritated, it can lead to referred pain in areas such as the temple and cheekbone.

Additionally, the pain could be related to muscle tension or spasms in the jaw area, which can occur after dental work due to the prolonged opening of the mouth during the procedure. This tension can lead to headaches and discomfort in the surrounding areas. It is also worth noting that dental procedures can sometimes trigger a condition known as "myofascial pain syndrome," where pain is felt in the muscles and fascia of the jaw and face.

Another consideration is the potential for sinus involvement. The upper wisdom teeth are located near the maxillary sinuses, and any inflammation or infection in the sinus cavities can lead to referred pain in the face and head. Since you mentioned experiencing mild nasal congestion, it is possible that sinus pressure could be contributing to your discomfort.

In terms of recovery, while some discomfort is expected after wisdom tooth extraction, persistent pain that lasts beyond a few days should be evaluated further. If the pain continues for more than a week or worsens, it would be advisable to consult with your dentist or an oral surgeon. They may recommend imaging studies, such as X-rays or a CT scan, to rule out any complications, such as dry socket, infection, or nerve damage.

As for the timeline for recovery, most patients experience a gradual decrease in pain and discomfort within a week or two after the extraction. However, individual healing times can vary based on factors such as the complexity of the extraction, the patient's overall health, and adherence to post-operative care instructions.

In summary, while some level of discomfort is normal after wisdom tooth extraction, persistent pain in the temple and cheekbone area warrants further investigation. It is essential to communicate your symptoms clearly to your healthcare provider, who can assess your condition and determine if additional treatment or evaluation is necessary. If you have concerns about nerve involvement or if the pain does not improve, seeking a second opinion from a specialist, such as a neurologist or an oral surgeon, may provide further insights and management options.

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