Dental Anesthesia Pain and Post-Procedure Complications

Q: Dental Anesthesia Pain and Post-Procedure Complications

Hello： It is possible that the discomfort is related to the lower posterior teeth area, where a mandibular nerve block may sometimes be performed. <br>The injection site is indeed close to the area you described. <br>If the discomfort persists, it is advisable to return for a fol

Dental anesthesia for cavity filling?

Hello, Doctor.
I noticed your patience and thoroughness in answering questions in the Q&A section, so I would like to ask you for advice.
Recently, after having my lower horizontal wisdom teeth extracted, I discovered that my molars in front had cavities.
Since the decay was quite deep, some gum tissue was cauterized to facilitate the filling.
Before the procedure, I received a local anesthetic injection.
I consider myself to have a high pain tolerance, but during this particular injection, the pain I experienced was truly unprecedented.
I couldn't help but cry out in pain—not from the initial needle prick, but from the process of injecting the anesthetic itself.

Yesterday, on July 26, after getting the filling done, I took pain medication, and by the next day, July 27, I felt much better and was able to eat and brush my teeth normally without feeling any pain from the injection site.
However, I noticed a swollen area in the middle of my cheek where it connects to my mandible.
When I press on it even slightly, it causes excruciating pain.
I'm not entirely sure where it is; it doesn't feel like my gums, but rather like the deeper area where my cheek and gums connect.
If I remember correctly, this is the same area where the anesthetic injection was extremely painful.

Is this situation normal? I've had local anesthesia several times before at the dentist, but this is the first time I've experienced such intense pain and swelling the next day.
Could it be possible that the anesthetic was injected incorrectly? (The entire process of anesthesia and filling was performed by a resident, while the attending physician only briefly checked on the filling situation.) Additionally, the dentist informed me that the cavity was quite deep and close to the nerve, so I was advised to monitor whether there was any swelling or pus formation in the tooth.

Could it be that the swelling and pain I mentioned are unrelated to the anesthetic and are simply due to nerve inflammation or an abscess? (However, the swollen area seems somewhat distant from the decayed molar, and I feel like the location is not quite right.
Besides that, I have no idea what nerve inflammation or an abscess should look like.) I would appreciate hearing your professional opinion on this matter.
Thank you very much.

Jellyfish, 30~39 year old female. Ask Date: 2023/07/28

Dr. Lin Jiayong reply Dentistry

Hello: It is possible that the discomfort is related to the lower posterior teeth area, where a mandibular nerve block may sometimes be performed.
The injection site is indeed close to the area you described.
If the discomfort persists, it is advisable to return for a follow-up, especially if there are underlying cardiovascular conditions (such as hypertension or arrhythmias), as it is important to monitor for severe headaches.
On another note, dental pulp pain can also be quite severe; however, pulp pain typically presents as intermittent episodes rather than continuous pain, and it can usually be managed with over-the-counter non-steroidal anti-inflammatory drugs.
If you are being treated at a medical center, it is recommended to follow up with the dental or oral surgery department to determine if a referral or consultation with a neurologist or other relevant specialties is necessary for ongoing monitoring.

Reply Date: 2023/07/28

More Info

After undergoing dental procedures such as tooth extraction or root canal treatment, it is not uncommon to experience pain and discomfort. Understanding the reasons behind this pain and the potential complications can help patients manage their expectations and seek appropriate care when needed.

Understanding Pain After Dental Procedures
1. Pain from Injection: The pain you experienced during the anesthesia injection can be attributed to several factors. The needle's size, the technique used by the practitioner, and the specific site of injection can all contribute to discomfort. In some cases, the anesthetic solution itself can cause a burning sensation, especially if it is injected too quickly or if the tissue is sensitive. While this pain is usually temporary, it can be quite intense, as you described.

2. Post-Procedure Pain: After a dental procedure, it is normal to experience some level of discomfort as the anesthesia wears off. This pain can be due to inflammation in the tissues surrounding the treated area, the trauma from the procedure itself, or even the pressure from the dental work. In your case, since the cavity was deep and close to the nerve, it is possible that the inflammation is more pronounced, leading to increased sensitivity and pain.

3. Swelling and Tenderness: The swelling you felt in the area where the anesthesia was administered could be a result of localized inflammation. This can occur due to the injection itself or as a response to the dental work performed. If the swelling is significant and accompanied by severe pain, it may indicate a complication such as an infection or an abscess.

4. Possible Complications: While it is possible that the pain and swelling are related to the anesthesia, they could also be indicative of other issues. For example, if the cavity was deep and close to the nerve, there is a risk of pulpitis (inflammation of the dental pulp) or even an abscess if bacteria have invaded the pulp. Symptoms of pulpitis can include sharp pain, sensitivity to temperature, and swelling. An abscess may present with localized swelling, pain, and possibly fever.

5. When to Seek Further Care: If the pain persists beyond a few days, worsens, or if you develop additional symptoms such as fever, difficulty swallowing, or a bad taste in your mouth, it is crucial to return to your dentist for further evaluation. They may need to perform additional imaging, such as an X-ray, to assess the situation and determine if there is an infection or other complication that requires treatment.

6. Management of Pain and Swelling: In the meantime, managing pain with over-the-counter medications like ibuprofen or acetaminophen can be effective. Applying a cold compress to the outside of the cheek can also help reduce swelling. It is essential to follow your dentist's post-operative care instructions and maintain good oral hygiene to prevent infection.

In conclusion, while some pain and swelling after dental procedures are normal, it is essential to monitor your symptoms closely. If you experience severe pain, prolonged swelling, or any signs of infection, do not hesitate to contact your dentist for further evaluation and treatment. Understanding the potential causes of your discomfort can help you navigate your recovery more effectively and ensure that any complications are addressed promptly.

Similar Q&A

Is It Normal to Feel Pain After Dental Anesthesia? Insights and Tips

During a dental filling procedure, the dentist administered several injections of anesthesia in the upper jaw due to the depth of the cavity. After the anesthesia wore off, there was no pain in the tooth, but there seems to be some discomfort around the area where the anesthesia ...

Dr. Lin Jiayong reply Dentistry
Hello: There may be a skin break at the injection site. It is recommended to apply a soothing ointment and observe for 3 to 5 days. If discomfort persists, please return for a follow-up appointment as soon as possible. Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung H...

Understanding Post-Dental Treatment Pain: Is It Anesthesia Aftermath?

Two weeks ago, I underwent treatment for a cavity in my front tooth. Anesthesia was administered at that time, but afterwards, my entire jaw and the bone below my ear were in severe pain, requiring ice packs and massage for relief. I'm not sure if this is a side effect of th...

Dr. Zhuang Suhui reply Dentistry
First, may I ask how old your daughter is? Brushing teeth after eating is a good habit; however, after consuming acidic foods, it is recommended to rinse with water first, and then brush your teeth after 30 minutes, as the enamel temporarily softens. Brushing too often does not c...

Managing Dental Anesthesia Risks: What to Do After Adverse Reactions

Hello Doctor: I previously had two incidents at the dentist. The first time, the doctor used an air syringe and accidentally injected air into my subcutaneous tissue along the wound, causing subcutaneous emphysema, which made my cheek swell for about ten days. After that, I often...

Dr. Lin Jiayong reply Dentistry
Hello: It is strongly recommended to proceed at a major hospital, as other specialists can intervene promptly if there are adverse reactions to medications or other surgical aspects. This is a response from Dr. Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry o...

Understanding Complications After Root Canal Treatment: A Patient's Journey

Hello Dr. Huang, In May, I underwent a root canal treatment in Sydney due to tooth pain. However, a month later, I started feeling discomfort again. I found a dentist near my residence (still in Australia), who also recommended another root canal. During the first treatment, I ...

Dr. Huang Tingfang reply Dentistry
Dear Anna, Hello! As mentioned, the doctors treating you are very thorough; it is suspected that the discomfort may be caused by medication stimulation, or there may be accessory canals near the apex. The recommended approach is: 1. Start with pain relief medication 2. Consult a...