To Replant or Extract: Navigating Dental Implant Pain and Wisdom Teeth Issues - Dentistry

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Should I undergo replantation or have my wisdom teeth extracted?


I had dental implants placed in the first and second molar areas of my lower right jaw, while my wisdom tooth is still present.
However, since the implant procedure, I have been experiencing intermittent pain in the lower right jaw.
Initially, the pain was severe for the first three days before the stitches were removed, especially where the sutures were placed between the second molar and the wisdom tooth.
After the stitches were taken out, the pain improved somewhat, but I still experience muscle pain in the lower right jaw, which sometimes radiates to my neck.
During the time the stitches were in, I also had some fever-like symptoms, although I never had a true fever.
After the anesthesia wore off, drinking water became easier, but I still had issues.
My wisdom tooth is slightly tilted, and some of it was ground down to accommodate the crown, but the treating dentist did not apply any protective measures, leading to ongoing soreness.

I returned to my implant dentist for a follow-up, but he reassured me not to worry and did not conduct a thorough examination.
I am not worried; I am genuinely in pain! Isn’t pain an indication that something is wrong? Later, I consulted a second dentist who mentioned that my second implant is too close to the wisdom tooth, and there is some inflammation in the gums or periodontal tissue between them.
He suggested that if it’s not a re-implantation, I may need to have the wisdom tooth extracted; otherwise, food could easily get trapped, jeopardizing the implant since I have not yet completed the final crown placement.
Should I ask my implant dentist to re-implant or extract the wisdom tooth? Is it possible that the implant is close to a nerve?

momo, 30~39 year old female. Ask Date: 2012/11/28

Dr. Cui Chongji reply Dentistry


Thank you for your detailed question.
However, to effectively address this issue, we may need to further examine the patient in person and conduct a thorough physical examination along with a panoramic X-ray to provide more substantial recommendations.
If you have any further questions, feel free to visit our dental clinic for additional consultation.

Reply Date: 2012/11/28

More Info


Navigating dental issues, especially after receiving implants, can be quite challenging and painful. Your situation involves a few critical factors that need to be addressed to ensure your oral health and comfort.
Firstly, it’s essential to understand that pain after dental implant surgery can occur for various reasons. The discomfort you experienced immediately after the procedure, particularly around the stitches, is not uncommon. However, ongoing pain, especially if it radiates to other areas like your neck, could indicate complications such as infection or inflammation in the surrounding tissues. The presence of swelling or discomfort in the jaw muscles can also suggest that your body is reacting to the surgical procedure or that there may be an issue with the implant placement.

The fact that you mentioned experiencing a fever-like sensation could also be a sign of inflammation or infection. While you may not have a full-blown fever, any increase in temperature or discomfort should be taken seriously. It is crucial to communicate these symptoms clearly to your dental care provider.

Regarding your wisdom tooth, the proximity of the implant to the wisdom tooth can indeed complicate matters. If the wisdom tooth is impacted or misaligned, it can create additional pressure on the implant site, leading to pain and potential complications. The recommendation from the second dentist to either replant the implant or extract the wisdom tooth is a common approach in such cases.
Here are some considerations for your decision:
1. Replanting the Implant: If the implant is indeed too close to the wisdom tooth and causing ongoing issues, replanting may be a viable option. This would involve removing the implant and placing it in a more favorable position, allowing for better healing and less interference from the wisdom tooth.

2. Extracting the Wisdom Tooth: If the wisdom tooth is causing significant problems and is not likely to erupt properly, extraction could alleviate the pain and prevent future complications. This is particularly relevant if the tooth is positioned in a way that it will continue to interfere with the implant.

3. Nerve Damage: Your concern about the implant possibly being placed too close to a nerve is valid. If you experience numbness, tingling, or unusual sensations in your jaw or face, it’s essential to inform your dentist immediately. They may need to conduct imaging studies, such as X-rays or a CT scan, to assess the position of the implant relative to the nerves.

4. Follow-Up Care: Regardless of the path you choose, ensure that you have a thorough follow-up plan with your dentist. Regular check-ups can help monitor the healing process and address any complications early on.

5. Pain Management: In the meantime, managing your pain is crucial. Over-the-counter pain relievers can help, but if the pain persists or worsens, you should consult your dentist for stronger medication or alternative pain management strategies.

In conclusion, your ongoing discomfort after dental implant surgery is a significant concern that should not be overlooked. It’s vital to have open communication with your dental care providers about your symptoms and treatment options. Whether you choose to replant the implant or extract the wisdom tooth, both decisions should be made based on a thorough evaluation of your specific situation, including the potential for complications and your overall oral health. Always prioritize your comfort and well-being in these discussions, and don’t hesitate to seek a second opinion if you feel your concerns are not being adequately addressed.

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