Post-Wisdom Tooth Extraction: Managing Tooth Sensitivity and Discomfort

After the extraction of the upper left wisdom tooth, the surrounding teeth are sensitive?

Hello Doctor, I would like to ask: After I had my upper left wisdom tooth extracted in early October this year, although the pain subsided quickly and the follow-up examination showed that the wound was healing well, I started experiencing sensitivity and discomfort in my lower left teeth 4.5 days post-extraction.
This has also affected my left ear and caused intermittent migraines, but it doesn't happen every day.
At one point, the discomfort was so severe that even painkillers were not very effective for sleep.
During a follow-up visit, the doctor said that my teeth showed no abnormalities and that it should not be related to the extraction (the upper teeth have no nerves), and advised me to monitor the situation.
Everything was fine until two days ago when I noticed significant swelling in the gums near the extraction site, which was uncomfortable.
I originally planned to see the doctor again, but when I woke up today, the swelling had subsided.
Additionally, I have been experiencing a strange salty taste near the extraction site that seems to persist in my mouth, and I have confirmed multiple times that it is indeed coming from that area.
I would like to ask for your experience: is it really unlikely that this is a dental issue? Should I seek help from another specialty? Thank you!

Ting, 20~29 year old female. Ask Date: 2015/10/20

Dr. Zeng Guanghui reply Dentistry

In the above situation, it is recommended to consult a dentist for a re-evaluation with X-rays and to undergo a thorough diagnosis and treatment.

Reply Date: 2015/10/20

More Info

After wisdom tooth extraction, it is not uncommon to experience tooth sensitivity and discomfort in the surrounding areas. Your situation, where you have developed sensitivity in the lower left teeth and associated discomfort in your ear and headaches, can be attributed to several factors related to the extraction process and the healing phase.

Firstly, it is important to understand that after a tooth extraction, especially wisdom teeth, the surrounding teeth and tissues may react to the trauma of the procedure. The sensitivity you are experiencing in your lower left teeth could be due to a few reasons:
1. Bone and Tissue Healing: After the extraction, the bone and soft tissues in the area undergo a healing process. This can lead to temporary sensitivity as the nerves in the area may become more reactive during this time. The healing process can also cause inflammation, which might contribute to discomfort in nearby teeth and even referred pain to areas like the ear.

2. Changes in Bite and Alignment: The extraction of a wisdom tooth can alter the way your teeth come together (occlusion). If the bite is slightly off, it can lead to discomfort and sensitivity in adjacent teeth. This misalignment can also cause muscle tension and headaches, which might explain the intermittent nature of your discomfort.

3. Infection or Dry Socket: Although your dentist has indicated that there are no signs of infection, it is essential to monitor for symptoms such as persistent pain, swelling, or a bad taste in your mouth, which could indicate an infection or a condition known as dry socket. Dry socket occurs when the blood clot at the extraction site dislodges or dissolves, exposing the bone and nerves underneath, leading to significant pain and sensitivity.

4. Nerve Sensitivity: In some cases, the extraction process can irritate nearby nerves, leading to heightened sensitivity in adjacent teeth. This can manifest as sharp pain or discomfort when biting down or when exposed to temperature changes.

Regarding the salty taste you mentioned, this could be related to several factors, including:
- Saliva Mixing with Blood: After an extraction, it is common for some blood to mix with saliva, which can create a metallic or salty taste.

- Healing Tissue: As the extraction site heals, the tissue may produce fluids that can have a distinct taste.

- Infection: If there is an infection, it can also lead to unusual tastes in the mouth.

Given that your symptoms have fluctuated and you have noticed swelling in the gum area, it is advisable to keep monitoring the situation. If the swelling returns or if you experience increased pain, it would be prudent to follow up with your dentist or seek a second opinion. Additionally, if the discomfort persists or worsens, consulting with an oral surgeon or a specialist in dental pain management may provide further insights and treatment options.

In the meantime, here are some general recommendations to manage your symptoms:
- Maintain Oral Hygiene: Keep the extraction site clean to prevent infection. Gently rinse with warm salt water to promote healing.

- Pain Management: Continue to use over-the-counter pain relievers as needed, but consult your dentist if the pain becomes unmanageable.

- Avoid Hard Foods: Stick to soft foods that won't irritate the extraction site or the sensitive teeth.

- Follow-Up: If symptoms persist beyond a few weeks or if you notice any new symptoms, do not hesitate to return to your dentist for further evaluation.

In summary, while your symptoms may not be directly related to the extraction itself, they warrant careful observation and possibly further investigation to rule out any complications. Your comfort and health should always be the priority, so seeking additional help if needed is a wise choice.

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