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FAQ:  Extractions


Videos:
Molar Extractions (GRAPHIC)
8 extractions in 4.5 minutes(GRAPHIC)
Easy X-TRAC Extraction Device
Broken Root Tips FAQ
Article:
Extractions without Bone Loss
Graphic Photos:
Extraction JawBone Issues


Bad Tooth Extraction Ask The Dentist Edward Brant Question:
Five months ago I had a tooth extraction which took the dentist over half an hour chipping bit by bit as it was a crowned tooth.

Eventually he had to get the consultant in to extract the tooth which took him all of 3 seconds.

I suffer from Multiple Sclerosis and since extraction I have a lot of pain and my jawbone especially is in a lot of pain, throbbing pain and aching, almost like sinus pain.

I have since been to the hospital and seen a consultant who did xrays which showed nothing and was told that due to the excessive pressure and my mouth being open for a long time during the extraction I have strained my jawbone and have exercises to do but still not getting any better. ...Visitor from UK

Answer:
You did not inform us of where the tooth was in the mouth but we will do our best for you. The explanation given to you is probably correct. The incidence of muscle related problems after extended treatment times is common. However, 30 minutes to extract a tooth is not considered excessive by most dental professionals. Some teeth are harder to remove than others.

Investigate the possibility of a TMJ dysfunction if you feel symptoms extending into your ear and jaw joint, along with radiating pain the extends into your neck, head or shoulders.

Consulting with a dentist who specializes in tmj and/or neuromuscular dentistry would facilitate access to assessment and treatment technologies that general dentists typically don't have. Sometimes, removing a tooth can "throw the bite off."

There is also a remote possibility that root tips were left behind... which can be very common with difficult molar extractions.

Root tips have been known to linger for years without x-ray detection. A cone beam CT scan, which creates 3D images are popular for finding this type of material. Once "seen" it can be removed. An implant periodontist or implant dentist may be the best resource for this.

The sinus pain symptoms may be secondary to the suspected TMJ dysfunction which can involve an unbalanced occlusal bite...or, depending upon the proximity to the extraction site, could be related to an infection process associated with a root tip.

Assuming this extracted tooth was in the upper arch, one last possibility is the existence of a compromised sinus cavity floor where the extracted tooth once was. A careful examination of the area looking for a small opening from the mouth into the sinus cavity or a good CAT scan might help to reveal any abnormalities in that area.

If there is an issue there, surgical correction will likely be indicated. One treatment option might be a sinus lift procedure (incorporates bone grafting)... videos of which are on this website.

Edward Brant, DDS, MS
Reconstructive Periodontist
447 Lake Avenue
St James, NY 11780
(631) 584-4395

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