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HomeAnswersOral and Maxillofacial Surgerydental implantI am having severe pain after the placement of a dental implant in my upper jaw. Why?

What could be the reason for severe pain after dental implant placement?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At March 29, 2023
Reviewed AtSeptember 1, 2023

Patient's Query

Hi doctor,

Three years ago, I did a tooth implant on tooth number 22. After the implant, immediately started paining on the same area of the face. Later, I have found out that I have a necrosis on tooth number 21. I was tried endodontic treatment but it did not succeed and the doctor recommended for second implant. Doctor extracted the tooth and placed the implant immediately. I had a severe pain for one week after the implantation and then the pain become bearable. There is no sign of infection, the gums are slightly paler than around other teeth. I had done cone beam computed tomography and the doctor says that everything is fine. Currently I am suffering from severe pain. Please help.

Hi, Welcome to icliniq.com.

Thank you for your query, I totally understand the reason for you being disappointed in the dental treatment you received. As an implantologist, I need to tell you that not everyone can make good cases for implants. Dental implants can be successful only when you have a fair amount of jaw bone and no gum issues at all in the region surrounding the tooth. The cone beam computed tomography report attachment removed to protect the patient’s identity) shows that there is extensive bone loss and necrosis in relation to the upper central and lateral teeth. The pain you are experiencing now and the reason your endodontic treatment failed previously are both linked to gum and bone infection only that are synonymous to each other. The cause of bone loss is also jaw infection or bone infection. I wanted to ask you a few questions before I diagnose and give you the remedies now. Did you get your deep scaling or cleaning done anytime? What painkiller have you been taking to control the pain? Please let me know and I can give you a list of strategies that you can implement to stop the dental implant from failing and also to prevent gum infection. I will also be prescribing some antioxidants for you that may helps to reduce your gum infection.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply,

I have been experiencing this type of pain for years, and every doctor has told me that I have trigeminal neuralgia but the pain is constant. I opened the computed tomography myself and noticed that my bone or jaw is damaged. My oral surgeon recieved this report five months ago and said everything is fine but my pain is becoming worse day by day. I am afraid if there could be more bone lose because this report has taken almost five months ago? Do you recommend to take new one? I have not done deep cleaning ever. I am taking Ibuprofen 800 mg but it did not work and, also have a sinus infection that has spread from maxillary sinus on that side and I am currently taking erythromycin 500 mg.

Hi,

Welcome back to icliniq.com.

Can you please confirm me your age before I prescribe you the antioxidant therapy and i will also be giving you list of measures to fight your gum infection. You will need to follow the instructions for atleast an year. I am sure definitely you will find improvement in your gums and it can certainly prevent implant failure and bone loss as well further. Deep dental cleaning needs to be done in every six months. There's nothing to worry about with the new cone beam computed tomography. You are unlikely to find any positive changes in the new cone beam computed tomography even if you get it done now. Please confirm your age and let us know if you are currently taking any medications or have any other health issues other than nasal issues. Have you been taking Ibuprofen 800 mg only for pain control and also how long have you been using it? Did you consult any neurologist to confirm if it is trigeminal?

Please follow up for further assistances.

Thank you.

Patient's Query

Hi doctor,

Thank you doctor for your reply,

I am 26 years old. I saw multiple neurologists but they were not sure if it is trigeminal or migraine or something else because I told them that I had constant pain and not trigeminal pain. I was sent to neurologists because my oral surgeon said that everything is fine with my implants. I did an magnetic resonance imaging to exclude the artery conflict with the trigeminal nerve. That is why I suspected that the pain comes from the implants area because I can feel the pain in the gums when I touch certain parts of them. The most painful part of gums is from 21 to 11. I am taking the tablet Ibuprofen from time to time when it hurts too much. Last time I took it was about 15 days ago and I started the pain again yesterday and also, I have less prothrombin time.

Hi, Welcome back to icliniq.com.

Fine, I wanted to confirm firstly whether you had seen a neurologist or not. Most neurologists also cannot correctly comprehend facial pain is because dental infections also give similar pain. You are certainly right in concluding that pain is coming from the gum region around the implant particularly. that means it is a clear gum and bone infection. Please do the following measures if you have any doubts you can ask me. Once you implement all these around three to four months ,then you will definitely see changes in the bone and gums both . Get a deep dental scaling done at your local dentist and this needs to be repeated every six months. Regular scaling will relieve your possibility of gum infection. I suggest you to start with vitamin E tablets. Puncture them and apply it onto your gums locally, around the region of the gums all around the implants. You can apply this best at night time and do not rinse with water. Whenever you have pain, you can apply the combination of Choline Salicylate and Lidocaine hydrochloride 2 %. Apply this over the gums any number of times in a day to prevent sensitivity or pain. I suggest you to start using Chlorhexidine gluconate mouthwash or Betadine 2% mouthwash twice a day. This may definitely not only heal your gums, but also help regrow them back to an extent. both mouthwashes are quite effective. Also, you can use any one of them on a regular basis . Continue with Ibuprofen 800 mg or alternatively Ketorolac tromethamine tablet twice a day for three days whenever you get severe pain. Once you start using all of these may be you will start getting so much pain in that region especially after deep dental cleaning. if you follow these measures it will be more effective. My advice is as a surgeon to heal your bone and gums both. You might find it different from most of the local dentists. Follow these strategies and you will definitely see the positive results soon. Anytime you have a doubt after a month or two or still you are facing pain, then definitely follow up with me. in that case you will need high dose antibiotics to quell the infection. Please implement all the procedures I have suggested daily.

Please follow up for further assistance.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply,

I will follow all written measures and get in touch again. Thank you.

Hi,

Welcome back to icliniq.com.

You need to follow these measures atleast one to two months and you will definitely find improvement. I guess once your gum condition improves, you can follow up with me again.

Please follow up for further assistance.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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