HomeAnswersDentistryimpacted toothI have pain in the left side last tooth. Is it gingivitis?

Is surgical removal necessary for last tooth pain?

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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

Dr. Vinodhini J.

Published At January 12, 2020
Reviewed AtJanuary 12, 2020

Patient's Query

Hello doctor,

One week ago, I started feeling pain in the mouth in the left side last tooth. The pain was so severe that I was unable to open mouth and also ulcer over that area was not visible to the doctor (GP). He advised me to take Becosules, Rubifol, and Zocon DT for five days. I started taking those medicines, but I started feeling pain in the full left side teeth and jaw that extends towards the ear. After searching over the net I came to know that it is a swelling of gum and something called gingivitis which may be the cause of my pain. After I have gone to the dentist, she advised me the following medicines:

Augmentin 625 mg TDS for five days, Metrogyl 400 mg TDS for five days, Chymoral forte bd for five days, Zerodol P BD for five days, Rantac 150 mg od for five days.

I asked the dentist to reduce so much of medicine but she told me that you cannot modulate the antibiotics as it is a course. Plus she told me that your affected teeth i.e beneath the swollen gum needs to be surgically removed once you get back to normal. I started taking these medicines leaving the above medicine advised by GP except Becosules.

Now my queries are: After one day, I started vomiting. And minor flecks of blood were also visible in the vomit. Now I want to know whether I am taking the right medicines and the right dosage? Whether any of the above medicines can be removed? Since I had gone to the dentist after full five days of ulcer medicines my jaw was not opening that time, but from the next day I started reliving pain and gradually my jaw also started working and helps in chewing foods. So can I reduce the dosage of the above medicines and leave Zerodol as I think it is a pain killer and I do not have so much pain now?

I am scared of hearing surgical removal of my teeth, so whether it is necessary to get it removed? Will I get back to normalcy after medicine? Whether removal is actually required in case of gingivitis? Any other suggestions?

Hello,

Welcome to icliniq.com.

I am sorry to hear about your problems. The symptoms and line of treatment you have described points to be normal. Though you can take painkillers as per your requirement, I advise you to not to stop the antacid (Rabeprazole and Domperidone in many cases) as they may help you prevent conditions like nausea and vomiting.

The blood appearing is alarming, and the source of bleeding should be figured out. Notice if the blood is coming out along with pus of the tooth or not. You may consult or call me in this regard. It would be better if you send me a picture of the tooth and gums in questions to pinpoint the condition. It is not always necessary to go for surgical procedures.

Patient's Query

Thank you doctor,

Recently, I have taken a TMJ x-ray. So please refer to that and suggest if there is anything serious to think about. Also, scaling was done one month ago due to my bad breath problem.

Moreover, after scaling I used to do mouth wash and was using Vintage toothpaste as advised by the dentist for my sensitivity problem. But now I left using that toothpaste as it gives more sensitivity while brushing teeth. And my sensitivity is also not reduced and I still feel the sensitivity while eating sweets, etc.

Hello,

Welcome back to icliniq.com.

I have seen your x-ray. (attachment removed to protect patient identity).

I will like to inform you that your upper left last molar appears to be directed more towards the throat (distally erupted wisdom tooth). If your symptoms persist, it is better to go for extraction.

I recommend you take an intraoral picture of the tooth that reflects the actual view in the oral cavity before we call that extraction a 'surgical' one. For sensitivity, I recommend you take a medicated toothpaste as suggested by your doctor, the reason being, molecule varies according to nature, and duration of complaint.

Patient's Query

Thank you doctor,

Please clear my doubt. For intraoral picture, is it an x-ray or you want me to take a photo of my teeth on my own? Right now my problems are chewing discomfort, bad breath, sensitivity, and sometimes pain near the ear.

Also, refer my previous x-ray sometimes back for the same problem. Has it improved or became more problematic?

Hello,

Welcome back to icliniq.com,

Intraoral picture pertains to the picture of you, ask any of your family members to capture the teeth we are concerned with. The previous x-ray (attachment removed to protect patient identity) depicts the lower third molars within normal limits (and uppers are slightly tilted away), and the latter x-rays depict the lower third molars also not fully erupted. Hence, in all, the problems can be grossly attributed to all of the wisdom teeth to a more or lesser extent. The problems involve radiating pain in and up to head, neck, shoulders, and even chest. If this is accompanied by occasional cheek bites, we should give it a priority.

If your age is beyond 25, there is not much hope for the teeth to get back to normal angulations. The final decision about the extraction of the wisdom teeth will depend upon your age and an intraoral picture of the teeth in concern. I have already answered the above for the sensitivity you are having.

Bad breath is met with teeth cleaning, then followed by good oral hygiene maintainance (like brushing, flossing, and mouthwash). If the problem persists beyond three weeks of treatment, one should seek the opinion of the physician.

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

Dr. Iyer Parth Laxminarayan
Dr. Iyer Parth Laxminarayan

Dentistry

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