Q. Is severe pain in the jaw normal after coronectomy and wisdom tooth extraction?

Answered by
Dr. Mousam Chattopadhyay
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Nov 10, 2020

Hello doctor,

I had wisdom tooth extraction in addition to coronectomy on one tooth, and I am having extreme pain in my ear and jaw. Is this normal? I took OTC painkillers and ice, but the pain is not going away. I do not have a fever, and I do not have a dry socket or infection.

I am currently taking Oxycodone 5 mg, Tylenol, and Ibuprofen.

#

Hello,

Welcome to icliniq.com.

I went through your query. I am very sorry for the discomfort.

Kindly upload an image of the extraction site. Use flash for clicking the image. And please mention when did you get the extraction done?

You need antibiotics as just over the counter pain medicines are not enough to facilitate infection-free healing. They are not visible but delays the healing process.

Once I receive the image, I will guide you through the management needed and suggest proper medication to ease the discomfort. But first and foremost, I need to see the extracted site. So kindly upload an image.

Thank you doctor,

It is hard to get a picture there but I tried my best to get a good one. I had my operation one and a half weeks before.

#

Hello,

Welcome back to icliniq.com.

The image is too hazy, and the extraction site is not seen (attachment removed to protect patient identity). But I think you have trouble opening your mouth wider.

Since the extraction and surgical procedure was done about 1.5 weeks ago, you should be pain-free by now, unless there is an infection to the extracted site.

Kindly do let me know whether you have difficulty in mouth opening or mouth opening is fine? Do you notice any swelling from the outside?

Since 1.5 weeks are more than sufficient to cope with the pain, I suspect it might be an infection as you do not mention any antibiotics. Or it could be a dry socket. The area remains reddish and inflamed in the dry socket, and the bony socket is visible along with food lodgement and smell. No such reduced mouth opening is noticed.

In any case, first, the pain has to be coped with. I am suggesting some medications. If you feel relieved, then it is just infection due to food lodgement that would subside. But if the pain remains over the area, then it is surely a dry socket. You need to visit your dentist. He/she will place a medicated gauge that will promote healing and minimize the pain.

You can take capsule Sporidex 500 mg (Cephalexin 500 mg) BD for five days, tablet Ibuprofen BD for five days, capsule Omeprazole BD before meal for five days. Use Betadine mouthwash, gargle in lukewarm water two to three times a day (Povidone-iodine 2%).

Avoid sticky or sweet food as much as possible. Brush twice gently. Start the medication. Gargle twice or thrice a day to remove any food lodgement. If possible, upload a clear image as it would be clear that it is an infection or a dry socket.

Thank you doctor,

I notice a small swelling from the outside, and I cannot open my mouth wide. I saw the oral surgeon last Monday, and she said I do not have a dry socket. Is it possible that it has still developed?

#

Hello,

Welcome back to icliniq.com.

If the area has already been inspected by an experienced surgeon, chances of redeveloping are nil. Then all the attention comes to dental infection and inflammation. That in turn, leads to reduced mouth opening and swelling.

In this case, the medication I suggested will help you as a miracle as they are the best and safest. You need to stop using ice water and gargle with the mouthwash two to three times a day. If Povidone-iodine 2% (Betadine mouthwash) is not available, any other mouthwash will also help, but never forget to use it in lukewarm water.

Start on capsule Sporidex 500 mg (Cephalexin 500mg) BD, tablet Ibuprofen BD for five days, capsule Omeprazole BD before meal for five days. Use Betadine mouthwash, gargle in lukewarm water twice or thrice a day for a week (Povidone-iodine 2%).

Avoid sticky or sweet food as much as possible. Brush twice gently. These medications will help a lot. Do not apply any external source of heat, such as a warm water sponge.

As you have mentioned, if the dry socket has already been ruled out, then dental infection and inflammation due to surgery are causing the pain. Start the medications as directed, and you will be fine in no time.

I hope this helps.


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