Dental Chronicles

[Mrsmorton]

I have noticed a number all of the dental related questions on MN get repeated once a month or so; this may be entirely unwelcome but what I intend to do is to make a series of detailed posts answering the most common questions so that I can signpost posters to an answer. Often they disappear in chat and then resurface.

I am a dentist (that's no secret on here) but I have no way of proving my qualifications and neither do I feel the need to. I hope that this will be of some assistance to someone at some point!!

Thank you, will enquire

mrsmorton it's me again...

Well I didn't last much past 11am when I had that radiating pain...

I went to the emergency dentist and he didn't suck anything, he gently picked what was left of the packing out. Then he swilled three times with corsodyl and had me spit. Then on the last time he said hang on there's a big chunk of something, he took that out and he said God knows what that is. Then he packed it again, it was like proper stinging pain for a few hours so I resorted to cocodamol.

He said it looks okay for 3/4 day of extraction and I said it's day 10 but it was a horrendous extraction and there was some root left. So he frowned a bit and said it should feel better tomorrow. If it's not better by Wednesday I need to go back to the dentist and see if it's the left behind root that's causing a delay in the healing. I am fed up being in pain, and fed up crying....having kids is so much easier than toothache :-(

Hello mrsm, sorry me again....
I had a back lower molar out last Friday, it was still v painful and had a bit of bony bit sticking out so I went back to the dentist on Wed, he sorted the bony bit by smoothing it down, it was part of the socket, and said I had a dry socket. He cleaned it and packed it, the relief was amazing, I could have cried, I was pain free for the first time in weeks!
The brown dressing thing is coming away now, does that matter? Can I just ignore it?
The other thing is that I have this pain in my jaw now, it has always clicked when I open my mouth, but now it seems much worse, I can feel the click when I hold my jaw when I open it and the pain is always there although painkillers dull the pain. Do I need to go back to the dentist again, or should I wait and see if it settles down? I think my dentist is probably sick of the sight of me!

I mentioned the brown stuff (it's called alveogyl) before, where a pp asked about dry socket. Just ignore it and it will go away. As long as the dry socket pain is better it doesn't matter.

Give the click a few weeks to settle and go back if it's no better. Take ibuprofen if you can as it helps with inflammation of the jaw muscles.
this is very helpful.

Thank you, the link starts to work but then goes blank ? It looks like it Is an nhs link?

Elginflower it's the TMJ exercises which are good, I also have TMJ so I can't really work out if the pain is dry socket, TMJ or neuralgia :-( I find a nice warm scarf around the jaw helps with movement too - at the minute it hurts to smile my muscles we so mauled.

So is your dry socket all healing now? Mine seems to be slow...I guess that's what dry socket is.

Just google TMJ Exercises. It's an NHS pdf that comes up but there are lots of resources online.

Regarding dry socket / dressing and numbness - numbness started a few days before I had the dressing put in. I am confused as to whether it is dry socket / infection / both - when the dentist spoke to the dental nurse she called it dry socket, when she spoke to me she said it was an infection, and when I asked her if it was dry socket or an infection she said they are the same thing. So who knows!

No one ever said I was high risk for nerve damage, so am hopeful that the sensation will come back.

Great thread by the way - I work in healthcare and learnt lots from this, so thank you.

Thanks so much for the TMJ advice, I have been doing the exercises and it is much better
The alveogyl is still there (since Wed) in a sticky lump and I'm not in.pain but the gum seems to be healing over it, should I try to get it out, or go back to the dentist, it really doesn't look like it's going to budge !?

JUST LEAVE IT.

It will sort itself out, at present its acting as an obtundant, plugging a hole and allowing the bone to calm down. Just. Leave. It. Ok?

Pulling it out will delay things.

Glad the TMJ exercises are helping should listen to my own advice

Leave the brown stuff. Yes??

Yes boss! I will leave it be (promise) but bleughh I hate it, just want it gone! I am such a worrier about my teeth, I must spend hours a week worrying about the state of my teeth, I know it's crazy and my dentist is very reassuring that they aren't that bad but I can't help it. They are very clean though, I am meticulous about cleaning and flossing so there is maybe a good side to my paranoia !

Anybody living in Leeds or the west Yorkshire area that can recommend an orthodontist that they have had success with re adult braces. I had a back tooth out on either side at the bottom and wasn't warned by my dentist that this causes the teeth to fold in they seem to be moving in so quickly that I feel in danger of losing the outside ones and am a little panicked about going with the recommendation of my own dentist as I have lost faith in them. My teenage daughter was told she had slight decay in a baby tooth then was told woops its an adult tooth and the decay was deep seated so she had to have her tooth removed. Sorry for the ramble hoping someone can help. x

Just spotted this great thread after starting a new post about tooth pain. I cant copy and paste on my tablet so would be really grateful if you could please take a look.
Thankyou

Hello MrsM. We've just found out that our 10 year old DS has no incisors (the ones either side of his two front teeth). The dentist's referring him onto an orthodontist and says they'll see how his jaw develops. I think the plan is to stick with his baby teeth for as long as they can, then either implants will go where the incisors should be (she said not until late teens/ early 20's with a bit of luck), or if they think it'll work he'll have braces to move his teeth round to fill the gaps. I was so surprised when she told me that I didn't ask too many questions. Do you have any wise thoughts? I've heard of people not having all their wisdom teeth, but the front ones is a bit of a shocker and I'm worried he'll have years of dental work ahead..!

The lateral incisor is the most commonly missing tooth (after the wisdom tooth). It's really common, there are MNers who've got this. The orthodontist will be able to see how much space there is. If there is crowding then it makes sense to move the canines into the space, if there's no crowding then keep the space.

Implants are highly successful and predictable although expensive. (And not the only option, bridges can also be used). Orthodontics is cheap in comparison altho the appearance can be slightly compromised.

I just googled "congenitally missing lateral incisors" and lots came up but its all a bit technical (was hoping to be lazy and just send you a link). Maybe have a Google yourself and PM me with any specific questions.

Thanks Mrs M I will google and try and make sense of it!

Well Mrsmorton I just thought I would come back and update...

Day 13 after extraction presented myself at emergency dental hospital to be treated with utter care by a ton of students and their tutor. They had a good poke around, did an x-ray and discovered that oh yes there was a 1cm x 1cm square root left behind and not the numerical kind. They extracted there and then although that sounds a lot easier and less painful than it was. Note to everyone if you ignore your toothache or don't go back and seek advice it apparently can cause lots more pain on extraction.

Anyway I am post root extraction day 4. I am assuming since the socket it full it is healing. It's been black grey with white on top, today I had a tiny little pinprick red mark and a teeny ooze of blood and then it's all looking like it's got this fatty white stuff on top. Apparently there was a bit of infection there which he said came out with the tooth. The only pain I have is inside my cheek at the jaw joint where the needles go in cos I am bruised like mad on account of the 4 needles and 2 nerve blocks either side of the tooth it took to numb it. Also jaw is a little stiff to open, as soon as I realised how bruised I was, put ice on (first 24 hours) and stretched mouth open little by little and post 24 hours put heat on doing the same. Think I am very lucky that the stiffness has been much reduced. Salt water rinses from 24 hours post op.

Absolutely paranoid about dry socket obviously and after today's little ooze of blood am like argh!!!

Anyway does it sound like it's all going well and is there anything else I should be doing?

a silly one maybe ...
what can I do to relieve the itching from cutting into my gums when flossing? my excuse is that I use different floss than usual that slips easier...

Um, no idea. Maybe brush them afterwards? Use a different floss? Not dealt with itchy gums before. Swill vigorously with some water? don't know!!

Check your technique mous, floss won't cut into the gums if you are wrapping it round the tooth in a c shape and wiping up the tooth. Check YouTube for instructional videos

Mrs Morton, thank you for a great thread, but I wonder if you can give me any info/thoughts on gum grafts? Due to gum recession (which I have suffered from for many years) I see the hygienist every 4 months and am very fussy about brushing,using tepees etc. Despite doing everything I can (and the hygienist always says I am doing a good job) I have noticed the recession on 2 of my bottom teeth has worsened and is exposing quite a bit of tooth below the ridgey bit. Is a gum graft ever done routinely for this sort of thing and do you know how successful they are? Any info would be welcome!

Brilliant information here Mrs Morton, I have learnt loads. Can I ask for advice please?

My lower canine/cuspid tooth became sensitive to cold, the gum felt tender and I developed intermittent dull ache in it, sometimes it woke me up from sleep and strangely the next night it would be fine. No bite pain. I saw a dentist, but not usual one as overseas and he did an xray, saw nothing but said the tooth had twisted overtime due to the molar next to it being removed in childhood. He renewed the filling in the tooth as it was an old amalgram but after the anaesthetic wore off, it was as sore as ever, pain in my lip, cheek, tender gum, I actually felt as though I had be assaulted. This has gradually got a bit better but it is still very sore and last night I was woken up with a dull pain again.

This dentist did say that perhaps it needs a root canal treatment but as I am currently abroad and my trustworthy dentist is back in the UK, I am reluctant to go ahead in case I get the same pain after the anaesthetic wears off again as he did say there was nothing to see on xray.

I have been googling (bad idea) and not sure if I should go back to this dentist or plan a trip back to the UK to see my trusted one for a second opinion. Could it be sprained tooth syndrome? I still have a dull ache, but not that bad and sore gum.

Sea I don't know much about gingival grafting I'm afraid. It's a specialist procedure and privately available in the UK.
Your dentist would be able to refer you to someone (a periodontist) who will be best placed to advise. Sorry I can't be more help.

charlotte are you sure it's the canine? These teeth are usually some of the healthiest and not normally restored in amalgam. Did the dentist do "sensibility testing" putting ice on the tooth or a strange electrical machine to see if the nerve was working normally?

A trip to your dentist is worthwhile but remember, you don't have to have anything done.

Sea: I've only seen one patient who had a gingival graft and it failed. It's quite a tricky and expensive procedure for not much pay off. I'd say you're best off to continue taking advice from your hygienist and focus on preventing further recession.

Mrs Morton, no you're right, it is the 1st biscupid - I read the chart wrong!