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Old 01-23-2010, 08:53 AM   #1
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Exclamation Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

To give you the broad overview, I am a 29 year-old woman and I have had 2 root canals and an apicoectomy on tooth 7, the lateral incisor. I originally had the first root canal done because tooth 7 was cold sensitive, and after the second half of the first root canal--my dentist did the procedure in 2 parts--I had pain when I pushed on the face of tooth 7 and the tooth throbbed. Ultimately, the 2nd root canal was done to make sure there wasn't a fracture in the tooth and to make sure the 1st root canal was done well, but the pain remained the same after the 2nd root canal. No fracture was detected in the tooth by way of that 2nd root canal, so the endo who did it advised me to get an apicoectomy. No fracture was detected during the apicoectomy, which was done by way of a large flap that spanned tooth 6, 7, and 8, though the endo said that it's possible that there's one on the back of the root (where he simply can't see). However, the endo did find a big lesion in the bone, so he had to drill a big chunk of the bone away to get rid of the infection. (He surmises that I suffered a trauma to the tooth at some point in my life because of the nature of the lesion. I don't remember such a trauma, but I obviously must have had one.) My problem is this: It's been 3 weeks since I had the apicoectomy done and I'm still in pain. My chronic pain--the pain I felt when I pushed on the face of tooth 7--has disappeared. However, tooth 8 now hurts when I put biting pressure on it from the bottom, and more generally, it now hurts to smile, make a kissing face at my fiance, and floss. It's also hard not to feel like I'm going to drool a little when I talk, and I sometimes even feel my gums pulling if I'm washing my face or if I make a loving squint at my cat. Ultimately, it seems like I'm feeling the periodontal ligament or the gum tissue around tooth 7. What I mean by that is that it seems like there's a straining sensation around the tooth when I do the things I describe above.

Ultimately, I want to know the following:
1. Is what I'm feeling normal?
2. How long will it last? In other words, will I be pain free once the bone fully forms, or is this pain not related to the hole in my bone? Why am I feeling this pain?
3. Does it sound like the tooth could still be fractured? What would indicate whether the tooth is fractured?
4. Should I have the tooth pulled and have an implant put in?
5. If I did have the tooth pulled, would I be out of pain, or is the pain I'm in now relating to my gums unrelated to tooth 7 being there?
6. I've already had a millimeter of gum recession around 7. If I got an implant, would I have more gum recession?

Please note that I've been taking 2 advil every 6 hours for 2 weeks now. (Before that, I was taking 4 advil every 6 hours for 2 months.) I'm getting married this summer and want to look and feel good for my wedding, so I need to take a smart course of action at this point or I need to put my wedding off, which is something I really, really don't want to do. (But I also want to be able to kiss my husband-to-be and not wipe drool from the sides of my mouth when I'm saying my vows or talking to my guests!)

Please help me. I need to know what's normal and I need to know how to proceed. I don't want to live in pain anymore, and I want to look like a normal 29-year-old woman when this is all said and done.

I particularly appreciate responses from professionals in the field and individuals who have gone through similarly horrifying ordeals.

Last edited by tooth7pain; 01-24-2010 at 05:27 AM.

 
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Old 05-09-2010, 05:32 PM   #2
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

I sure hope you read this and give me an update on your condition!! We could be twins! I had an apic on tooth 7 about 3 weeks ago. I constantly feel discomfort but nothing extremely painful. I swear my gums are moving around my tooth. The most sensitive area is high above the tooth almost at the base of my nose. I go back to the dentist this Friday for a post and temp crown on the tooth. I have already been through two courses of antibiotics but an xray about 2 weeks ago showed no sign of infection. Please let me know how you did!!

 
Old 05-09-2010, 06:09 PM   #3
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

Hi! I still feel discomfort and it has been almost 6 months since my apico. However, the pain is FAR lesser now that I figured out what the problem was: I grind and clench my teeth at night, and the clenching and grinding was keeping the surgical area from properly healing. I ultimately had to get a night guard (which I'll use for the rest of my life) and get on anti-inflammatories and muscle relaxing pills (for about 3 months total). I'm basically off of the drugs at this point, though I take them every now and then if I'm not feeling well. My lasting discomfort is likely just from the fact that the bone has yet to fully heal. Apparently, it can take as long as a year for it to fill in, so discomfort can last as long as that. (Plus a root-canalled and apico-ed tooth never feels exactly the same simply because the nerve is gone, from what I understand.) Good luck to you. I hope the insight into my own experience helps you with yours. And please feel free to write with questions if you have any. I really had such a bad experience with this and I'm very happy to be of help to anyone who is going through something similar.

 
Old 05-09-2010, 06:19 PM   #4
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

P.S. You might want to wait to get the post and the temporary crown. It depends on just how sore you are right now, but the less discomfort you have going into the procedure of getting the post, the less you'll have after it. Another week or two may make a real difference for you, especially if you address a clenching/grinding problem if you have one. (By the way, if you're sure that clenching/grinding isn't your problem, I have some other ideas for you. As I said, feel free to write to me to discuss this more.)

 
Old 05-10-2010, 05:53 AM   #5
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

Thanks for the update!! I'm almost positive clenching isn't my problem. It is early morning that the area feels "the best". It seems the more I move my mouth... chewing, talking, etc, the more I feel the area. My dentist wants to get the tooth capped ASAP because I have already waited too long since my root canal (almost 2 years or more).

It really isn't painful... just terribly annoying. I feel the area every time i move my mouth... like it is stretching and pulling. Playing with it with my tongue doesn't help anything !!

Keeping fingers crossed.

 
Old 05-10-2010, 06:09 AM   #6
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

I had the same exact kind of feeling--the stretching and pulling, and, like I said in my post, a sort of "straining" sensation and pain when I pressed just right of my right nostril. Plus I always felt best in the morning and then worse as the day went along. If your pain isn't intense, just annoying, the problem really may just be that the bone has yet to fully fill-in. If that's the case, you'll feel better and better as time goes by. But that 2 week recovery we were told about is a total lie! I still have that weird straining sensation and I had my apico at the beginning of January, 2010. The good news is that it has lessened increasingly with time as the muscle in the gums has increasingly more bone to back it up.

 
Old 05-10-2010, 08:36 AM   #7
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

My dentist never told me a definite recovery period but I didn't ask either. I knew it had to be done so... I am definitely feeling more confident the more I chat with you so hopefully this issue will be a "memory" sometime in the not so distant future.

 
Old 06-25-2010, 06:03 AM   #8
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

This is so interesting. I went to the dentist two weeks ago because I had exactly the same feelings you describe (straining sensation, pulling, tightening on my upper gums and front left tooth when I moved my mouth in certain ways, also an extremely unformfortable feeling when I pushed lightly just under the left nostril). That front tooth was injured in an accident when I was a child (ca. 25 years ago). They saved the tooth but did a root canal on it, and then a put on a veneer. Two weeks ago the dentist, as well as an ENT, told me I needed an apico and I had one done last week. Problem is I still feel the same sensations, slightly less to be sure but same nonetheless. I don't know what's going on. Did the apico not work? I realize healing takes a while - but why would I be feeling the SAME sensations. Do I live with this wierd sensation? Could it be my jaw bone that's infected? Who do I go to to determine/rule that out? My dentist and oral surgeon only ever took x-rays? Did anyone ever have a MRI or a CATscan? Thanks!

 
Old 06-26-2010, 01:52 PM   #9
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Re: Pain after apicoectomy on tooth 7. Is this normal, or should I get an implant?

To me, it seems very strange that you had the sensation before and after the apicoectomy. I only had the sensation following the apico. Before the apico, I couldn't put any pressure on the front/face of the tooth--not even the pressure of my upper lip against it, let alone the tooth brush brushing the tooth properly. It's now been 6 months since I had the surgery, and I can say that I'm almost but not entirely better. Particularly after I unconsciously clench into the tooth, I continue to feel the strained feeling. I also still feel the tooth when I make a kissing face/pucker. It doesn't hurt anymore (as it did right after the surgery), but it definitely doesn't feel the way it did before anything went wrong, and really I'm not sure that it ever will. At least it doesn't hurt anymore though; it just feels sort of weird. And it took me roughly 5 months to get from sensations that I'd identify as painful to the sensations that I have now, which I'd identify as merely uncomfortable. Regarding the CT scan: I was ready to go ahead and have one done because the pain was so unbearable 2-6 weeks after the surgery, but I was told that the cost/benefit didn't work in my favor. Instead of getting the CT scan done, I saw Dr. Tannenbaum, a very famous (and very expensive) oral/facial pain specialist on Long Island in New York. He ordered an MRI and consulted with a neurologist who found nothing out of the ordinary, so Dr. Tannenbaum came to believe that the problem was that I was carrying very extreme tension in my face--due in part to everyday stress and in part to unconscious clenching in the night. He prescribed a night guard, physical therapy twice a week (they massaged my scalp, face, and neck), Klonopin to relax the facial muscles and the atrophied muscle that no longer had skull bone behind it, and an anti-inflammatory typically prescribed for arthritis patients. (The anti-inflammatory is rarely prescribed and I don't remember the name of it, but combined with the klonopin, it worked wonders for me. It was in the form of an evergreen-colored gel capsule. Note that I took the anti-inflammatory only in the morning and the Klonopin in the morning and in the evening. I also took extremely low dosages of each. This went on for five months, but after about 3 months, I began tapering the meds.) Really, Dr. Tannenbaum was the only Doctor who actually helped me because he was able to look beyond the "normal" x-rays etc. Even though there was nothing wrong with me according to x-rays, MRIs, etc, I was still in pain, and he didn't give up on me or on treating my pain. I hope you find someone like Dr. Tannenbaum--a neurologist or a TMJ specialist, perhaps, or maybe someone who is familiar with Dr. T's work. I think that before you get anything pulled or shaved away or anything drasctic done, you should make sure the problem isn't something that someone as innovative as Dr. Tannenbaum could treat. By the way, I just read what I'm posting right now to my husband, and he wants me to say that he believes that I'll feel completely normal/better at the 12-month-mark--12 months after the apico, that is. I am adding what he asked me to add to this post because he's seen me through this whole ordeal and has seen my dramatic progress in recent months, particularly as a result of what Dr. Tannenbaum prescribed. If my husband continues to have hope for me, I have a bit more hope for myself, and you should have hope for yourself, too! Just give it time and do attend to the facial stress that very much could be the culprit behind most if not all of your pain.

 
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