How Can I Have a Toothache Where There is No Tooth!?!

I had a tooth pulled during an emergency dental visit just shy of two months ago. The doctor said the tooth couldn’t be saved. It was broken at the gumline and I had an infection on top of it. I expected it to be uncomfortable for a few days or maybe even a week or so after, and it was, but it wasn’t anything Tylenol couldn’t handle for me. But, after that, the “tooth” never stopped hurting. It’s the weirdest thing. I’m sure it’s that spot. It’s not extreme pain and it somewhat subsides sometimes, but I’m always aware of it. Is it normal to have this kind of sensation after a tooth is removed and, if so, how long does it usually last? If it’s not normal, does it mean the dentist did something wrong? I’d go back and see him again, but if he botched it the first time, I don’t have confidence he will set things right.

Thanks,

Alex

Dear Alex,

Sorry to hear you’re not recovering how you should be. Most people are feeling ok within a few days to a week, with the pain reducing bit by bit over time. Once you hit the two-week mark after an extraction, it’s usually considered abnormal to be hurting.

There are several potential causes of your phantom toothache.

If you experience extreme pain a few days after an extraction, the most likely culprit is dry socket. Since you didn’t mention a spike in pain in the early days, that’s probably not the issue.

Following this, the next best bet is an infection. Chances are, you’d have other symptoms to go along with this, like swelling, a bad taste in your mouth, the presence of pus, and so forth. Absence of these doesn’t mean there isn’t an infection though.

There’s also some chance portions of a root fractured and stayed embedded. Dentists will examine a tooth once it’s out to ensure they have the whole thing, but sometimes if a tooth is in bad condition before it comes out and has already fractured or lost pieces, it’s difficult to tell. Occasionally, a dentist will leave a fragment behind intentionally if removing it could traumatize the area more. These aren’t usually problematic though sometimes they can work their way up and put pressure on the tissue.

Lastly, you can’t overlook possibilities like nerve damage or atypical odontalgia (oral pain with no identifiable cause). These are incredibly rare—to the point some dentists never see them in their entire lifetimes—but could be potential causes. And, the list goes on…

You should go back for an exam.

The bottom line is that you’re in pain and the only way you’re going to find relief is to get a diagnosis. Particularly since infection is a likely cause, this is something you’ll want to have checked out sooner rather than later. There’s nothing to suggest your dentist did anything wrong here, but if you’re worried, you can also visit someone new for an emergency exam.

This blog is sponsored by Elgin dentist Dr. Steve Sirin. If you’re experiencing a toothache or other dental emergency, contact his office to inquire about a same-day appointment.