Third molar extraction complication

Joined
Jan 8, 2023
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Hello everyone . I had my left lower third molar extracted in April 2022. I had a complication where Parts of my jaw bone broke snapped leaving sharps protrusion on the ridge below preventing the gum from healing. As a note the dentist that extracted the tooth wants nothing to do with recovery as it was an emergency referal ( this is unfortunately how it works in the UK at the moment due to a broken dentistry system) so I went to a separate private dentist. He tried to smoothen the bone but did not solve the problem and instead ended up removing bone and creating a bit of a trench slightly behind the area where the pain was occuring and was then a bit nervous to do any more smoothening due to concerns of hitting a nerve. Whilst the area he smoothened has since healed and is causing me minimum discomfort I have had chronic pain on my ridge for 8+ months now which is significantly interfering with my daily life. The gum is very thin and unable to heal properly and on touch the ridge is very pointy and sharp. The dentist who tried to help me seems to think I should just learn to live with the pain which seems a bit ridiculous and very depressing prognosis to me. Having reviewed the few pieces of literature available on this topic which appears to be a rare complication called lingual bone dehiscence I believe it should be possible to address the problem by simply smoothening the ridge but in the correct location and by an experienced oral surgeon. On another matter I still have a feeling of trama in the extraction point and surrounding teeth and there are bones sticking out the gum in the extraction site which based on literature is not normal 8+ months after surgery. The gum above the site is also constantly sore. I'm not sure if this is due to me having a bone spicule still trapped inside or my upper molar also being impacted. I will try and upload a picture of the site below. I'm seeing a face surgeon next month for an initial consultation which I'm praying will have some positive options but there are incredibly long waiting times now in the UK before national health service operations can be carried out so I am thinking of consulting with a different private dentist to see if they can resolve the problem sooner. Given the big cost of private dentists I was hoping
somebody had any thoughts on the issue and whether this is something a good dentist firm should be able to help with and that I've just been unlucky. I will try and post a current picture of the site below. Regards NL
 

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MattKW

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Firstly, tooth numbering: the wisdom tooth was the 38, and the one in front is the 37 (FDI).
  1. I doubt that you have pointy bones sticking thru the gums, that looks more like scar tissue from your photo. Similarly, if there was any spicule remaining, it would have either come to the surface by now, or created a small infection.
  2. Trying to smooth the bone where you have arrowed is a strong risk for lingual nerve damage, and it would be useful to have notes that describe how he went about this issue. I doubt that the nerve has been badly damaged, or you would have a numb tongue on that side.
  3. There is also a nerve in the area distally where you have labelled "chronic sore gum", the long buccal nerve. Again, how the operation was performed and the types of incisions may explain your problems.
  4. There is also the risk that the 37 was damaged either by the 38 before the extraction, or during the extraction.
I would ask the treating dentist for records of the extraction, including any Xrays, so that you can take them to the OS for review.
 

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Joined
Jan 8, 2023
Messages
3
Firstly, tooth numbering: the wisdom tooth was the 38, and the one in front is the 37 (FDI).
  1. I doubt that you have pointy bones sticking thru the gums, that looks more like scar tissue from your photo. Similarly, if there was any spicule remaining, it would have either come to the surface by now, or created a small infection.
  2. Trying to smooth the bone where you have arrowed is a strong risk for lingual nerve damage, and it would be useful to have notes that describe how he went about this issue. I doubt that the nerve has been badly damaged, or you would have a numb tongue on that side.
  3. There is also a nerve in the area distally where you have labelled "chronic sore gum", the long buccal nerve. Again, how the operation was performed and the types of incisions may explain your problems.
  4. There is also the risk that the 37 was damaged either by the 38 before the extraction, or during the extraction.
I would ask the treating dentist for records of the extraction, including any Xrays, so that you can take them to the OS for review.
Thank you. Your advice is incredibly appreciated. Under point 1 it is hard to get a camera at the correct angle but I can literally pick at the bone with a finger. It's hidden behind 37. I hope with Your point 2 that the bone pointing to the ridge does also not present the same nerve ridge. Thanks Again
 

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