Tooth Extraction went badly - advice needed!

Discussion in 'Dental Archive' started by Unimobiles.com, Jun 7, 2006.

  1. Hello,

    I went to my UK NHS dentist a few weeks ago who identified a badly
    decaying wisdom tooth (rear upper on my left hand side) . He asked me
    if it had been causing any pain at all, to which I answered no. He
    indicated his surprise that it had not been causing pain.

    He said the tooth would need to be extracted to which I agreed. An
    appointment was booked for 3 weeks later.

    I had the extraction today, however it did not go smoothly. I was
    given no advice to the procedure before hand. He injected the area
    with an anesthetic before commencing so my face was totally numb.

    Basically the tooth did not want to come out, was deeply rooted and
    wouldn't budge easily using the elevators/forceps. He had a great
    difficulty using the instruments to claw onto anything because most of
    the tooth was already gone. It took about 15 minutes of wiggling of
    the tooth before it came out.

    The problem is not all the tooth came out. I saw the tooth lying on
    the table and saw very little of the root. I don't know what's been
    left behind, but my guess is, most of the root. The dentist said that
    the gum should grow over the remaining piece of tooth, and there
    should not be any more problems. But if I had pain the future, to get
    back in touch.

    After speaking a friend, he said the same thing happened to his
    father. His father was told the same story about the gum growing over
    and everything being OK, but he has had pain on that side of his mouth
    ever since the extraction and can only eat on one side of his mouth!
    This was with a different dentist.

    This is the advice leaflet I was given after the extraction
    http://www.unimobiles.com/dentist.jpg

    It describes "discomfort" - but I'm in *pain*, period. I found some
    more comprehensive information on
    http://hcd2.bupa.co.uk/fact_sheets/html/tooth_extraction.html

    My tooth was badly damaged but this definitely did NOT occur -

    "If your tooth is very damaged, there may not be enough of the tooth
    left for the forceps to grip, or it may crumble during the extraction.
    In these cases, your dentist may need to make a few small cuts in your
    gum to reach the roots of the tooth. Some of the surrounding bone can
    then be removed with a drill to lift the tooth out in one piece. The
    cuts will be closed with stitches which are usually removed about a
    week later.7,8"

    The website goes on to say

    "However, in order to make a well-informed decision and give your
    consent, you need to be aware of the possible side-effects and the
    risk of complications."

    Here are the problems and questions

    1/ I was not told of any of these side effects and complications! I
    was very disorientated after the anesthetic and it took my a while to
    get home due to all the confusion followed by pain.

    2/ Some of the tooth is still left in there! He didn't cut the gum in
    an attempt to take the whole lot out. I'm frightened that I have a
    lifetime of pain ahead of me only being able to eat on one side of the
    mouth.

    3/ Should the dentist have attempted to take out the root as well and
    cut at the gum to lift out the whole tooth? Given that he knew the
    tooth was badly decayed, did he make a mistake using the
    forceps/elevators before cutting the gum first?
     
    Unimobiles.com, Jun 7, 2006
    #1
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  2. Unimobiles.com wrote:
    Unfortunately, it's impossible to answer your questions definitively.
    Yes, the dentist should have attempted to remove the root. Sometimes
    removing root tips involves more risk than it is worth, and it is the
    dentist's judgement as to how risky.
    My guess is that this dentist didn't have much experience with surgical
    extractions. Nothing wrong with that--neither do I. If I see an
    extraction I think I will have trouble with, I will refer to my friendly
    local oral/maxillofacial surgeon, who can usually remove the tooth in
    scant minutes. In those very rare instances where I misjudge my ability
    to remove a tooth and get into trouble, I call the oral surgeon anyway,
    and they get me (and the patient) out of trouble. They don't mind doing
    this for me, as they know it's only going to happen very occasionally.
    You may or may not have pain. My advice is to go outside the NHS if
    necessary and see an oral surgeon.

    Good luck,
    Steve
     
    Mark & Steven Bornfeld, Jun 7, 2006
    #2
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  3. Unimobiles.com

    George Guest

    Hi Unimobile,

    Your dentist should have proceeded with a surgical extraction is he/she
    thought she had a reasonable chance of removing the rest of your wisdom
    tooth. Because wisdom teeth can be quite tricky and this one was also
    badly decayed, I guess he/she thought she would cause even more danage
    if she tried to remove it surgically.

    The answer here is to visit a oral and maxillofacial surgeon, who is
    trained to deal with such difficult extractions. There are surgeons of
    this kind in almost any NHS hospital in the UK. Just visit your dentist
    and ask to be referred to the oral surgery department of the nearby
    hospital. It usually takes some time, but in the meanwhile some care of
    the extraction area and painkillers will usually take care of the acute
    pain.

    I'm also NHS and do loads of extractions. Every month I have to refer
    2-4 patients to an oral surgeon because of broken teeth that seem
    impossible to remove.

    Good luck,
    George
     
    George, Jun 7, 2006
    #3
  4. Hi George,

    Thanks for your advice on this. After reading
    http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=43#faq582
    there is a question and answer

    "Are wisdom teeth difficult to take out?

    It all depends on the position and the shape of the roots. Your
    dentist will tell you how easy or difficult each tooth will be to
    remove after looking at the x-rays. Upper wisdom teeth are often
    easier to remove than lower ones, which are more likely to be
    impacted. Your dentist will say whether the tooth should be taken out
    at the dental practice, or whether you should be referred to a
    specialist (oral surgeon) at a hospital. Very occasionally there is a
    possibility of some numbness of the lip after the removal of a lower
    tooth – your dentist will tell you if it is possible in your case.

    You will probably have either a local anesthetic – as you would have
    for a filling – or sedation. You could also have a general anesthetic
    (where you would be asleep), but this will usually be given only in a
    hospital."

    This is very interesting because X-Ray's were certainly not done.
    Although I had X-rays a few years ago, I 99% sure he did not look at
    them, I don't even know if he has them on file. From reading the
    above, it's clear he would have lost his money (£28 + whatever the NHS
    pay him) for the extraction if he had done the X-rays and then
    referred to the specialist. When I tell people the tooth wasn't
    causing me any pain everyone just says to me "why did you take it out
    then?". The simple enough answer was because he recommended it and I
    trusted him. However, if I knew of the risks and complications, I
    would have applied "if it's not broke, don't fix it".

    Anyway, 80 hours since the extraction I'm still in pain. My brain is
    blocking a lot of the pain, but it is making me very nervous and I
    can't think clearly or work properly as a result. I was up in the
    middle of the night, having to take painkillers. Even as I type this I
    am making lots of mistakes because my brain is firing a lot of bugs.
    It is like a constant dull ache on the left hand side of my
    mouth/brain.

    He did say to contact him if I was in pain, but I found out to my cost
    he closes his surgery early on Friday afternoon. I'm not to keen to go
    back to him bearing in mind I was given no information about the
    procedure and risks (only a few tips on a sheet afterwards), no X-Rays
    being done and the fact I don't think he cut the gum and pulled it out
    at the root like he should and as a result left the root in there.

    My question is : How long does this pain last? I'm now at 80 hours.
    At what point do I call the dentist and say I'm in pain and what is he
    going to do? At what point can I assume the remaining part of the
    tooth has to come out? I don't want him to try and take out the root,
    the only thing I would consider letting him do is referring me to a
    specialist. Do I need to visit him again for him to do that, or can he
    do it after talking to me on the phone?
     
    Unimobiles.com, Jun 10, 2006
    #4
  5. Hi George,

    Thanks for your advice on this. After reading
    http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=43#faq582
    there is a question and answer

    "Are wisdom teeth difficult to take out?

    It all depends on the position and the shape of the roots. Your
    dentist will tell you how easy or difficult each tooth will be to
    remove after looking at the x-rays. Upper wisdom teeth are often
    easier to remove than lower ones, which are more likely to be
    impacted. Your dentist will say whether the tooth should be taken out
    at the dental practice, or whether you should be referred to a
    specialist (oral surgeon) at a hospital. Very occasionally there is a
    possibility of some numbness of the lip after the removal of a lower
    tooth – your dentist will tell you if it is possible in your case.

    You will probably have either a local anesthetic – as you would have
    for a filling – or sedation. You could also have a general anesthetic
    (where you would be asleep), but this will usually be given only in a
    hospital."

    This is very interesting because X-Ray's were certainly not done.
    Although I had X-rays a few years ago, I 99% sure he did not look at
    them, I don't even know if he has them on file. From reading the
    above, it's clear he would have lost his money (£28 + whatever the NHS
    pay him) for the extraction if he had done the X-rays and then
    referred to the specialist. When I tell people the tooth wasn't
    causing me any pain everyone just says to me "why did you take it out
    then?". The simple enough answer was because he recommended it and I
    trusted him. However, if I knew of the risks and complications, I
    would have applied "if it's not broke, don't fix it".

    Anyway, 80 hours since the extraction I'm still in pain. My brain is
    blocking a lot of the pain, but it is making me very nervous and I
    can't think clearly or work properly as a result. I was up in the
    middle of the night, having to take painkillers. Even as I type this I
    am making lots of mistakes because my brain is firing a lot of bugs.
    It is like a constant dull ache on the left hand side of my
    mouth/brain.

    He did say to contact him if I was in pain, but I found out to my cost
    he closes his surgery early on Friday afternoon. I'm not to keen to go
    back to him bearing in mind I was given no information about the
    procedure and risks (only a few tips on a sheet afterwards), no X-Rays
    being done and the fact I don't think he cut the gum and pulled it out
    at the root like he should and as a result left the root in there.

    My question is : How long does this pain last? I'm now at 80 hours.
    At what point do I call the dentist and say I'm in pain and what is he
    going to do? At what point can I assume the remaining part of the
    tooth has to come out? I don't want him to try and take out the root,
    the only thing I would consider letting him do is referring me to a
    specialist. Do I need to visit him again for him to do that, or can he
    do it after talking to me on the phone?
     
    Unimobiles.com, Jun 10, 2006
    #5
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