abscess after failed tooth extraction

Tragen

I had some work done in April of this year, part of which was a broken tooth that needed removing. My dentist failed to remove it and left the root in. I was told that it would work its way out and she would look at it again in 6 months.

I had toothache a month later, but by the time of the appointment, it had gone. She iterated the same thing, telling me it would work its way out.

Since then, I've had regular tooth ache, which I've managed with ibuprofen.

However 2 days ago, I have it again, except this time it is much worse and the lower left half of my jaw is throbbing, I have sharp pains constantly, and almost feels swollen but numb around it.

I am seeing the dentist tomorrow (earliest appointment), but I would like some advice on how to handle this.

Obviously I am in a lot of pain and extremely stressed and annoyed that this has happened.

The tooth is in the same position it was 5 months ago. I feel like it could have been avoided if she had removed the tooth successfully. I cannot believe a tooth can be that hard to remove; if she could not do it, why not refer me to someone who can?

Tomorrow I'm expecting her to either refer me or just give me anti-biotics (which in general I do anything avoid).

I also feel like I should not have to pay for this visit. It is a result of her failed extraction which I paid for in the first place.

Argh.

Can anyone advise me on what position I should take with them. I'm finding it hard to think straight!

Thanks

brook2jack

It can be very difficult to extract a tooth, they can break for very many reasons (large filling, lots of decay, very brittle tooth in very hard bone).

In the past if root was left a surgical extraction was carried out, but this was often difficult, uncomfortable and had risks. So it is generally agreed that the best way is to leave the root to come up to the surface where it is easier to extract. Indeed for difficult wisdom teeth taking off the top and leaving the root to come through is now an approved method (decoronation).

The tooth needed taking out because of a problem that was not the dentists fault. The tooth broke, a well known complication of extraction. The dentist informed you of this and followed an accepted protocol. Unfortunately you have an infection, again that is a well known complication, not the dentists fault.

If you are a NHS patient the dentist does not set the rules on charging and again a broken tooth is a well known complication of extraction.

As to referral yes it can be done , but be warned on the NHS , even if you are in pain, you will probably have a long wait to be seen , let alone treated.

You have been very unfortunate but from what you have said this is a situation that can and does happen with teeth that need extracting.

Tragen

Thanks for backing up what she has told me, that does offer me some comfort and confidence.

Of course, my neglect is the cause of the tooth needing extracting in the first place, it was rotten and broken already.

It is the tooth which is in front of the lower molars, I'm hoping there is a chance she can remove it tomorrow, fingers crossed!

Thanks again.

welshdent

There is, in my experience, a general assumption that taking a tooth out is easy. It isn't. Ignoring dental skill - all of us are trained the same way. Some go on to acquire enhanced skills in more difficult extractions bit most of us can handle non surgical.

A number of factors can influence an extraction and all these are out of control of the dentist. As teeth decay, have fillings or root fillings they become weaker. That means they are less able to withstand the force necessary to remove them from bone. If they are already broken or break further, we have less substance in which to work with to remove. Some teeth undergo what is called ankylosis, which is difficult to spot but means the bone and tooth integrate together where previously they were attached via a ligament. They are effectively anchored to your bone.
As we age, our bone gets effectively harder. It gets harder to dilate the socket the tooth is within to allow it to come out.

Combine a few of these - harder bone and a brittle tooth and we have a recipe for a difficult extraction. There are also anatomical issues such as a low maxillary sinus complicating upper molar removal and curved or thin roots which make the path of removal almost impossible atraumatically and thin roots are more likely to break with the applied forces.

I do not do many extractions these days but in my experience patients are quick to blame the dentist but invariably the problem was not the technique but the tooth they were faced with.

More often than not though a broken retained root does not cause problems and gradually over years works its way out. I appreciate it may be a great inconvenience but it does not mean the dentist did anything wrong.

Tragen

So in a case like mine, for example she is unable to extract it tomorrow - what is the course of action? I am in a lot of pain and I'm fairly sure there is an infection, the area around the tooth feels swollen and almost numb.

ERICS_MUM

on a couple of occasions I've had a tooth abcess my dentist has given me anti-biotics to clear up the infection before he would tackle the tooth itself.