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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5813
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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I have a bone coming out of my gum, in the lower right rear

Resolved Question:

I have a bone coming out of my gum, in the lower right rear of my mouth on the inside lower than the top of the gum, i did have a tooth pulled 5 month ago in the area, my dentist is telling me my bone is curling and prescribed triamcinolone dental paste which is hard to apply to this area way in back, i can barley see it and if i put it on my finger the paste sticks to it....any help or ideas big questions when will the pain stop ??? 1 weeek 2 weeks?
Submitted: 2 years ago.
Category: Dental
Expert:  replied 2 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

If your contention that bone is emerging through your gum is correct, there is no rational justification for using a topical corticosteroid. This would represent either a tooth root tip that was inadvertently left behind in the course of the extraction, or a piece of devitalized bone (a "sequestrum"), or perhaps even an osteomyelitis (bone infection) or osteonecrosis-- a loss of blood supply to an area of bone. Whichever this bony protuberance represents, a corticosteroid suppresses your immune system at just the time when you need your immune system to be strong. Steroids will temporarily suppress inflammation and its consequent symptoms, but do nothing to address the underlying cause.

If you have not yet consulted with an oral surgeon, this would be an excellent time to do so. Oral surgeons are better qualified to diagnose and manage post-surgical complications, and it would seem that your situation calls for a change in treatment strategy. You can find contact information for an oral surgeon near you by consulting the online directory of the American Association of Oral and Maxillofacial Surgeons.

Hope this helps...
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5813
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld, DDS and other Dental Specialists are ready to help you
Customer: replied 2 years ago.

The dentist had another one take a look, the bone he said was the "ridge" of the bone the tooth was in, and it was "curling" he said be patent and the area would realine. he told me other option was numb up cut gum and file down bone and close up...my biggest issue is , when i walk or bend over i feel the nerve pulse in the area. my jaw is a little swollen in that area also...I have a bad habit of chewing on ice and this irritated the area.

so i should consult an oral surgeon and have this corrected? other question is, will this paste cover work and how long, its very hard to cover area and is no pain relief at all..

Expert:  Mark Bornfeld, DDS replied 2 years ago.
I am inferring from your revised description that the bone is not really coming through or out of the gum, but rather that the prominent bony socket ridge is protruding from under the gum and making that prominent gum tissue vulnerable to physical injury from functional (chewing) and para-functional (chewing on ice) activity. This suggests that your pain is due to cuts in the gum, or perhaps canker sores initiated by minor trauma.

Although it is true that your gum ridge may eventually become more rounded and less sharp, that bone remodeling process can be glacially slow. Therefore, waiting for matters to take care of themselves may be impractical. Forget about the triamcinolone creme, because it will not persist long enough to have any therapeutic effect due to friction from the adjacent tongue, even if you could accurately apply it to the lesion. If this has been going on for five months, it's time to take the initiative and go to the oral surgeon for an alveoloplasty-- a minor procedure that involves a simple contouring of the bone. This will provide comfort in the shortest amount of time. In the meantime, you may get more benefit from using an over the counter topical anesthetic product, such as Anbesol.

Hope this helps...
Customer: replied 2 years ago.
this started 2 days ago. how long before the pain subsides ? ball park ? i know it would be hard to give me an idea with out a consult. I dont think i will last a week, trying to work, it hurts after any chewing even on other side of mouth. I will be going to pick up anbesol asap. would i feel the nreve through this? i walked out of a movie and re activated the pain without eating. this is righ against my tongue and its lke i crazy glued my tongue to the area when i apply it (even at bed time) how painfull is contouring of the bone? what is recovery time from treatment? thank you for all the help
Customer: replied 2 years ago.
i can see bone and feel it. i thought it was bone chip and rubbed area trying to get it out at first. will gum just recede around this area and make it worse?
Expert:  Mark Bornfeld, DDS replied 2 years ago.
It's really difficult to estimate, because doing so requires a certain amount of presumption about the true nature of the problem. If is is a minor cut in the gum or a canker sore (apthous ulcer), the symptoms usually resolve within two to three days. Of course, you will need to make a concerted effort to avoid chewing anything in the area so that the wound can heal without being disturbed.

Alveoloplasty is done using local anesthesia; there is no pain during the procedure, but typical postoperative pain (on par with an extraction) afterwards. It requires the placement of stitches to close the surgical incision; those stitches either fall out (if they're the self-dissolving variety) or are taken out (if they're traditional silk sutures) in 5-7 days, and healing is essentially complete after two weeks.

Hope this helps...
Customer: replied 2 years ago.
thank you, XXXXX XXXXX is the nerve feeling i have from area. i had a dry socket from this extraction in septemeber and it was very painful. this AM i took 3 advil, and iced my jaw for relief....and pain comes back after ice goes away....and i can feel area when walking or bending over to tie my shoe....so if left alone it could take 2 weeks to re aline or see another dentist for alveoloplasty check....my dentist described this a little and told me i dont want it. oral from this office took quick look and feel and said same thing...but i am the one in pain from it and miserable.
Expert:  replied 2 years ago.
I should clarify-- the bone is not going to become any less prominent in 2 weeks; the only thing that might happen in that time frame is that the surface ulcer may heal. However, the gum contours will remain, and the gum tissue will continue to be vulnerable to additional injury until an alveolectomy is performed.

Based on the severity of your pain, it may be prudent to seek consultation with an oral surgeon sooner rather than later. Your dentist's relatively passive approach to what seems like severe pain is curious, and I'm uncertain whether he has taken the full measure of the problem. A second pair of eyes looking at the area may clarify additional issues that were overlooked by your dentist, and allow a more timely resolution of the problem.

Good luck!
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5813
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld, DDS and other Dental Specialists are ready to help you

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