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Dr. Peel
Dr. Peel, Dentist
Category: Dental
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Experience:  General dentist with 20+ years of experience.
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Hard, painful bump on gums near tooth extraction site

Customer Question

I had a root canal and crown put on my #19 molar several years ago. At the beginning of this month, I developed an abcsess on the tooth and after several consultations agreed to have it extracted. The tooth was extracted and a week later I flew to Hawaii for a conference. While there, my jaw swelled up again and i was in extreme pain so I went to a dentist who did a debriedment (sp?) repacked it and prescribed new antibiotics. A week after the debriedment and I am still I'm agony - 800 mg ibuprofin and sometimes two 7.5-325 Vicodin are the only things that will touch the pain.
Here's my question (Finally) - after the swelling went down I noticed a very hard bump on my gum right next to the surgical location. It looks like a pimple and it is very hard to the touch. It's also the source of this continued searing pain. The general dentist in Hawaii said it was likely that my jaw was fractured during the extraction and that my pain would stop in a few days and I would just have that bump from now on. Do you agree with this assessment?

PS it has been two days and the localized pain had not stopped or lessened.
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Peel replied 1 year ago.
Hello and thank you for asking. I will do my best to answer your question.

I am not sure why the dentist is saying that the jaw was possibly fractured. I am wondering why that dentist did not take an x-ray to back up such an accusation.
What it sounds like to me is a dry socket . That is when bone is exposed because of infection or the clot fell out of the socket . That is very painful and sometimes takes several courses of antibiotics and debridment to calm down and heal.

Another thing that this could be is a retained piece of bone or root tip .

In either case, an x-ray would confirm a diagnosis. treatment would only be different if the site needed re-opening to remove a piece of bone or a root tip.

I would advise going back to the surgeon (or if you are in Hawaii for an extended time go to an oral surgeon there) and getting an x-ray as well as follow up treatment. This will most likely clear up in a week or so with continued attention to the infection and re-dressing.

Hope this helps.
Customer: replied 1 year ago.
Thank you for the quick reply. I asked about dry socket, and the dentist said this was not it. Would dry socket explain the hard, painful bump on the gums? The dentist did take an X-ray but said that it might not clearly show a slight fracture. His x-rays were the small film kind.
He also didn't find root tip or bone during retreatment.
Customer: replied 1 year ago.
Thank you for the quick reply. I asked about dry socket, and the dentist said this was not it. Would dry socket explain the hard, painful bump on the gums? The dentist did take an X-ray but said that it might not clearly show a slight fracture. His x-rays were the small film kind.
He also didn't find root tip or bone during his retreatment.
Expert:  Dr. Peel replied 1 year ago.
Sorry it took me so long to get back again.
The bump would signify a re-infection or something left behind. That , along with the pain, seemed to indicate dry socket, but if he ruled that out, that's good. A larger x-ray at a surgeons office would be better to show a fracture. If you have osteoporosis or the surgery was particularly rough or difficult it might be a break but that is not common.
Are you still taking antibiotics? What kind and how many left?

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