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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7364
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Burning and Inflammation after extraction

Customer Question

Ever since tooth #11 was extracted over 3 yrs ago, I have had redness/inflammation and burning pain in that area. An implant was placed 2 yrs ago, and the problem persists. Multiple dentists offer absolutely no help, saying they have no idea what it is, so I go in search of yet another professional.


Sometimes it looks worse, as far as the redness, but the burning pain only subsides during sleep. I have been evaluated by an ENT who found nothing. I have been evaluated by a Neurologist ( whose opening line was " I am tired of dentists messing up and then referring their patients here" ) who tried a few meds (nortryptyline and lyrica) to no avail. One dentist gave me a tiny tube of kenalog paste. I used it for a few days and the burning pain subsided somewhat.. Then, when I stopped using it (tube empty) the very next day, its back. Wouldnt that in itself indicate a dental issue? My current dentist will not prescribe kenalog paste and gave me what he called "Miracle Mouthwash" which is like applying orajel to the entire inside of the mouth. Both he and the Neurologist  say its probably some form of neuropathy, but then why the inflammed look to the gums from tooth 10 to 13? Its not just a mild soreness. It ranges from mild redness to full blown beet red and it HURTS. So I am told that its not Dental and as far as the neuropathy, they have no clue about that either. I am unable to take NSAIDS due to a prior anaphylactic reaction.


I have undergone multiple procedures - 2 flap surgeries, a root canal and ultimate extraction of #12, and a root canal on #13. I had laser surgery to remove some of the resulting scar tissue, but it feels like scar tissue still remains. Most days when I awaken, the pain is low, maybe a '2' but gradually increases.. by mid-day it peaks at about 6 or 7 and remains there all day. I have also tried two  antibiotics - amoxcillin and clindamycin. No side effects, but no benefit from either. CT scan showed nothing except 'possible' peri-implantitis and a shadow (artifact?) at the top of missing #12..This shadow appeared on a CT scan before the #12 root canal and extraction and was thought to be an abscess or infection and that is why that tooth was treated.


I currently have a 3 unit bridge (#11 implant, #12 pontic, #13 crown) that is very uncomfortable, assumably because there is something else wrong with the gum or nerves. This is my 3rd attempt at temporary restoration, one time going all the way to a permanent restoration only to have it removed to start over again with a different dentist.


 


I have been patronized to the point that one doctor said I need to understand that it is not Cancer!   I never implied it was, or even thought that for one moment. All I know is there is a problem that has been going on for over 3 years and no one has been able to identify or treat it.

Submitted: 7 months ago.
Category: Medical
Expert:  Dr. Rick, MD replied 7 months ago.
Hi. My name isXXXXX and I am online and available to help you today. Thank you for your patience.

At this point it sounds like you have spent quite some time trying to get to the bottom of what is going on. I am sure that your previous dentists and doctors have thought of, and ruled out, all of the common and easily treatable conditions that could be causing your issues. Would you say this is a correct statement?

It sounds like you have been receiving good care from very qualified Dentists, oral Surgeons and doctors without any significant lasting improvement in your condition. At this point I think the best thing for you to do would be to gather up copies of all your medical records and travel to a large University Teaching hospital that has a Dental and Medical School associated with it. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7364
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 4 other Medical Specialists are ready to help you
Customer: replied 7 months ago.


Thank you for your reply.



Can you please answer this question..If the gum looks inflammed and red and burns, not so much to the touch, just an all-day/every-day pain... is this indicative of a neurological or dental issue? I did not think that even TN would present with inflammed gums.. Not that I think I have TN as I do not have the classic symptoms of that disorder. But I find it hard to believe a neuropathy would cause an isolated area over 3 teeth to be red and inflammed.

Expert:  Dr. Rick, MD replied 7 months ago.
Mary Ann,

From what you have posted I feel the problem is dental in nature -- you are correct: A neurological issue would not cause localized redness and inflammation.

I suggest you consult with a periodontist, perhaps at a Dental School/medical school.

Make sense?


Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

I hope this information was helpful. I do my best to give everyone excellent service. Should you have any further questions, please ask -- I'll be happy to respond. Thank you! Dr. Rick, MD

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