Dental Education Lecture: Pain after Extraction

Mrs. Smith is 76 years old.  She has had all of her bottom teeth extracted in preparation for complete denture.  For 2 months since extraction, she has had pain.  Exam shows that there is an infection in her front jaw (arrowhead in Fig.1).  The painful and infected gums are as red as strawberry.  X-ray shows that there is possibility of a root tip (arrowhead in Fig.2) remaining in one of the sockets (#26).  Surgery reveals that the sockets of #25 and #26 are empty, while the socket of #27 has healed (look at this surgical photo only if you do not faint to blood).  Infected gum tissue and bone/tooth chips (Fig.4; arrowhead: root tip) are removed from these two empty sockets.  The following day, the senior patient is pain free for the first time in two months.  The photo of Fig.3 is taken 4 months after surgery.  The wound completely heals.  Mrs. Smith is now having a new and comfortable lower denture.  One and a half years later, she develops a new infection due to denture pressure and bone spine.

Xin Wei, DDS, PhD, MS 1st edition 02/19/2011, last revision 10/19/2012