Clenching following molar extraction

Hi guys,

A few years ago, I needed my lower wisdom tooth extracted. I'd had the upper ones taken out previously with no issues, but was told that the right lower one was sitting right on the nerve and that there was a high risk (higher than normal) of ending up with a permanently numb lip/chin if it was extracted, so it was decided that I should leave it a bit and see if it moved a bit. Well, it didn't and I ended up with quite bad decay in the molar next to it where the wisdom tooth was growing into it, leaving no room to blush/floss.

So my normal dentist referred me to another one specialising in extractions and I was told the same thing again - that it would be risky to extract that wisdom tooth. I was advised to have the molar next to it out and leave the wisdom tooth. I didn't like the sound of that at all, had my mam come in for a second opinion (I was only about 22 at the time), she didn't like the sound of it either. We left without having anything done and went back to the original dentist. He backed up what this dentist said, that it would be better to have the molar out than risk a numb lip or leave it and end up getting an infection (as there was already a lot of decay). I wasn't happy at all, but had time constraints, as I was going to London to start a course and wanted this sorted out. I had got my second opinion and the general consensus from anyone I asked was to stop being so silly/vain and just get the molar out. NOTHING about potential issues arising from losing a molar was explained to me. And I asked multiple times. The two dentists convinced me that the only issue would be having a gap at the back of my mouth that nobody would see.

So I had this done and basically have had ongoing dental issues ever since. I started clenching/grinding, which I'd never done before and ended up damaging my teeth. My new dentist in London recommended a mouthguard, which I had made and use daily, but I still clench and suffer from jaw pain. He reckons it's due to stress but I think it's due to the extraction, as I never clenched before. I think this extraction changed my whole 'bite' and funnily enough, I recently read an article where the author experienced something similar and frighteningly spoke of bone loss and other issues related to losing molars. Can I take any action towards my dentist for not explaining any future risks to me?

And now, what can I do? Is it too late to get an implant? The extraction was almost 4 years ago and the wisdom tooth has moved over since then into some of the gap left by the molar. Is there any way I can 'cure' the TMJ and clenching? The mouthguard is effective but it's a pain in the ass and I still wake up wrecked every day from clenching with pain in my jaw.

Dianthus

Tbf, it sounds like you were stuck between a rock and a hard place!
Had you taken the wisdom tooth out, you'd have been left with a permanent numb lip&/tongue.
Had you left both the wisdom tooth& the decayed tooth, the decay would have continued regardless, as you say it was impossible to clean.

4 years ago, you had tooth out. Directly afterwards you moved to London& started a course. It's not unreasonable to link the stress of a new life with the onset of grinding....wearing a splint is annoying but it sure as hell beats lifelong numbness.

ballsymchugh

there's plenty of people with all their teeth present who have issues with grinding too. removal of the tooth is more than likely co-incidental.
ask your dentist in london to refer you to a TMD specialist in one of the dental hospitals if it really bugs you,

Oral Surgeon

Gage Fast Eagle wrote: »

Hi guys,

A few years ago, I needed my lower wisdom tooth extracted. I'd had the upper ones taken out previously with no issues, but was told that the right lower one was sitting right on the nerve and that there was a high risk (higher than normal) of ending up with a permanently numb lip/chin if it was extracted, so it was decided that I should leave it a bit and see if it moved a bit. Well, it didn't and I ended up with quite bad decay in the molar next to it where the wisdom tooth was growing into it, leaving no room to blush/floss.

So my normal dentist referred me to another one specialising in extractions and I was told the same thing again - that it would be risky to extract that wisdom tooth. I was advised to have the molar next to it out and leave the wisdom tooth. I didn't like the sound of that at all, had my mam come in for a second opinion (I was only about 22 at the time), she didn't like the sound of it either. We left without having anything done and went back to the original dentist. He backed up what this dentist said, that it would be better to have the molar out than risk a numb lip or leave it and end up getting an infection (as there was already a lot of decay). I wasn't happy at all, but had time constraints, as I was going to London to start a course and wanted this sorted out. I had got my second opinion and the general consensus from anyone I asked was to stop being so silly/vain and just get the molar out. NOTHING about potential issues arising from losing a molar was explained to me. And I asked multiple times. The two dentists convinced me that the only issue would be having a gap at the back of my mouth that nobody would see.

So I had this done and basically have had ongoing dental issues ever since. I started clenching/grinding, which I'd never done before and ended up damaging my teeth. My new dentist in London recommended a mouthguard, which I had made and use daily, but I still clench and suffer from jaw pain. He reckons it's due to stress but I think it's due to the extraction, as I never clenched before. I think this extraction changed my whole 'bite' and funnily enough, I recently read an article where the author experienced something similar and frighteningly spoke of bone loss and other issues related to losing molars. Can I take any action towards my dentist for not explaining any future risks to me?

And now, what can I do? Is it too late to get an implant? The extraction was almost 4 years ago and the wisdom tooth has moved over since then into some of the gap left by the molar. Is there any way I can 'cure' the TMJ and clenching? The mouthguard is effective but it's a pain in the ass and I still wake up wrecked every day from clenching with pain in my jaw.

Sorry to hear op...
Without seeing your previous X-ray it's hard to say but I think that the risks of altered sensation is overplayed especially in light of a clinical need for wisdom tooth removal....
I've seen loads of people who have had second molars removed but still continue to have issues with the impacted wisdom tooth and then also need that removed too... The ideal plan in most cases is to remove the wisdom and restore the more ideal positioned and useful second molar.....

If this wisdom tooth has moved forward, is it possible that it is causing an interference with your bite and exacerbating the tmj / muscle issues??

Dianthus

Dianthus wrote: »

Tbf, it sounds like you were stuck between a rock and a hard place!
Had you taken the wisdom tooth out, you'd have been left with a permanent numb lip&/tongue.
Had you left both the wisdom tooth& the decayed tooth, the decay would have continued regardless, as you say it was impossible to clean.

4 years ago, you had tooth out. Directly afterwards you moved to London& started a course. It's not unreasonable to link the stress of a new life with the onset of grinding....wearing a splint is annoying but it sure as hell beats lifelong numbness.

Yep, it was a rock and a hard place. I knew I wouldn't be happy with either scenario. The thing is that I may well NOT have been left with a numb lip and tongue. The guy I saw in the dental hospital in London reckoned they could have taken out the wisdom tooth no bother and that the dentist in Belfast was just underconfident/underskilled, but it's easy to say that after the fact, I guess.

ballsymchugh wrote: »

there's plenty of people with all their teeth present who have issues with grinding too. removal of the tooth is more than likely co-incidental.
ask your dentist in london to refer you to a TMD specialist in one of the dental hospitals if it really bugs you,

I know, but it's weird that I'd never had that issue before. I have been referred to the dental hospital and didn't find them much help. There's not really a lot they can do, I don't think.

Oral Surgeon wrote: »

Sorry to hear op...
Without seeing your previous X-ray it's hard to say but I think that the risks of altered sensation is overplayed especially in light of a clinical need for wisdom tooth removal....
I've seen loads of people who have had second molars removed but still continue to have issues with the impacted wisdom tooth and then also need that removed too... The ideal plan in most cases is to remove the wisdom and restore the more ideal positioned and useful second molar.....

If this wisdom tooth has moved forward, is it possible that it is causing an interference with your bite and exacerbating the tmj / muscle issues??

That's what I think has happened. I know it's hard to know what was to be done for the best - I certainly wouldn't have wanted to end up with a numb lip/tongue/chin and that would certainly be much worse than the grinding/clenching issues, but I feel like the risk of numbness was overplayed and risk of having issues after the molar removal downplayed...

btkm8unsl0w5r4

ballsymchugh wrote: »

there's plenty of people with all their teeth present who have issues with grinding too. removal of the tooth is more than likely co-incidental.
ask your dentist in london to refer you to a TMD specialist in one of the dental hospitals if it really bugs you,

This is true.
Cause and effect is temporal, in that you tend to blame things that have happened. However loads of people get teeth removed without TMJD and loads of people with intact teeth do get TMJD. TMJD specialist is the best bet, if it is any consolation it will most likely go away with time, however not much help in the hear and now.

ballsymchugh

Gage Fast Eagle wrote: »

I know, but it's weird that I'd never had that issue before. I have been referred to the dental hospital and didn't find them much help. .

was it an oral surgeon or a TMD specialist? was it a local hospital in london with an oral surgery dept or was it into King's/Guys/Eastman etc?

ballsymchugh

ballsymchugh wrote: »

was it an oral surgeon or a TMD specialist? was it a local hospital in london with an oral surgery dept or was it into King's/Guys/Eastman etc?

TMD specialist at Eastman

ballsymchugh

hmmm. you're screwed. won't find a better place to go in london. best you can do now is manage the situation until it alleviates, if it does, and it's quite likely it will.