Differential Diagnosis for Pain after Tooth Molar Removal
Single Most Likely Diagnosis
- Dry socket (alveolar osteitis): This is the most common complication after tooth extraction, especially for molars. It occurs when the blood clot is dislodged from the socket, exposing the bone and nerve endings, leading to severe pain.
Other Likely Diagnoses
- Pulpal pain or infection: Pain can arise from the adjacent teeth, especially if they were affected during the extraction procedure or have pre-existing pulpitis.
- Soft tissue trauma: Injury to the surrounding soft tissues (gums, cheek, tongue, or lips) during the extraction can cause pain.
- Trismus (lockjaw): Inflammation of the muscles of mastication can lead to limited mouth opening and pain.
- Post-extraction infection: Bacterial infection of the extraction site can cause pain, swelling, and fever.
Do Not Miss Diagnoses
- Fractured jaw or mandible: Although rare, a fracture can occur during the extraction, especially if the tooth was deeply impacted or the bone was weakened.
- Nerve damage (inferior alveolar nerve or lingual nerve): Injury to these nerves can cause numbness, tingling, or pain in the tongue, lip, or chin.
- Osteomyelitis: A rare but serious infection of the bone that can occur after tooth extraction.
- Abscess formation: A collection of pus that can form in the soft tissues or bone, requiring urgent drainage.
Rare Diagnoses
- Eagle syndrome: A rare condition where the styloid process or ligament causes pain in the jaw, ear, or throat.
- Temporomandibular joint (TMJ) disorder: Although not directly related to tooth extraction, pre-existing TMJ disorders can be exacerbated by the procedure, leading to pain and limited jaw movement.
- Maxillary sinusitis: In rare cases, the extraction of an upper molar can cause inflammation or infection of the maxillary sinus.
- Hematoma or bleeding disorder: Excessive bleeding or a hematoma can occur, especially in patients with bleeding disorders or those taking anticoagulant medications.