Differential Diagnosis for Gum Pain after Wisdom Teeth Extraction
Single most likely diagnosis
- Dry socket (Alveolar osteitis): This condition is a common complication after wisdom teeth extraction, characterized by a dull, aching pain that can radiate to the ear or eye. The description of a "hole in the mouth" and pain when chewing or swallowing are consistent with dry socket, which occurs when the blood clot is dislodged from the extraction site, exposing the bone and nerve endings.
Other Likely diagnoses
- Pulpitis or tooth sensitivity: The patient may be experiencing sensitivity or pulpitis in an adjacent tooth, possibly due to the extraction procedure or pre-existing condition. This could cause pain when chewing or swallowing.
- Gingivitis or periodontal disease: Inflammation of the gums (gingivitis) or periodontal disease could cause gum pain, especially if the patient has poor oral hygiene or a history of periodontal issues.
- Suture irritation: If sutures were used during the extraction, they could be causing irritation or discomfort, especially if they are rubbing against the tongue or cheek.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Infection or abscess: Although less likely, an infection or abscess could be developing at the extraction site, which would require prompt antibiotic treatment or drainage to prevent serious complications.
- Nerve damage: The inferior alveolar nerve or lingual nerve could have been damaged during the extraction, causing numbness, tingling, or pain in the tongue, lip, or chin.
Rare diagnoses
- Osteomyelitis: A rare but serious infection of the bone, which could cause persistent pain, swelling, and fever.
- Neoplasm: A rare possibility of a tumor or cyst developing at the extraction site, although this would be unlikely to present with such acute symptoms.