Image of retromolar ulceration in the first consultation
This case arrived in my surgery after the patient had been to a variety of doctors and dentists. The patient, aged 67, had an ulcer behind the last lower molar on the left-hand side of her mouth on the inside of the gum.
Something white and hard was visible and could be felt when touched. The patient said that it also sometimes gave her a bad taste in their mouth. Having had breast cancer 5 years previously, she was afraid that this was “something bad”, or in other words, cancer metastasis.
Scanning of the wisdom tooth under ulceration, to see the level of the inferior dental nerve.
Having taken a panoramic X-ray, it turned out that she had a wisdom tooth which had been impacted for years. With age, and the shrinking of her gum, the latter had perforated to reveal something whiteish in colour. This is the first photograph in the article.
Rx.Preview to the extraction
Food and bacteria had subsequently entered through the hole, causing a great deal of tooth decay in the third molar. This is what was causing the bad taste. In the panoramic X-ray we could see how the nerve of the tooth was stuck to the roots. We sent the patient for a jaw scan, which showed that the molar was neither surrounded nor encompassed the nerve of the lower tooth, making extraction simple.
We started antibiotic treatment and set about extracting the tooth, which came out in a single piece. After the extraction, the patient continued to take the antibiotics, as well as the anti-inflammatory medication when required, plus mouthwashes with chlorhexidine for a week. On the first day, ice and soft food.
Panoramic Rx at 12 days after extraction
The patient suffered no pain after the operation and hardly any inflammation. We took another panoramic X-ray 12 days after the extraction, and a photograph of the area a month and a half later. Everything was fine and the patient was delighted
Image a month and a half after extraction
