Tooth extractions, particularly wisdom tooth removal, can sometimes lead to long-term pain and complications. While many patients recover without issues, others experience persistent problems such as jaw pain, chronic headaches, or pain in a tooth with a filling years after treatment.
Persistent Headaches After Wisdom Tooth Extraction
In rare cases, patients develop chronic daily headaches (NDPH – New Daily Persistent Headache) following a dental procedure like wisdom tooth removal. These headaches:
- Appear suddenly after extraction
- Are bilateral (felt on both sides of the head)
- Cause a pressing or tightening sensation
- Range from moderate to severe pain
NDPH has been linked to surgical procedures, viral infections, and stress, and in some cases, dental surgeries like wisdom tooth extraction may trigger long-term nerve-related pain.
One documented case involved a 48-year-old man who developed severe, one-sided headache attacks two weeks after a wisdom tooth extraction. He had no prior history of headaches or dental pain. His condition was treated with oxygen, prednisolone, verapamil, and lithium carbonate, which helped reduce the severity and frequency of his headaches.
Why Do Some People Develop Chronic Pain After Tooth Extraction?
One possible explanation lies in the trigeminal nerve system, which processes pain signals from the teeth and jaw. When a tooth is removed, especially a tooth with a filling that had previous damage, it can lead to:
- Nerve hypersensitivity, where the brain continues to perceive pain from a missing tooth (phantom tooth pain)
- Reorganization of neural pathways, making the brain more sensitive to pain over time
- Delayed-onset pain, where symptoms develop weeks, months, or even years after the extraction
This could explain why some individuals report that a tooth with a filling hurts years later—even if the tooth has been treated previously.
Hematoma Formation After Dental Surgery
Another potential post-extraction complication is hematoma formation, where blood collects outside blood vessels due to prolonged bleeding. This can occur if:
- A dentist accidentally injures a blood vessel during local anesthesia administration
- Blood leaks into surrounding soft tissue, forming a painful, swollen lump
Hematomas can sometimes cause serious complications, such as:
- Breathing difficulties if they form near the airway
- Vision problems or blindness if they develop near the eye (intraorbital hematoma)
A 21-year-old patient developed severe swelling around his left eye after wisdom tooth removal under IV sedation. He was treated with IV antibiotics, eye ointments, and protective shielding, and recovered within a few weeks.
Tooth Pain Years After a Filling or Extraction
Sometimes, a tooth with a filling starts hurting years later, even without recent dental work. Possible reasons include:
- Micro-leakage: Tiny gaps forming around the filling, allowing bacteria to enter and cause infection
- Cracked Tooth Syndrome: Hidden fractures in the tooth structure leading to sharp, intermittent pain
- Nerve damage: If a filling was deep, it might have irritated or weakened the nerve, leading to delayed pain
- Referred Pain: Pain from a missing tooth affecting nearby teeth, making it feel like an old filled tooth is hurting
Whether it’s jaw pain, persistent headaches, or a tooth with a filling hurting years later, post-extraction complications can be frustrating. Understanding the underlying causes—nerve changes, chronic pain syndromes, or hematoma formation—can help patients seek appropriate treatment. If you experience ongoing dental pain years after a procedure, a consultation with a dentist or neurologist may be necessary to explore treatment options.
