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After surgical extraction of wisdom teeth in lower jaw which was close to nerve, patient is experiencing upper teeth pain on same side. Reasons?

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wisdom tooth extraction postoperative upper teeth pain same side dry socket infection sinus dental advice

Upper teeth pain on the same side after a lower wisdom-tooth extraction is often due to referred pain. The teeth, jaw muscles, and extraction area share branches of the trigeminal nerve, so the brain can mislocalize postoperative pain to nearby or opposite-jaw teeth.
Other possible reasons:
  • Normal postoperative inflammation and jaw-muscle strain: swelling, prolonged mouth opening, clenching, or chewing differently can make the upper teeth and cheek feel sore.
  • Dry socket (alveolar osteitis): typically pain that becomes worse rather than better about 3 to 10 days after extraction, sometimes radiating toward the ear, temple, or other teeth. A bad taste or bad breath may occur. It is more common after lower wisdom-tooth surgery. Hull NHS guidance
  • Infection at the surgical site: increasing pain/swelling after initial improvement, pus, fever, feeling unwell, or tender neck/jaw glands.
  • A separate upper-tooth issue: decay, cracked tooth, gum inflammation, bite trauma, or sinus inflammation can produce true upper-tooth pain. Sinusitis can cause tooth pain, and dental pain can also be referred. Roberts and Hedges’ Clinical Procedures in Emergency, section “Acute Toothache in the ED.”
  • Nerve proximity: being close to the lower jaw nerve mainly raises concern for altered sensation in the lower lip, chin, gums, or tongue. It does not usually directly cause upper-tooth pain, though nerve-related/referred pain is possible.
Pain and swelling commonly peak around days 2 to 4, then gradually improve. If the pain is newly worsening after day 3 to 4, or is severe, contact the oral surgeon/dentist promptly for an examination of the socket and the upper teeth. Cleveland Clinic recovery guidance
Seek urgent dental or emergency assessment for rapidly increasing facial/neck swelling, fever, difficulty swallowing or breathing, inability to open the mouth, pus, or persistent numbness/tingling of the lip, chin, or tongue.
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