After Extraction of Wisdom Teeth

For most wisdom extraction procedures, we will provide local anesthesia.  Once the teeth are extracted, the gums may be sutured.  And to control bleeding, place and bite down on gauze.  Before leaving our office, we will provide you post-operative instructions, a prescription for antibiotics (if necessary), and over-the-counter pain medication.  

How will I feel after surgery?

On the first day after surgery, you may experience some discomfort and bleeding.  You should cover your pillowcase with a towel to avoid potential blood stains.  Each patient varies in how they feel and recover.  Some may notice more discomfort than others.  It is normal to experience a bit of swelling after surgery.  This is your body’s healing response.  You can reduce swelling by using ice for the first 48 hours.  The more ice you apply, the less severe your swelling could be in the subsequent days.  Please ice your face the first day even if it may be slightly uncomfortable.

On day 3, you may notice your jaw muscles stiffen, and it may be difficult to open your mouth.  If that occurs, you may apply a heated wet towel to your jaw to relax the muscles.  We ask that you follow our post-operative instructions closely.  Doing so will make you speed your recovery time.  Please allow your body to heal before resuming an active social, academic, or athletic schedule.

Are there any problems after the extraction of wisdom teeth?

Here are common symptoms and experiences patients may have after their wisdom tooth extraction:

• If you experience numbness of the lip, chin, or tongue, there is no cause for worry.  This is often temporary.  You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation.  So be careful biting when it’s numb.
• Slight elevation of temperature immediately following surgery is common as that’s your body’s healing response to fighting potential infection.  If elevated temperature persists, please notify our office.  Tylenol or ibuprofen should be taken to reduce the fever.
• You should be careful going from the lying position to standing position.  You could get light headed from low blood sugar or medications.  Before standing up, you should sit for one minute before getting up.
• Occasionally, patients may feel hard ridges with their tongue.  They are not roots.  They are the bony walls which support the tooth.  These ridges usually smooth out spontaneously.  If not, they can be removed by your surgeon.
• If the corners of your mouth are stretched, they may dry and crack.  Your lips should be kept moist with an ointment, such as vaseline.

What are possible serious complications I should be aware of?

Complications may arise after any surgical procedure.  Here are potential complications that few patients may experience after wisdom tooth extraction:

Dry Sockets

Dry socket is a painful dental complication that occasionally occurs after having a permanent adult tooth extracted.  When we do see it, it often arises from lower wisdom teeth extractions.  A dry socket is when a blood clot fails to develop at the site of the tooth extraction (or it’s dislodged or dissolved before the wound heals).

Normally, a blood clot forms in the empty tooth socket.  This clot serves as a protective layer for the bone and nerve endings in the empty tooth socket.  The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.

Exposure of the underlying nerves results in intense pain, not only in the socket, but also along the side of your face.  The socket becomes inflamed and may fill with food particles, which stimulates the nerve endings, causing more pain.  If you develop dry socket, the pain usually begins one to three days after your tooth is extracted.

This is the most common complication following tooth extractions, especially with the removal of wisdom teeth.  Unfortunately, over-the-counter medications alone won’t be enough to treat the pain.  Your dentist or oral surgeon can offer treatments to relieve your pain.

Nerve Injury

Although far less common than dry socket, injury to sections of a nerve called the trigeminal nerve is another possible complication of wisdom tooth extractions.  It can cause pain or numbness in your tongue, lower lip, chin, teeth, and gums.  The damage is usually temporary, lasting for a few weeks or months.  However, it can be permanent if the nerve has been severely damaged.

A nerve injury can interfere with how you eat, drink, or speak.  However, even though it causes sensation problems, it won’t cause any weakness to your lip or tongue.  Your dentist or oral surgeon will minimize the possibility of nerve damage when removing your wisdom teeth (especially that our office uses advanced CT scanning technology for an in-depth examination prior to surgery).

Sinus Exposure

The roots of upper wisdom teeth often extends up into the sinus cavity.  Occasionally when an upper wisdom tooth is extracted, a hole can open where the roots went into the sinus.  This can be problematic as foot and bacteria from your mouth can get into your sinus and cause an infection.  If you develop an exposure hole into the sinus cavity, a second procedure may be required to close this hole to prevent future infections.  However, exposure holes may close spontaneously on its own.

If the teeth are removed at an early age, the root formation is minimal, and this complication becomes very unlikely.  However, if it does occur, you will be required to follow careful instructions.  For example, avoid blowing your nose for two or three days following the surgery.  You can wipe your nose, but don’t blow your nose.  If you have to sneeze, you should sneeze with your mouth open into a tissue.  Pressure should not be generated in the sinus, which may dislodge the healing blood clot that may form a dry socket.

Post Operative Infection

Surgical procedures may lead to infections.  If you notice an abnormal amount of swelling, aching, or throbbing pain, or if you notice a fever, pus-like discharge from the extraction site, or a bad taste in your mouth that persists, you should consult your dentist or oral surgeon.  Antibiotics and oral irrigation may be necessary to help your body fight and overcome the infection.  Often, just taking a course of antibiotics for one week will treat the infection.  Regardless, treat your infection as soon as possible as it can be serious and can spread throughout your body systemically.

Please contact our office by calling (626) 288-8940 if you notice any complications arising from your treatment.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.