After Extraction of Wisdom Teeth
In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen), moderate/conscious sedation, or deep sedation anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum tissue is sutured. The stitches will dissolve on their own. To help control bleeding bite down on the gauze placed in your mouth. You will recover under our supervision in the office until you are ready to be taken home. Upon discharge your postoperative kit will include postoperative instructions, a prescription for pain medication, an antimicrobial mouth rinse. In some instances you may be prescribed antibiotics. You will also receive a follow-up appointment in one week for post-operative evaluation. If you have any questions, please do not hesitate to call us at Lafayette Office Phone Number 337-352-BEND (2363).
What will I feel like after wisdom teeth removal surgery?
On the first day after wisdom teeth removal surgery, you may experience some minor bleeding and will likely be numb for the majority of that day. It is important to remember that each individual’s reaction to surgery varies, and post-operative discomfort usuallys range from mild to moderate discomfort. A variable amount of swelling can be expected following the surgery. This is part of the healing process. This swelling usually peaks on day 3 after the surgery. You can limit the amount of swelling you will have by using ice for the entire first day. Then after the first 24 hours transition to moist heat. On the third day, you may notice that your jaw muscles seem stiff, and it may be uncomfortable to open your mouth wide. You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider. Most of the time you will want to limit your activities for a few days. We ask that you follow your post-operative instructions closely. Doing so will make you as comfortable as possible during the first few days following your procedure. Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.
Are there any problems after the extraction of wisdom teeth?
As with any medical procedure, there can be complications or an unanticipated result. Some complications that patients undergoing wisdom tooth extraction may experience include:
- damage to the sensory nerve that supplies sensation to the lips and tongue
- sinus communication
- infections
- dry sockets
- delayed healing
After the procedure, our assistants will review your post-operative instructions with your escort. We ask that you follow these instructions closely, as they will make you most comfortable following your procedure. If you were sedated, you will be drowsy when you leave the office. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days. Dr. Stanford will review relevant post-operative events with you and answer any questions during your office visit.
Damage to Sensory Nerve:
A primary concern is a nerve within the lower jaw bone that supplies feeling to the lower lip, chin (Inferior Alveolar Nerve) and tongue (Lingual Nerve). Both of these nerves are frequently very close to the roots of the lower wisdom teeth and very close to the bone surrounding the wisdom teeth, respectively. Having these teeth out prior to full root development, between the ages of 12 and 18, usually provides shorter roots so nerve injury is less of a risk. In very rare instances, if the impacted teeth have an abnormal position or there is complete root development the nerve can become injured during removal. When local anesthesia wears off, you may experience a tingling or numbing sensation in the lower lip, chin, or tongue. Should this occur, it is usually temporary and will resolve gradually over a period of days, weeks, or months. On rare occasions it can result in a permanent alteration of sensation. We feel that you should be aware of this possibility before consenting to surgery.
Sinus Communication:
The upper wisdom teeth are situated close to your maxillary sinuses, and their removal can result in an opening between your mouth and the sinus, called an “oroantral communication”. Once again, if the impacted teeth have an abnormal position or complex root structure, the risk of this complication may be increased. However, if this does occur, it will usually close spontaneously, but you may be given special instructions (sinus precautions) to follow, such as avoid blowing your nose for a few weeks following the surgery. You may wipe your nose, but don’t blow your nose. If you have to sneeze, you should sneeze with your mouth open. Pressure should not be created in the sinus area. If you sense this condition occurring after the surgery, please contact the office. An additional procedure may be necessary to close the opening.
Dry Sockets:
Dry sockets (aka: alveolar osteitis) continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. This can result in a deep, dull, continuous aching on the affected side(s). Patients may even first notice the pain starting in the ear radiating down towards the chin.
Treatment usually involves irrigating extraction site with an antimicrobial rinse that will be prescribed to you. Irrigating the tooth sockets will help gradually decrease the pain and help remove food particles from the socket.
Infection:
Occasionally, post-operative infections occur. The most common of these would be a “subperiosteal abscess”. This is a result of a small piece of bone remaining in the surgical site. This usually presents at about 7-10 days after the surgery. In more rare instances, a condition called osteomyelitis can develop. This is smoldering infection of the bone marrow. The treatment of this would require debridement and course of antibiotics.
All of the risks and complications presented above are rare. The vast majority of patients do not experience any of these complications. Dr. Stanford likes his patients to understand all surgery come with risks. He will explain all of these risks in more detail during your evaluation.