After Extraction of Wisdom Teeth
Expect to stay and rest on the day the wisdom teeth are removed and for the following two days, working on your diet and hygiene. Please reread your postoperative instruction sheet again.
What Will I Feel Like after Wisdom Teeth Removal Surgery?
On the first day after surgery, you may experience some minor bleeding and pain. You should cover your pillowcase with a towel to avoid getting blood on it. Each individual’s reaction to surgery varies, and the sensation of pain can range from mild discomfort to severe pain. A variable amount of swelling can be expected following the surgery. This swelling usually peaks at 72 hours and should begin resolving over the next four days. You can limit the amount of swelling you will have by using ice for the first 72 hours. The more ice you use, the less swelling you are likely to have. It is normal to have limited opening of your mouth for 5-6 days after surgery. You can start exercises trying to stretch your mouth open starting 4-5 days after surgery. You can apply moist heat to your face to bring your jaw swelling down starting 4 days after surgery. Most of the time you will want to limit your activities for a few days. We do not suggest any exercise for at least one week after surgery. We ask that you follow your post-operative instructions closely. Doing so will make you as comfortable as possible following your procedure.
Are There Any Problems after the Extraction of Wisdom Teeth?
As with any medical procedure, there can be complications or an unanticipated result. Drs. Blecha and Jandali has minimal postoperative complications. It is his goal to have no complications. However, neither the patient nor Drs. Blecha and Jandali can take normal wound healing or other complications for granted. Drs. Blecha and Jandali wants his patients to understand the benefits and risks of any surgical procedure up front, so that they can make educated decisions about whether to proceed with surgery.
With any tooth extraction, the socket could heal slowly and the pain may resolve slowly. Good postoperative hygiene helps to prevent this. Many patients are concerned about getting a dry socket, a condition in which the pain in the socket is slow to resolve. Drs. Blecha and Jandali suggests that you see him if your pain does not taper over 5-6 days for help with this pain.
Almost all wisdom teeth sockets heal well. However, should a socket have problems in healing, it may require further treatment or surgery to promote proper healing. Following good postoperative oral hygiene procedures will help in prevention of wound healing problems.
Lower wisdom teeth have two nerves that are variably close to these teeth. Because of this, there is a small chance that these nerves can be disturbed. It is less likely in the younger patients when the roots of these teeth are incompletely formed. The incidence of nerve injury increases once the roots of the teeth have formed and as the patient ages. Nerve damage is less likely before the roots have finished their formation. Drs. Blecha and Jandali will inform you of your likelihood of nerve problems even if it is a 1-2% chance, as most patients will not envision that nerve injury could occur following removal of a tooth.
Should injury to the nerve occur, a patient could feel numbness of the lower lip or the side of the tongue on the side involved. The lip or tongue is not paralyzed. The lip or tongue does not droop. The lip and tongue look and move normally. One’s appearance to others is normal, but to the patient, the lip or tongue feels numb. If one’s tongue feels numb, your sense of taste on that side of the tongue could be decreased. However, there are many other taste receptors in the mouth.
The symptoms surrounding nerve injury typically resolve with time. However, the process is often slow, and may take 2-8 months. It is possible that a patient could have permanent numbness of the lip or tongue or decreased taste on that side, but usually, the nerve slowly heals. Drs. Blecha and Jandali will consider these aspects before he makes a recommendation to extract or leave these wisdom teeth. Drs. Blecha and Jandali does not give a standard recommendation to remove all wisdom teeth. Rather, he evaluates the advantages and disadvantages of extraction of any tooth for each patient on an individual basis.
Upper wisdom teeth molars do not have similar nerves located near them. Thus, nerve injury is not an issue on upper wisdom teeth. However, upper wisdom teeth are located near a sinus cavity. Some of the upper wisdom teeth roots extend into the sinus cavity. A small percentage of patients could experience sinus symptoms such as congestion, infection, or a communication between the socket and the sinus. Management of such symptoms might include use of a decongestant, an antibiotic, or saline nasal drops. Should a communication between the socket and the sinus develop, Drs. Blecha and Jandali may ask the patient not to blow their nose, drink through a straw, or smoke for 2 months. Creating pressure or suction in the mouth or nose could blow or suck out the blood clot in the socket. This blood clot is needed for the socket to heal and close. With proper patient care, these problems usually resolve without further treatment.
Damage to Sensory Nerve:
A primary concern is a nerve within the lower jaw bone that supplies feeling to the lower lip, chin, and tongue. This nerve is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 12 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth. Occasionally, when the teeth are removed, and especially in older patients, the nerve can become injured. 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 weeks or months. On rare occasions it can result in a permanent alteration of sensation similar to having local anesthesia. We feel that you should be aware of this possibility before consenting to surgery.
The upper wisdom teeth are situated close to your sinuses, and their removal can result in an opening between your mouth and the sinus. Once again, if the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely. However, if it does occur, it will usually close spontaneously, but we may give you special instructions to follow, such as 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 an open mouth into a tissue. Pressure should not be created in the sinus area, which may dislodge the healing blood clot. If you sense this condition occurring after the surgery, please contact the office. An additional procedure may RARELY be necessary to close the opening.
Dry sockets 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 or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin.
The symptoms frequently begin in the middle of the night, and your pain medication regimen may not help. Treatment can involve changing your prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and may require dressing changes every day or two, for five to seven days. Dressings usually are removed when you have been pain free for 2 to 3 days.
The dressing doesn’t aid in healing. The only reason to place a dressing is for pain control. If medication is controlling the pain, the socket will heal without a dressing. Following removal of the dressing, an irrigation device may be provided to help you to keep food particles from lodging in the extraction site.
Occasionally, post-operative infections occur. This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection. If it persists, the area will have to be drained and cleaned. Other temporary problems you may experience in the post-operative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The post-operative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the office at Naperville Oral, Maxillofacial and Implant Dentistry Phone Number 630-961-5151.