After Extraction of Wisdom Teeth

In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia), or general 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 is sutured. To help control bleeding bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge your postoperative kit will include postoperative instructions, and a prescription for pain medication and antibiotics if necessary, with a follow-up appointment typically scheduled in 5-7 days. If you have any questions, please do not hesitate to call us at La Jolla Office Phone Number 858-452-8606.

Our services are provided in an environment of optimum safety. We utilize modern monitoring equipment and our staff are experienced in anesthesia techniques.

 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 pain. You should cover your pillowcase with something so that you don’t get any spotting 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 48 hours afterwards and should start to resolve on the third day. You can limit the amount of swelling you will have by using ice intermittantly for the entire first two days. The more ice you use over these two days, the less swelling you are likely to have afterwards. On the second day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face starting on the third  day allowing your muscles to relax more and open wider. Most of the time you will want to limit your activities for several days. We ask that you follow your post-operative instructions closely. Doing so will keep you as comfortable as possible during the first 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 after 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:

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 given general anesthesia, you will be comfortable and drowsy when you leave the office. Most patients prefer to go home and rest with no other physical or scholastic activities planned for several days. With any medical procedure, there can be unexpected results. These can include delayed healing, infection and post-operative numbness or tingling in your lip, chin, or tongue. Dr. Yamada will review relevant post-operative events with you and answer any questions during your office visit.

A representation of numbness caused by damage to a sensory nerve

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 extracted between the ages of 14 and 16 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 could 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 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.

A diagram showing the opening that can occur between your mouth and sinuses

Sinus Communication:

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 one to two weeks 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.

A visual of dry socket that developed after the removal of wisdom teeth

Dry Socket:

Dry socket continues to be a common problem people experience following impacted wisdom tooth removal. It arises due to the premature loss of a blood clot in the  tooth socket. This seems to occur with an even greater frequency in people who smoke or are taking birth control pills. This condition usually occurs in the lower jaw on the third to fifth day. It can cause a deep, dull, continuous aching on the affected side. Patients may first notice the pain starting in the area of the extraction site, radiating into the ear and even radiating forward in the jaw into the other teeth.

When the symptoms begin, your pain medication regimen may not help. Treatment can involve changing your prescription. Traditionally, it was helpful to place a medicated dressing in the empty tooth socket. This would help decrease the pain and protect the socket from food particles and would help to alleviate the pain for 24-48 hours but require dressing changes every one to two days, for seven to ten days total before final removal.

The dressing did not aid in healing, it only helped for pain control.  The use of the dry socket dressing actually slowed the healing process because a foreign material was placed in the healing socket.

Currently, we find the use of an oral hydrogel, dispensed in our office, to significantly reduce the incidence of dry socket.  With its use now, we rarely have to treat dry socket.   Instructions how to use this oral hydrogel will be given to you before you are discharged on the day of your surgery.

A diagram depicting an infection that occurs after wisdom teeth removal

Infection:

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 mouth, facial bruising, and minor 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 La Jolla Office Phone Number 858-452-8606.