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 associated with removal of wisdom teeth (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. After removal of wisdom teeth, the surgical sites are sometimes sutured. To help control bleeding a gauze packing will be placed over the sites. 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, a prescription for pain medication, antibiotics, and a follow-up appointment for one week if sutures were placed. If you have any questions, please do not hesitate to call us at Huntington Oral & Maxillofacial Surgery, PC Phone Number 631-421-0100.
Our services are provided in an environment of optimum safety. We utilize modern monitoring equipment and our staff is experienced in all anesthesia techniques.
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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 something so that you don’t get any 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 on the second day and should begin resolving on the third day. You can limit the amount of swelling you will have by using ice for the entire first and second day after your surgery. The more ice you use the first two days, the less swelling you are likely to have. Please remember to put ice on even if it is somewhat uncomfortable to have the cold next to your skin. On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth. You can start applying moist heat compresses to your face on the third and fourth days. This allows the muscles to relax, resulting in gradual wider opening of your mouth. You may also perform gentle stretching / mouth opening exercises to help alleviate the muscle stiffness. 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 surgical 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 and dry sockets.
After the procedure, the doctor and/or his staff 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 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 a few days. With any surgical procedure, there can be unexpected results. These can include delayed healing, infection and post-operative numbness or tingling in your lip, chin, or tongue. The oral surgeon 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, and tongue. This nerve is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 15 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 be necessary to close the opening.
Dry sockets continue to be the most common problem people experience following oral surgery. They arise due to premature loss of a blood clot in the extraction 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 fourth 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 can be quite uncomfortable 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 extraction socket. This will help decrease the pain and protect the socket from food debris. The effectiveness of the dressing in alleviating the pain usually occurs in 20-30 minutes of it being placed and will last for a couple of days. Once the dry socket symptoms have resolved, the site will go on to heal in the usual way.
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. After the dry socket symptoms resolve, an irrigating syringe may be provided to help you to keep food debris from accumulating in the extraction site as it continues to heal.
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 Huntington Oral & Maxillofacial Surgery, PC Phone Number 631-421-0100.