After Extraction of Wisdom Teeth
In most cases, the removal of wisdom teeth is performed under local anesthesia and intravenous sedation, although as mentioned previously, all anesthesia options will be discussed at the consultation appointment. During the consult, the surgical risks (such as sensory nerve damage, sinus complications, development of infection or dry socket) will be discussed with you as well.
At your surgical appointment, your treatment will be provided in an environment of optimum safety, utilizing modern monitoring equipment and involving health professionals who are very experienced in anesthesia techniques.
Once your wisdom teeth are removed, the gum tissue is sutured. Biting down on gauze placed in your mouth will help to control the bleeding. You will then rest under our supervision in the office until you are ready to be accompanied home. Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication and antibiotics, and a follow-up appointment in one week for post-operative evaluation and suture removal if non-dissolving sutures were placed. Should you have any questions at any time, please do not hesitate to contact us at Prince George Phone Number (250) 614-1828.
What will I feel like after wisdom teeth removal surgery?
On the first day after wisdom teeth removal surgery, some minor bleeding and pain may be experienced. We therefore recommend protecting your pillowcase from blood stains by covering it with an old pillowcase. Every individual’s reaction to surgery varies, and the sensation of pain may range from mild discomfort to severe pain. Before the local anesthesia (freezing) wears off, we therefore recommend you begin taking pain medication to alleviate the anticipated discomfort. The non-narcotic anti-inflammatory medications such as Ibuprofen (Advil® or Motrin®) should be taken first. If Ibuprofen in the recommended dosage does not adequately treat your pain, one can take Tylenol® or Extra Strength Tylenol® as recommended at the next time interval. Should neither the Ibuprofen nor Tylenol® formulations be effective enough for your pain management, at the subsequent time interval you may begin taking the prescription pain medication as Dr. Özcan has directed. 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 applying ice as directed for the entire first day. The more ice is applied the first day, the less swelling you are likely to have on the second day. Please remember to apply ice on the first day 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 normally. You can apply moist heat to your face on the second and third day, allowing your muscles to relax more and open wider. You will need to limit your activities for a few days in order to have a better recovery. 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 3 to 5 days post-surgery.
could there be any problems after the extraction of wisdom teeth?
As with any medical procedure, there may be complications or an unanticipated result. Some complications that patients may experience following wisdom teeth extraction include:
- damage to the sensory nerve that supplies sensation to the lips, chin and tongue
- sinus communication
- development of infection
- development of dry socket(s)
After the procedure, our surgical assistants will review your post-operative instructions with your escort. We ask that you follow these instructions closely, as they will enable you to experience the best recovery possible following your procedure. If you were sedated, you will be comfortable and drowsy when you leave the office. We stress the importance of proper rest once patients arrive home, and strongly recommend that patients do not have physical, scholastic or work activities planned for a few days. As with any medical procedure, there may be unexpected results. These may include delayed healing, development of infection, development of dry socket(s), sinus communication, and post-operative numbness or tingling in your lip, chin, or tongue. Dr. Özcan will review relevant post-operative events with you and answer any questions you may have during your office visit.
Damage to the Sensory Nerve
A primary concern when performing surgery in the lower jaw, is a nerve 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 wisdom teeth removed when one is 12 – 18 years of age, is therefore very advantageous, as the wisdom teeth roots have not fully developed yet, and this nerve is therefore not as 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 permanent alteration of sensation, similar to the feeling when one has local anesthesia. We feel that you should be aware of this possibility before consenting to surgery.
The upper wisdom teeth are situated close to the sinuses, and their removal can result in an opening (communication) between your mouth and the sinus. Once again, if the teeth are removed at an early age, this potential complication is much less likely as the wisdom teeth roots have not yet fully developed. However, should a sinus communication occur, it will usually close spontaneously. We may give you special instructions to follow, such as avoiding blowing your nose for two or three days following the surgery. You can wipe your nose, but should not blow your nose. If you have to sneeze, you should sneeze with an open mouth into a tissue. This is to prevent creating pressure in the sinus area, and to thereby avoid dislodging the healing blood clot. If you sense a sinus communication has developed following the surgery, please contact the office. An additional procedure may RARELY be necessary to close the opening.
Development of dry socket(s) is the most common problem experienced following wisdom teeth surgery. This arises due to premature loss of a blood clot within the empty tooth socket. This occurs with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, dry sockets more often develop in the lower jaw, and most frequently on the third to fifth day post-surgery. The sensation experienced when a dry socket(s) has developed, is a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain as beginning in the ear, and then radiating down towards the chin.
The symptoms frequently begin in the middle of the night, and your pain medication regimen may not help. Treatment may involve Dr. Özcan changing your prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket, and we will therefore likely ask you to return to the office for this evaluation. Placement of a medicated dressing will help decrease the pain experienced, as well as protect the socket from food particles collecting, which would exacerbate the discomfort. 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.
Application of the medicated dressing does not aid in healing, but rather helps with pain control. If medication alone 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, a post-operative infection may develop. This will usually require an office visit and clinical examination. Placing you on an antibiotic regimen for one week may take care of the infection, although if more significant, the area may also need to be drained and cleaned. Other temporary problems that may be experienced in the post-operative period include stiffness of the jaws, chafing around the corners of the lips, facial bruising, and blood oozing from the extraction sites. The post-operative instruction sheet we provide should answer many of the questions related to these more common concerns. Should one have additional questions, however, please do not hesitate to contact us at Prince George Phone Number (250) 614-1828.