Wisdom teeth removal is a common surgical procedure carried out by oral surgeons and dentists. As with any form of surgery, it carries some risks, but fortunately they are quite small.
THE BEST TREATMENT
- Rest and allow your body to recover (Avoid heavy exercise for at least 24 hours)
- Do not rinse out with mouthwashes or salty water to clear the blood taste from your mouth. You risk washing away the blood clots.
- Do not smoke for 1 week before or after surgery. Or at least reduce the amount you smoke.
- Eat properly. You may not feel like eating but your body needs food to help you recover. Avoid hard brittle foods for a couple of days.
- Avoid alcohol for at least 48 hours.
- Try to reduce the strength and quantity of the painkillers you take. They do make you nauseous.
The risks from surgery to remove wisdom teeth include:
- Stiffness in the jaw
- Dry socket – also known as alveolar osteitis
- Numbness and partial numbness – this can result from temporary or permanent nerve damage
- Infection – you should visit your dentist if you think that the extraction site has become infected.
- Bleeding (hemorrhage) – also visit your dentist if you are bleeding heavily at the site of extraction
- Nausea and upset stomach
- Sinus problems
Pain varies depending on the difficulty of your extractions. Advice will be given as to which pain killers to take and processes which may help reduce discomfort.
Generally panadiene and/or ibuprofen will relieve your discomfort. If stronger pain is expected a script will be given for a suitable pain killer. Please contact me if the pain relief is not adequate.
Swelling usually occurs after dental extractions. An anti inflammatory (dexamethazone) will be given if a lot of swelling is expected. Swelling normally peaks in 3 days. Use ice packs as frequently as possible for 48 hours.
A frozen packet of peas wrapped in a tea towel makes for a good temporary icepack. The hospitals will normally allow you to take an ice pack home with you.
Stiffness in the jaw
Bleeding or oedema (fluid from swelling) can cause restriction in your jaw opening. This is transient and your movement will normally improve as your swelling subsides.
Ice packs for 48 hours helps and then gentle movement of the jaw gets your muscles moving again.
If you do bleed into the surrounding tissue the stiffness may last longer as the blood clot takes time to resolve. As your swelling reduces you may develop a bruise about 1 cm from the corner of your mouth, it will resolve in a few days.
Dry socket (alveolar osteitis) is one of the most common complications of wisdom tooth removal. It occurs when a blood clot fails to develop in the tooth socket, or if the blood clot becomes dislodged or disappears. This can happen three to five days after surgery.
Also called Localized Alveolitis, dry socket occurs in 5% non smokers, 20% smokers. Refrain from smoking, using straws and spitting for 72 hours after the procedure.
If you do develop a “dry socket” it may need a socket dressing to relive the pain. Please contact me if you suspect you have a problem.
Dry socket is a localised infection and is more common than a generalised infection. If you develop a fever, an unexpected swelling or a swelling greater than 5 days postoperatively you may have a generalised infection. Please call me.
Numbness and partial numbness
A small number of patients who have their wisdom tooth removed are affected by numbness and partial numbness due to nerve damage. This can occur when the nerves closest to the root of the tooth are bruised or damaged during surgery. There may be a temporary loss of feeling to the front of your tongue, lower lip or the side of your mouth where the tooth was removed. This could mean that you can’t feel pain, touch or a change in temperature in this area.
Typically resolves after 24 hours from the local anaesthesia
Extraction induced numbness:
90% resolve in 6-8 weeks, 95% resolve within 6 months, 5% can be permanent
Please ensure you tell me all the drugs and medications including herbal remedies you are taking. Many medicines can affect your bleeding time.
Seepage is normal for the first 48 hours. Blood mixed with your saliva can appear as if you are bleeding excessively. Try not to spend a lot of time spitting and rinsing out the blood and saliva, it will only encourage further seepage.
It is suggested to place an old pillowslip or towel on your pillow for the first night as you will dribble while your mouth is numb.
Excessive bleeding – This is rare and can be caused by too much exertion or by vomiting. It can be stopped by placing gauze over the site and applying pressure by biting gently on the gauze for 20 to 30 minutes.
If severe bleeding does not stop, contact me or the hospital emergency department.
Nausea and upset stomach
Many people will feel nauseous postoperatively. This is not unusual.
If you are nauseous after the first day it is usually because you have not eaten properly.
Consider that you had nothing to eat before the anaesthetic, you have been taking painkillers and antibiotics and you have been swallowing blood, it is no wonder your stomach is feeling fragile.
Please eat something so your stomach can resume normal activity. If you are vomiting up whatever you eat I suggest you try a can of soft drink, drink half the can and wait 20 minutes then drink the other half even if the first half has come back and then rest for 30 minutes. It may help, then start eating small quantities of soft food.
The roots of the upper wisdom teeth are close to the sinuses. In some cases, a sinus may be opened when a wisdom tooth is removed. The opening will usually heal quickly without infection. However, if an infection occurs or other problems start, more treatment may be necessary. It is suggested that you do not blow your nose repeatedly or strongly for the first 24 hours.