wisdom teeth: After the extractions

Immediately following surgery

You will rest under our supervision in the office until you are ready to be taken home. If you were sedated, you will be drowsy. It is recommended you go home and rest the remainder of the day.  Our surgical assistants will review your post-operative instructions with your driver.

Upon discharge, you will receive a post-operative kit that will include post-operative instructions, ice packs, extra gauze and it may also contain prescriptions for pain medication or antibiotics, along with a follow-up appointment in one week to check the healing. Gauze pads placed over the surgical area should be kept in place for about a half hour or until you arrive home.  After this time, the gauze pads should be removed and discarded. 

What to expect after surgery?

  • Post-op soreness can typically be managed with over-the-counter medications, however all medication options will be discussed ahead of your surgery to ensure that you have adequate pain relief at home as the anesthesia wears off.
  • On the first day after surgery, you may experience some minor bleeding. This is normal and can usually be controlled by applying pressure by biting down on moist gauze pads.
  • Swelling is common after oral surgery and may increase during the first 24 to 72 hours. During the first 48 hours cold compresses or ice bags should be applied for no longer than 20 minutes at a time.  The more ice you use during the first day and second day, the less swelling you are likely to have.
  • On the third post operative day, you might notice that your jaw muscles are stiff and it may be difficult to open your mouth. You can apply warm heat to your face allowing your muscles to relax more and open wider.  This may also be used to facilitate the resolution of swelling.
  • We recommend starting your post-operative diet with liquids such as jello, broths and soft foods. Gradually increasing in substance as your comfort of chewing permits.
  • You will want to limit your activities and rest for a few days. Doing so will make you as comfortable as possible 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.  

We ask that you follow your post-operative instructions closely. For a more detailed list of instructions please click here – Surgical Instructions for Wisdom Tooth Removal

Wisdom teeth complications

As with any medical procedure, there can be complications or an unanticipated result. Luckily, complications following wisdom teeth removal are rare and largely avoidable. All surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. The oral surgeon will review relevant post-operative events with you and answer any questions during your office visit.

However, if you suspect any of these complications, please call us for instructions.

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

Dry Sockets:

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 can happen to anyone for a variety of reasons, including smoking, drinking through a straw, improper home-care such as vigorous rinsing, and even the use of 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.

Although a dry socket is not harmful, they can be painful. Contact our office so we can provide you with the proper care. We can place a medicated dressing in the empty tooth socket.  The effectiveness in alleviating the pain is almost immediate and a single dressing lasts for 24-48 hours. This does require dressing changes every day or two, for five-to-seven days. Dressings usually are removed when you are pain free.

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.

Signs of infections include fever, worsening pain and swelling.

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 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. 

A diagram showing the opening that can occur bewteen 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 will give you special instructions to follow during the healing phase.  Any additional procedures are RARELY needed to close the opening.