After Extraction of Wisdom Teeth
In most cases, the removal of wisdom teeth is performed in our in-office surgery suites under IV Sedation in conjunction with Nitrous Oxide Sedation and local anesthetic. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you at your initial consultation appointment, before the procedure is performed. Once the teeth are removed, the gum is sutured, if necessary. To help control bleeding we will use gauze packs in the office and instruct you and your responsible party on how to do this at home. You will be monitored under Dr. Schwartz and his surgical staff’s supervision in the office until you meet all discharge criteria. After the surgery your responsible party will be brought back into the surgical suite so that Dr. Schwartz and his surgical staff may go over, in detail, all the port-operative instructions with all parties. Upon discharge your postoperative kit will include written post-operative instructions, a prescription pain medication and antibiotics (if needed), and extra gauze. If you have any questions, please do not hesitate to call us at Daniel M. Schwartz DMD MD LLC Phone Number 216-464-1200.
Wisdom Tooth Removal Overview
For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our educational MiniModule in a separate window that may answer some of your questions about wisdom teeth.
What Will I Feel Like after Wisdom Teeth Removal Surgery?
Immediately after your surgery you may feel groggy and sleepy from the combination of different anesthesia techniques. The local anesthetic used can make your mouth and jaw feel numb for several hours, we will instruct you in the use of pain medications to lessen the discomfort as the local anesthetic starts to wear off.
For the rest of the day and possibly continuing into the second day, you may experience some minor bleeding and pain. 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. 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.
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 on their way to feeling normal in 3 to 5 days.
Are There Any Problems After The Removal Of Wisdom Teeth?
As with any medical procedure, there can be complications or an unanticipated result. Some complications that patients undergoing wisdom teeth removal 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, Dr. Schwartz and his surgical staff will review your post-operative instructions with you and your responsible party. We ask that you follow these instructions closely, as they will make you feel the most comfortable following your procedure. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days. The oral surgeon will review relevant postoperative events with you and answer any questions during your office visit.
At any time before or after your surgery, please feel free to call our office at Daniel M. Schwartz DMD MD LLC Phone Number 216-464-1200 and speak with a member of Dr. Schwartz’s surgical staff. They will be happy to answer any questions and explain any procedures to you.
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. 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 RARELY be necessary to close the opening.
Dry socket continues 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 seems to occur with greater frequency in people who smoke or take any action that creates a “suction” in the mouth, such as drinking through a straw, spitting and rinsing forcefully within the first 24 hours. 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. 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. Treatment can involve changing your prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket. This will help decrease the pain and protect the socket from food particles. 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.
This medicated dressing does not aid in healing. The placement of this medicated dressing is to help alleviate the pain associated with dry socket. If medication 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, 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.