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 (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed.

Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. 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, and a follow-up appointment in one week to check on your progress. If you have any questions, please do not hesitate to call us at Santa Barbara Office Phone Number 805-682-0933 (Santa Barbara) and Santa Barbara Office Phone Number 805-682-0933 (Lompoc).

Wisdom Tooth Removal Overview

For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about wisdom teeth.

Wisdom Tooth Removal Overview

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Our services are provided in an environment of optimum safety. We utilize modern monitoring equipment and our staff are experienced in anesthesia techniques.

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 day. The more ice you use the first day, the less swelling you are likely to have on the second day. Please remember to put ice on the first day even if it is somewhat uncomfortable to have the cold next to your skin.

On the second or third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. This is where you need to exercise your jaw to lessen the stiffness. Stretch your jaw and massage your gums with a clean finger. 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 want to limit your activities for a few days. Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule.

Self Care Tips After Wisdom Teeth Removal

  • Oral Care – On the first day do not disturb the surgical area. Bite down on the gauze packs that have been placed over the surgical areas for 30-60 minutes. Please avoid spitting. This will help blood clots form in the sockets, which allows proper healing. Do not start the oral rinses until tomorrow, but please brush your teeth gently. Do not smoke for at least 48 hours as it is detrimental to healing.
  • Nausea – Nausea is common after surgery, and it is sometimes caused by the narcotic pain medicines or IV anesthesia. If you have nausea, you can reduce it by consuming a small amount of food and/or liquid before taking the pain medications.
  • Diet – In general eat any nourishing food that can be taken with comfort and keep hydrated. Avoid extremely hot, hard or spicy foods. Avoid chewing near the surgical sites and using straws (especially with thick liquid). After your procedure, start with clear liquids (i.e., water, Gatorade, apple juice); letting ice cubes and/or popsicles melt in your mouth can provide hydration and also pain relief when placed over the sockets. Once tolerating liquids, advance to a soft diet (i.e., milkshakes, oatmeal, scrambled eggs, yogurt) and then to a normal diet as tolerated.
  • Bleeding – Intermittent oozing over the first 24 hours is normal. If oozing occurs bite on the gauze for 20-30 minutes and continue using the facial ice packs. If bleeding persists you may bite on a black tea bag (soaked in hot water, squeezed damp-dry and wrapped in moist gauze) for 20-30 minutes. If bleeding remains uncontrolled, please call our office.
  • Swelling – Often there is some facial swelling and bruising associated with oral surgery. You can minimize this by using a cold/ice pack wrapped in a towel applied twenty minutes on and off during the first 24 hours. Naproxen or ibuprofen taken regularly will be beneficial as well. If you had IV anesthesia and experience redness or swelling near the IV site, it usually resolves by applying hot/moist towel to the area. If it persists after 2 days, please call our office.
  • Pain Control – For post-operative discomfort we recommend that you take 600mg of ibuprofen or 500mg of naproxen (Aleve) before the local anesthetic has worn off. If the ibuprofen or naproxen do not provide adequate relief, you may supplement them with the prescribed narcotic medication.
  • Antibiotics – If antibiotics were prescribed, please continue to take them for the appropriate time period.
  • IV Anesthesia – The effects of anesthesia can linger for up to 24 hours. Please do not drive or operate heavy machinery for 24 hours.
  • Mouth Rinses – Keeping your mouth clean after surgery is essential. Use one quarter teaspoon of salt dissolved in 8 ounces of warm water and gently rinse, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily after meals for the next five days. If a mouth rinse is prescribed, use this instead of salt water three times daily.
  • Brushing, etc. – Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but make every effort to clean your teeth at your comfort level. There will likely be sutures that may be dissolvable depending on the type of suture. Be sure to massage sutures with a clean finger.
  • Exercises – Start stretching your jaw by opening and closing. If you cannot do this, put your finger in your mouth and slowly open it. Continue this until you can open your jaw easily. This can take a couple of days.

Symptoms

Normal healing after tooth extractions should be as follows:

  • The first day is usually the most uncomfortable, and there is some degree of swelling and stiffness.
  • The second day is usually far more comfortable, although likely still swollen.
  • From the third day on, you should see gradual steady improvement.

Abnormal Pain – If you experience pain that is worsening between day 3-5, please let us know: Santa Barbara Office Phone Number 805-682-0933 (Santa Barbara) and Lompoc Office Phone Number 805-735-3665 (Lompoc). This could represent a dry socket or infection. This pain is often characterized by persistent throbbing in the jaw, often radiating towards the ear and forward. Also, if you do not see steady improvement during the first few days after surgery, please contact us: Santa Barbara Office Phone Number 805-682-0933 (Santa Barbara) and Lompoc Office Phone Number 805-735-3665 (Lompoc).

Sharp Edges – If you feel sharp edges in the surgical areas, it is likely the bony walls, which originally supported the teeth. Occasionally small slivers of bone work themselves out during the first week or two after surgery.

Elevated Temperature – It is normal to have a fever for the first 2-3 days after surgery. This is a result of your body starting the healing process.

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. 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 medical 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, we will review 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 medical 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, Dr. Kiken and Dr. McAninch, will review relevant post-operative events with you and answer any questions during your office visit. Please have someone stay with you to help you for the entire day.

Diagram showing area of damage to Sensory Nerve in lower jaw

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.

Sinus Communication Illustration

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 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.

Illustration showing a Dry Socket from removed tooth in lower jaw

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 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 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. 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.

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. Following removal of the dressing, an irrigation device may be provided to help you to keep food particles from lodging in the extraction site.

Illustration showing Infection after Wisdom Teeth Extraction

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. 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 Santa Barbara Office Phone Number 805-682-0933.