Procedures

After Removal of Wisdom Teeth

In most cases, the removal of wisdom teeth is performed under general anesthesia or sedation. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you at your consultation appointment.

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. Please read the post-operative surgery pamphlet for all of your post-operative instructions. You may also find additional instructions on this website. If you have further questions, you may call to speak with our surgical nurses at Warminster Office Phone Number 215-672-6560 during regular business hours. The doctors are on call 24 hours a day, 7 days a week for after-hour emergencies.

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What Will I Feel Like after Wisdom Teeth Removal Surgery?

On the first day after surgery, you may experience some minor bleeding and discomfort. A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the fourth day and should begin resolving on the fifth day. You can limit the amount of swelling you will have by using ice on your face for the first two days after surgery. You can apply moist heat to your face on the day allowing your muscles to relax so you are able to 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 over the hump and on their way to recovery in 2 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 Tooth Removal may experience include: Damage to the sensory nerve that supplies sensation to the lips and tongue, sinus communication, infections, and dry sockets. Dr. Kienle, Dr. Steinkeler and Dr. Gunawardena will review relevant post-operative events with you and answer any questions during your consultation.

Our nurses will review your post-operative instructions with your escort. We ask that you follow these instructions closely, as they will make you most comfortable following your procedure. Most patients prefer to go home and rest with limited activities planned for a few days. With any surgical procedure, there can be unexpected results. These can include delayed healing, infection, and post-operative numbness or tingling in your lip, chin, or tongue.

Illustration showing possible area of numbness caused by damage to a sensory nerve

Damage to Sensory Nerve:

There 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 teeth. Having wisdom teeth out between the ages of 12 and 18 usually provides less risk to the nerve. Occasionally, when the teeth are removed, the nerve can become injured.

When the local anesthesia wears off, you may experience a tingling or numbing sensation in the lower lip, chin, tongue, or teeth. 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. If you experience the altered sensation for more than a week after your surgery, please contact our facility.

Illustrated diagram showing the opening that can occur between your mouth and sinuses after wisdom tooth removal

Sinus Communication:

The upper 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 avoiding blowing your nose for 4 – 6 weeks following the surgery.

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. An additional procedure may be necessary to close the opening if it persists for more than a few weeks following surgery.

Illustration: A dry socket that developed after the removal of wisdom teeth

Dry Sockets:

Dry sockets are one of 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. Dry sockets occur in the lower jaw on the third to fifth day after surgery. 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 may be helpful to place a medicated dressing (packing) 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. We typically only pack a socket once because packing it more often can prolong the healing problem.

The dressing does not aid in healing. The only reason to place a dressing is for pain control. If pain medication is controlling the pain, there is no indication to place packing in the socket. In many cases, this packing can actually impede the healing process and cause the dry socket issue to persist longer. Treatment of a dry socket is usually best accomplished with just additional pain medication.

Illustration: An infection in the lower jaw that can occur after wisdom teeth removal

Infection:

Occasionally, post-operative infections occur. This may require an office visit and clinical examination. Most times, placing you on an antibiotic for ten days will resolve the infection. If it persists or recurs, the area may have to be drained and cleaned. Infections may actually occur up to 6 months post wisdom tooth removal.

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 provide should answer many of the questions related to these more common concerns. If not, you may call the facility at Warminster Office Phone Number 215-672-6560 during regular business hours.

Please remember all of the procedures described here are surgical procedures. These surgical procedures are best performed by oral and maxillofacial surgeons. Oral and maxillofacial surgeons are the only dental specialists who are fully trained in all of these surgical procedures. Drs. Kienle, Steinkeler and Gunawardena are all fully trained and experienced in these surgical procedures. All doctors in our practice are board-certified in oral and maxillofacial surgery and in anesthesia and have also earned both a medical and a dental degree.

Drs. Kienle, Steinkeler and Gunawardena have the only practice in the Delaware Valley/Tri-State area where all of the surgeons have both their medical and dental degrees and are board-certified in oral and maxillofacial surgery and anesthesia, and in which all of our surgical facilities are fully accredited by the Joint Commission. You can be assured that Drs. Kienle, Steinkeler and Gunawardena have the best training and experience, along with the proper staff and facilities, to provide you with exceptional safety, and comfortable surgical care.

After Removal of Wisdom Teeth FAQS

How do I prevent dry socket?

It is very important to avoid:

  • using straws
  • no spitting
  • and no smoking or vaping for 2 weeks after your procedure

Does pineapple juice prevent dry socket?

This has not been proven and is not recommended at this time.

How long after wisdom teeth removal can I eat?

After the gauze is removed (approximately 1 hour post-op) it is best to start with a clear liquid or light meal. Be careful, if you are numb still to not burn yourself or bite your tongue or lips.

When can you drink water after wisdom teeth removal?

After the gauze is removed you can start drinking.

Can sneezing cause dry socket?

Sneezing is not a common cause of dry sockets.