Post-Wisdom Tooth Extraction Complications: When to Seek Further Care

Post-operative issues after wisdom tooth extraction?

About a month ago, I had my left upper wisdom tooth extracted, and I only experienced mild swelling, which completely resolved in about a week.
Then, I went back to the same doctor to have my right upper wisdom tooth removed, but this time, I not only had general swelling; now, on the ninth day post-extraction, my face is still swollen, and I have bruising that extends from my cheek down to my throat.
Additionally, there is a hard lump on my cheek.
The doctor took some X-rays and said there was nothing wrong, and during the examination, there were no signs of inflammation or pus.
The doctor mentioned that it shouldn't be swelling this much or bruising down to the throat, and advised me to go home, apply warm compresses regularly, and take my medication on time.
I have been diligent with the warm compresses and taking my medication, but the pain persists...
I have trouble sleeping at night, wake up in pain in the morning, and my mouth can hardly open, making it difficult to eat.
Should I go to a larger hospital for further evaluation?

Mandy, 30~39 year old female. Ask Date: 2020/10/21

Dr. Huang Tingfang reply Dentistry

Dear Miss Mandy,
Hello! It is best to have an examination at a major hospital or undergo a dental CT scan.
Take care! Wishing you peace and success in everything!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/10/21

More Info

After wisdom tooth extraction, it's not uncommon to experience some swelling and discomfort. However, your situation seems to be more complicated than typical post-operative symptoms. Given that you had significant swelling, bruising extending to your throat, and a hard lump in your cheek nine days after the extraction, it is essential to take these symptoms seriously.

In general, after a wisdom tooth extraction, patients can expect some degree of swelling, which usually peaks around 48 to 72 hours post-surgery and then gradually subsides. Most patients find that they can return to normal activities within a week. However, if swelling persists beyond this timeframe, especially if accompanied by bruising and pain, it may indicate a complication.

The hard lump you mentioned could be a hematoma, which is a localized collection of blood outside of blood vessels, often resulting from trauma or surgical procedures. While some bruising and swelling are expected, extensive bruising that travels down to the throat is not typical and could suggest that there was more significant bleeding during or after the procedure.
Additionally, the pain you are experiencing, especially if it is severe enough to disrupt your sleep and make eating difficult, warrants further investigation. Pain that does not improve with prescribed medications or that worsens over time could indicate an infection or other complications such as dry socket, which occurs when the blood clot at the extraction site dislodges or dissolves before the wound has healed, exposing the bone and nerves underneath.

Given that your dentist has already taken X-rays and found no signs of infection, it might be beneficial to seek a second opinion, especially from an oral surgeon or a specialist in a larger hospital. They can provide a more thorough examination and possibly additional imaging to rule out any underlying issues that may not have been visible in the initial assessment.
In the meantime, continue to follow your dentist's advice regarding pain management and care. Ensure you are taking your medications as prescribed, and maintain good oral hygiene to prevent any potential infections. Applying warm compresses can help with swelling, but if you notice any new symptoms, such as fever, increased redness, or discharge from the extraction site, seek medical attention immediately.

In summary, while some discomfort and swelling are normal after wisdom tooth extraction, your ongoing symptoms suggest that further evaluation is necessary. Do not hesitate to reach out to a healthcare provider for a more comprehensive assessment to ensure that you receive the appropriate care and treatment. Your health and comfort should always be the priority, and seeking further care is a responsible step to take in this situation.

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