Post-Wisdom Tooth Extraction: Pain and Swelling

Wisdom tooth extraction?

Hello Doctor: I had my lower right wisdom tooth extracted on May 3rd.
It was impacted, and after removing the gauze one hour post-surgery, I noticed that it was still bleeding, so I placed a new gauze to stop the bleeding (the wound felt quite large; the doctor mentioned that my tooth was very tight, and the extraction took a long time, requiring it to be broken into smaller pieces).
Today, I still feel a sharp pain at the extraction site.
Is this normal? The nurse said to apply ice for one day, but I still feel some swelling in my face.
Should I wait until today is over to start applying heat, as indicated on the instructions?

Xiao Mama, 20~29 year old female. Ask Date: 2006/05/04

Dr. Zeng Guanghui reply Dentistry

If the impacted wisdom tooth is tilted, the surgical procedure is more complex.
It may require the elevation of a soft tissue flap and the tooth may need to be sectioned into smaller pieces.
Additionally, some surrounding alveolar bone may need to be removed to completely extract the impacted wisdom tooth.
As a result, the postoperative wound will typically experience more swelling and pain compared to a standard tooth extraction.
It is recommended to apply ice packs on the day after the extraction and to take prescribed medications on schedule.
Maintaining normal oral hygiene is also important to prevent wound infection.
Generally, if there are sutured wounds, a follow-up appointment for suture removal can be scheduled about a week later.
However, if there is still severe pain after the procedure, it is advisable to return for a check-up to assess the wound and receive further treatment.

Reply Date: 2006/05/04

More Info

After undergoing a wisdom tooth extraction, especially in cases where the tooth was impacted or required surgical intervention, it is common to experience pain and swelling in the days following the procedure. Your description of persistent pain and swelling is not unusual, and I will provide some insights into what you might expect and how to manage your symptoms effectively.

Understanding Post-Extraction Pain and Swelling
1. Normal Healing Process: After a wisdom tooth extraction, the body initiates a healing process that involves inflammation. This is a natural response as your body works to repair the tissue and bone. Pain and swelling can peak within the first 48 to 72 hours post-surgery, and it is normal to experience some discomfort during this time.

2. Pain Management: It is essential to manage your pain effectively. Over-the-counter pain relievers such as ibuprofen or acetaminophen can be beneficial. If your dentist prescribed pain medication, ensure you follow the dosage instructions. Avoid relying solely on pain medication; instead, combine it with other methods of relief.

3. Swelling: Swelling is also a common occurrence after tooth extraction. Ice packs can be applied to the outside of your cheek for the first 24 hours to help reduce swelling. After this period, switching to warm compresses can promote blood flow to the area and aid in healing. It is advisable to apply ice for 15-20 minutes at a time, with breaks in between.

4. Bleeding: If you notice continued bleeding after the extraction, it is crucial to apply pressure to the area with a clean gauze pad. If bleeding persists beyond a few hours or is excessive, you should contact your dentist for further evaluation.

5. Dietary Considerations: During the healing process, stick to a soft diet to avoid irritating the extraction site. Foods like yogurt, mashed potatoes, and smoothies are good options. Avoid hot, spicy, or crunchy foods that could disrupt the healing tissue.

6. Oral Hygiene: Maintaining oral hygiene is vital, but be cautious around the extraction site. You can gently rinse your mouth with warm salt water starting 24 hours after the extraction to help keep the area clean. Avoid vigorous rinsing, as this can dislodge the blood clot that forms in the socket.

7. When to Seek Help: If your pain worsens after a few days, or if you notice signs of infection such as fever, increased swelling, or pus discharge, it is essential to contact your dentist. Additionally, if the pain is severe and unmanageable with over-the-counter medications, a follow-up visit may be necessary.

Conclusion
In summary, while experiencing pain and swelling after a wisdom tooth extraction is common, it is essential to monitor your symptoms closely. Follow the recommended care instructions, manage your pain effectively, and maintain good oral hygiene. If you have any concerns about your recovery or if your symptoms do not improve, do not hesitate to reach out to your dentist for further evaluation. Remember, healing takes time, and being proactive about your care can help ensure a smoother recovery process.

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