Managing Wisdom Tooth Extraction Recovery and Dental Sensitivity Issues

Wisdom tooth extraction wounds, cavities, and sensitive teeth..?

Hello, doctor! Last month, I asked you about my situation.
After being hospitalized in the emergency department (intensive care unit), I experienced weakness in my front teeth, which became sensitive, and my upper left wisdom tooth was blocking the front teeth, leading to cavities.
At the end of last month, I had the wisdom tooth extracted, and it has now been a month.
The extraction site has a significant depression! Three weeks after the extraction, the doctor examined the wound and noted that some tissue had started to grow back, but it would take a few months to fill in completely.
Since the extraction, I haven't experienced significant pain, so I haven't taken any pain medication.
I took anti-inflammatory medication (antibiotics) for three days right after the extraction, but I still feel like there's a piece of tissue missing, which often causes discomfort.
The dentist has examined it several times and confirmed that there are no issues, just that the wound is still healing, making it difficult to treat the cavities in the front teeth.
The dentist is hesitant to administer anesthesia in that area for fear of swelling.
Therefore, they can only drill a little at a time (and I have to endure the discomfort of the drilling).
Last week, I suddenly felt a lot of swelling at the extraction site, so I quickly went to see the dentist.
It turned out that the swelling was not from the extraction site but from inflammation caused by some debris left behind behind the adjacent tooth, leading to swelling in the gums of that tooth.
The condition of my front teeth has improved significantly, although they still feel a bit weak or tender occasionally.
Overall, there has been improvement over time.
Now, after eating, I can only rinse my mouth and use an interdental brush to clean the back of the front teeth (the dentist taught me to bend the interdental brush vertically and brush slowly).
A doctor at another clinic suggested that I have periodontal disease, which is causing the issues with my front teeth, and they helped me with other teeth, filling six of them.
I was prescribed medication for another week, but it feels like there hasn't been much change.
However, other dentists have examined my gums and said there are no issues, so it doesn't qualify as periodontal disease.
Now that the wisdom tooth extraction site has grown some new tissue, although not much, can I use a bit of force when rinsing my mouth after meals? Gently rinsing doesn't seem to remove the debris stuck in there! Sometimes, after rinsing, I also brush my teeth to help dislodge the food stuck in the hole using foamy mouthwash.
Given this situation, if I want to completely address the cavities, is it really not possible to use anesthesia? (I'm also worried it might cause the wound to swell).
Besides brushing, is it necessary to use mouthwash? Lastly, I have a smoking habit and a strong craving for cigarettes, but I'm afraid it will affect the wound, so I've significantly reduced my smoking.
However, the dentist at the clinic said, "Smoking does not affect the wound; if you can't quit, just smoke less." After smoking, I rinse my mouth with water, but I wonder if this will prevent the wound from healing completely (after all, I'm not young, and my healing ability has decreased significantly)...?

ken, 40~49 year old female. Ask Date: 2016/01/26

Dr. Zeng Guanghui reply Dentistry

After having wisdom teeth extracted, it takes about 2-3 months for the gum tissue or bone to fully heal and integrate.
Any cavities in the teeth in front of the wisdom teeth should be filled, and the surrounding gum tissue should be cleaned thoroughly to naturally improve gum inflammation.
If there is redness, swelling, or cavities in the front teeth, professional cleaning and cavity fillings are also necessary.
Additionally, proper brushing and the use of dental floss or interdental brushes to clean between the teeth are essential.
Mouthwash can help reduce gum inflammation but should only be used as an adjunct; the primary focus should be on brushing and flossing.
If there are concerns about the healing of the extraction site, regular follow-up visits with the dentist for check-ups are recommended.

Reply Date: 2016/01/26

More Info

Managing recovery after wisdom tooth extraction can be a complex process, especially when accompanied by dental sensitivity and other complications. It’s great that you’re actively seeking information and guidance on your situation. Let’s break down your concerns and provide some insights based on the information provided.

Understanding Sensitivity After Wisdom Tooth Extraction
It’s not uncommon to experience sensitivity in adjacent teeth after wisdom tooth extraction. This can occur for several reasons:
1. Trauma to Adjacent Teeth: During the extraction process, neighboring teeth may experience some trauma, leading to temporary sensitivity. This is often due to the manipulation of the surrounding tissues and teeth.

2. Changes in Bite: After the extraction, the way your teeth come together (occlusion) may change, which can lead to sensitivity in the teeth that were previously in contact with the extracted tooth.

3. Healing Process: The extraction site may take time to heal completely. As the bone and gum tissue regenerate, you might feel discomfort or sensitivity in the area.

4. Underlying Dental Issues: If there were pre-existing conditions, such as cavities or gum disease, these could also contribute to sensitivity post-extraction.

Managing the Extraction Site
Regarding the healing of the extraction site, it’s essential to follow your dentist’s advice. Here are some tips to manage the area effectively:
- Gentle Oral Hygiene: While it’s important to keep the area clean, be cautious not to disturb the healing tissue. You can gently rinse your mouth with warm salt water to help keep the area clean without applying too much pressure.

- Avoiding Irritants: Smoking can significantly impede healing. While some dentists may say that smoking doesn’t directly affect the wound, it can lead to complications such as dry socket, which is a painful condition that occurs when the blood clot at the extraction site dislodges. Reducing smoking is advisable, and ideally, quitting would be best for your overall health and recovery.

- Use of Mouthwash: If you choose to use mouthwash, opt for an alcohol-free variety to avoid irritation. However, consult your dentist about whether it’s appropriate for your situation, especially in the early stages of healing.

Addressing Dental Sensitivity and Future Treatments
As for the sensitivity you’re experiencing, it’s crucial to communicate openly with your dentist about your discomfort. If the sensitivity persists, it may be indicative of other underlying issues, such as:
- Cavities: If you have cavities in adjacent teeth, they may need to be treated before further dental work can be done.

- Gum Disease: If there’s a concern about periodontal disease, it’s essential to address this as it can affect the health of your teeth and gums.

Regarding the use of anesthesia for future treatments, your dentist may be cautious due to the potential for swelling or complications at the extraction site. However, if you’re experiencing significant pain or discomfort, it’s important to express this to your dentist. They may be able to provide a local anesthetic in a way that minimizes risk to the healing area.

Conclusion
In summary, managing recovery from wisdom tooth extraction involves careful attention to oral hygiene, monitoring sensitivity, and maintaining open communication with your dental care provider. It’s essential to follow your dentist’s recommendations and not hesitate to seek a second opinion if you feel your concerns are not being adequately addressed. Remember, healing takes time, and your comfort and health should always be a priority. If you continue to experience discomfort or have concerns about your healing process, don’t hesitate to reach out to your dentist for further evaluation and guidance.

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