Potential Complications of Wisdom Teeth Extractions

Wisdom tooth extraction is a common and generally safe procedure, but it is important to be aware of potential complications. Understanding these risks can help you make informed decisions, seek timely medical attention and ensure a smooth recovery.

What is a Dry Socket?

A dry socket (also called alveolar osteitis) is a relatively common complication after wisdom tooth extraction occurring in approximately 4 percent of all extractions. It occurs when a blood clot prematurely dislodges, dissolves or does not form properly in the empty socket, exposing the bone and nerves to the elements of the oral cavity like temperature changes or fluid and air flow. 

Dry socket typically occurs in the lower jaw due to smoking, excessive rinsing, straw use, food impaction, an infected site at the time of extraction, or older age. This can cause severe pain and bad breath as well as slowing the healing process. The pain often radiates from the socket toward your ear, temple, or chin. Your oral and maxillofacial surgeon (OMS) can give you instructions on how to prevent dry socket, such as avoiding smoking and using straws, and following good oral hygiene practices. Should your OMS diagnose a dry socket, they can discuss with you the best way to treat it and get your healing back on track.

Can I Get an Infection After Wisdom Teeth Surgery?

Although relatively rare, infections can occur after wisdom tooth extraction. Signs of infection include fever, increased pain, swelling, redness, salty or prolonged bad taste and pus formation. To reduce the risk of infection, it is important to follow your OMS’s postoperative instructions, such as good oral hygiene. Report your symptoms to your OMS immediately. They may prescribe antibiotics to treat the problem. Sometimes the infection needs to be drained if it does not respond well to antibiotics.

Are Swelling and Bruising Normal After Wisdom Tooth Surgery?

Swelling and bruising are common after wisdom tooth extraction. This is a natural part of the healing process and should subside over time. Applying cold compresses to the outside of your cheeks for the first 24 to 72 hours after surgery can help reduce swelling. Call your OMS if swelling worsens or persists for more than a few days.

What Are the Chances of Nerve Injury During Wisdom Tooth Surgery?

In some cases, wisdom tooth extraction can pose a risk of nerve damage, which can result in altered or total loss of feeling in the lip, tongue, cheek, chin, gums, teeth, side of tongue as well as taste sensation. The nerves that sensitize these areas may be located near your wisdom teeth and can be damaged or irritated during the extraction process. Numbness beyond a short period of time is uncommon and usually temporary but can be permanent in rare instances. Your OMS can assess your situation and provide appropriate guidance to minimize risk of nerve damage before the surgery.

Can Wisdom Tooth Surgery Cause Sinus Complications?

Wisdom teeth in the upper jaw may be located near the sinuses, and the roots commonly penetrate into the sinus cavity. In some cases, removal of the upper wisdom tooth causes a sinus membrane perforation and can result in an opening between the mouth and the sinuses called an oro-antral communication. Typically, these heal on their own, but they may lead to sinus infections or require additional treatment. Your OMS can carefully review your case and take precautions to minimize the risk of such complications. If you are experiencing drainage or sinus pain following your wisdom teeth removal, contact your OMS.

How Much Will I Bleed After Wisdom Teeth Surgery?

Bleeding is to be expected after wisdom tooth extraction, but excessive or prolonged bleeding is unusual. It is important to talk to your OMS about any medications you may be taking, as some can increase the risk of bleeding. It is important to follow your OMS’s instructions on how to use gauze to control bleeding. If excessive bleeding persists after you return home, contact your OMS.

What Are Other Wisdom Tooth Surgery Complications?

Other possible complications to be aware of include:

• Injury: Neighboring teeth, filling material, restorative crowns or bridgework may be accidentally dislodged or damaged during extraction.
• Root fragments: Sometimes long, thin tooth roots may break off during extraction. The OMS can usually remove the entire root fragment, but if it is close to a nerve or the sinus cavity, or removing it would jeopardize neighboring teeth, the surgeon may leave the small fragment in place. These fragments are unlikely to cause long-term problems and can be monitored.
• Jaw fracture: While very rare, jaw fractures can occur after wisdom teeth surgery, especially in the case of thin jaws or severely impacted wisdom teeth. Avoid eating hard or crunchy foods after surgery to reduce undue stress on the jaws.
• Jaw joint pain or abnormal jaw function: Rarely, jaw joint pain can begin after surgery. Be sure to inform your OMS about any pre-existing jaw function problems ahead of your surgery.

What Are the Side Effects to Anesthesia or Medications?

Some people experience side effects from the anesthesia or medications used during tooth extraction surgery. Side effects may include nausea, vomiting or allergic reactions. To minimize these risks, provide your OMS with a comprehensive medical history and follow all pre- and postoperative instructions.

Although complications can occur, most patients heal from wisdom tooth extractions without significant problems. Strictly adhering to your OMS’s instructions, maintaining good oral hygiene, attending follow-up appointments and seeking immediate medical attention if you have any concerns will minimize the chance of complications and promote a smooth recovery.

Contact your OMS if you have severe or persistent pain, excessive bleeding, swelling, infection or other symptoms that worry you. Your OMS will guide you through the recovery process, address any concerns and provide appropriate care.