Procedural and Post Procedural Risks
All types of surgery, including extraction of teeth all are associated with some risks. Each individual and their conditions are unique and there is no predictable way to determine the healing, the gum response or pain response of an individual. Complications that may result from extractions and anaesthetics include, but are not limited to:
- Adverse reactions to the anaesthetic, drugs, medications
- Bleeding risk: Wisdom tooth surgery is a minor surgical procedure. Some bleeding is expected and usually stops with pressure applied with a gauze. Certain medical conditions or medications may increase the risk of bleeding. If you notice uncontrolled bleeding, please contact us or a medical professional immediately.
- Bacterial Endocarditis: Because of normal existence of bacteria in the oral cavity, the tissues of the heart, as a result of reasons known or unknown, may be susceptible to bacterial infection transmitted through blood vessels, and Bacterial Endocarditis (an infection of the heart) could occur. It is my responsibility to inform the dentist of any heart problems known or suspected or of any artificial joints I may have.
- Sinus perforations: During surgery in the upper jaw, there is a potential risk of perforation into the maxillary sinus when teeth are being extracted. The sinus is the air space located above or at the tip of the roots of the upper molar teeth. If a small perforation occurs, it is usually manageable with instructions of home care and medication. If the perforation is more extensive, this may require referral to a specialist and in some cases, a minor surgical intervention may be essential.
- Risk of temporary/ permanent numbness to lips, chin, cheek and tongue or altered sensation: Paraesthesia of the jaw nerve may occur and present as altered sensation/numbness and/or tingling on the affected side. This may affect the jaw or the tongue. It is uncommon and is usually temporary, lasting from a few weeks to months. In rare cases, the jaw nerve damage is permanent.
- Fracture of adjacent structures/root tip of tooth:
During the extraction of teeth, the surrounding bone, vessels, and nearby tissues are gently stretched to create space for the instruments and to elevate the tooth. Minor damage may occur, but it typically heals without complications. On occasion, the roots of a wisdom tooth may fracture at the tip. Pursuing the broken root tip can pose additional risks, so in some instances, we may opt to leave it in place. It will either become embedded in the bone or eventually migrate to the surface, where it can be easily removed. - Accidental swallowing of foreign matter: Extraction procedures sometimes require fine and small componentry. The utmost care will be taken to prevent complications such as this; however, there is always a risk that the fine componentry can be accidentally swallowed during the procedure. If this occurs, there is a requirement to have appropriate x-rays and surgical treatment to have it removed.
- Soreness and Tenderness: Some patients may feel soreness and tenderness over the next couple days and may notice minor bruising and swelling as with most surgical procedures. This should settle over the next couple of days and weeks, but the exact duration of these complications is not determinable. There is a slight chance they may become permanent and irreversible. Jaw pain or trismus (locked jaw) symptoms may be evident after the procedure, this usually settles after a few days and it is best to keep up with pain relief, warm heat packs or anti-inflammatories and plenty of rest with the jaw as required. Please inform this clinic if such conditions persist.
- Dry Socket: This occurs due to the early loss of the blood clot that forms in the socket which exposes the underlying bone. This causes a constant throbbing pain which increases in pain over the following days and is sometimes followed by a bad smell. If you experience such symptoms, please contact your dentist as soon as possible. To help prevent a dry socket, there are a few things you can do:
- 1) Do not rinse out your mouth or spit with force for the first 24 hours after the procedure. This can dislodge the blood clot and slow healing.
- 2) Avoid smoking and alcohol for at least the first 24 hours. It is best not to smoke at all for the first two weeks as this significantly impairs healing.
- 3) Avoid vigorous activity involving the mouth or exercise which could affect the healing.
- Bony sequestrum: After removal of a tooth sometimes thin pieces of bone may have been chipped/fractured during the procedure, or the bone edges may not heal properly. This can result in small, hard bony protrusions that appear in the gum tissue. They can appear immediately after the procedure, and occasionally appear a few weeks to a few months later. If you notice these in your mouth, it is best to see your dentist for a consultation to see if they require removal.
- Delayed healing: The ability to heal varies greatly between individuals so do not be alarmed if the area is healing quickly or slower than expected. During the review appointment, the healing will be assessed and managed appropriately if the healing process is not going as expected.
- Bone loss: Over time, the absence of teeth can lead to gradual bone loss. When teeth are missing, the surrounding tissues and bone can undergo a process of resorption. If no intervention is planned to replace the extracted tooth, you can anticipate neighbouring teeth shifting or tilting into the vacant space. Additionally, the opposing tooth may start to over-erupt, moving into the area left by the missing tooth. This underscores the importance of addressing tooth loss to maintain proper dental alignment and bone structure.
- Surgical Site Infection: Infections can occur at the surgical site after wisdom tooth extraction. Bacteria may enter the wound during or after the procedure, leading to infection. Symptoms may include increasing pain, swelling, redness, discharge, and fever. Your dentist or oral surgeon may prescribe antibiotics before or after the procedure to prevent or treat infection. It's essential to take the prescribed antibiotics exactly as directed.
- Other standard complications include, pain, bleeding, bruising, swelling.