After Extraction of Wisdom Teeth
Wisdom Teeth Patient Instructions
In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia), or general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with each patient before the procedure is performed. Once the teeth are removed, the gum may be sutured. To help control bleeding, patients should bite down on the gauze placed in the mouth. Patients will rest under our supervision in the office until they are ready to be taken home. Upon discharge a patient’s post-operative kit may include post-operative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. Should a patient have any questions, they should not hesitate to call us at our offices in Fargo, Grand Forks, Bismarck, and Jamestown.
Our services are provided in an environment of optimum safety. We utilize modern monitoring equipment and our staff is experienced in anesthesia techniques.
What Will It Feel Like after Wisdom Teeth Removal Surgery?
On the first day after surgery, patients may experience some minor bleeding and pain. Each individual’s reaction to surgery varies, and the sensation of pain can range from mild discomfort to severe pain. A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the third or fourth day and should begin resolving afterwards. The amount of swelling can be limited by using ice for the entire first day, as instructed. The more ice used on the first day, the less swelling a patient is likely to have on the second day. Apply the ice packs 20 minutes on then 10 minutes off. On the third day, the jaw muscles may stiffen, and may be difficult to open the mouth normally. Moist heat may be applied to the face on the third day allowing the muscles to relax more and open wider. Patients will want to limit their activities for a few days. We ask that patients follow their post-operative instructions closely. Doing so will make them as comfortable as possible during the first few days following their procedure. Please allow time for the body to begin healing before resuming an active social, academic, or athletic schedule.
Are There Any Problems after the Extraction of Wisdom Teeth?
As with any medical procedure, there can be complications or an unanticipated result. Some complications that patients undergoing wisdom tooth extraction may experience include: Damage to the sensory nerve that supplies sensation to the lips and tongue, sinus communication, infections, and dry sockets.
After the procedure, our assistants will review the post-operative instructions the person who accompanied the patient. We ask that these instructions closely, as they will make the patient the most comfortable following their procedure. If the patient was sedated, they will be comfortable and drowsy when they leave the office. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days. With any medical procedure, there can be unexpected results. These can include delayed healing, infection, and post-operative numbness or tingling in the lip, chin, or tongue. The oral surgeon will review relevant post-operative events with each patient and answer any questions during their office visit.
Damage to Sensory Nerve:
A primary concern is a nerve within the lower jaw bone that supplies feeling to the lower lip, chin, and tongue. This nerve is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 12 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth. Occasionally, when the teeth are removed the nerve can become injured. This is particularly true for older patients. When local anesthesia wears off, patients may experience a tingling or numbing sensation in the lower lip, chin, or tongue. Should this occur, it is usually temporary and will resolve gradually over a period of weeks or months. On rare occasions it can result in a permanent alteration of sensation similar to having local anesthesia. Patients are informed of this risk prior to consenting to surgery.
The upper wisdom teeth are situated close to the sinuses, and their removal can result in an opening between the mouth and the sinus. If the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely. However, if it does occur, it will usually close spontaneously. We may give special instructions to follow, such as avoid blowing your nose for two or three days following surgery. Patients can wipe their nose, but can’t blow their nose. If they have to sneeze, they should sneeze with an open mouth into a tissue. Pressure should not be created in the sinus area, which may dislodge the healing blood clot. If a patient senses this condition occurring after surgery, please contact the office. An additional procedure may RARELY be necessary to close the opening.
Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin.
The symptoms frequently begin in the middle of the night, and the pain medication regimen may not help. Treatment can involve changing the prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and may require dressing changes every day or two, for five to seven days. Dressings usually are removed when a patient has been pain free for two to three days.
The dressing doesn’t aid in healing. The only reason to place a dressing is for pain control. If medication is controlling the pain, the socket will heal without a dressing. Following removal of the dressing, an irrigation device may be provided to help you to keep food particles from lodging in the extraction site.
Occasionally, post-operative infections occur. This usually requires an office visit and clinical examination. Many times, just placing the patient on an antibiotic for one week will take care of the infection. If it persists, the area will have to be drained and cleaned. Other temporary problems you may experience in the post-operative period include stiffness of the jaws, chafing around the corners of the lips, facial bruising, and blood oozing from the extraction sites. The post-operative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the offices in Fargo, Grand Forks, Bismarck and Jamestown.
Face & Jaw Surgery Center
They did a great job And caring about there Patience
- Brian G
If I need anymore teeth pulled or dental work that requires me to be put under I will definitely be back! 10/10 for patient care.
- Shelby C
Everyone was great and caring. It’s hard to go into a situation that tends to come with high anxiety and then let them sedate you and still be made to feel comfortable. Even with all the Covid protocols it was good.
- Lauren N
I had a pleasant experience on a not so pleasant task. I thank all of you for a totally professional and pleasant experience.
- Wayne P
I had been trying to get my last two wisdom teeth out for the past 3 years. I 've always been extremely anxious and somewhat terrified about doing the surgery all over again. I'll admit I cancelled a few times. I was very nervous that morning, but as soon as I walked in at the Bismarck location, I became less tense. The lobby was calm & relaxing. I loved the fireplace and there was a good view from the 3rd floor windows. The staff was welcoming, friendly and professional. The nurses knew what they were doing. Dr. Knoll was also friendly and professional. He explained eveything clearly and answered my questions. I was hooked up to machines with ease and put to sleep right away. He told me my wisdom teeth were like regular teeth, so he pulled them out and there was no need for stitches or medication. I can't believe the procedure only took 30 minutes. I arrived 7am (mountain time) and left by 8am. A couple of days have gone by and I am just so relieved that Face & Jaw was available in Bismarck. I would certainly go back...the whole experience was great. Thank you!
- Ann R
I went to the Fargo location for wisdom teeth extraction, and I am sorry to say I have no memory for names so I can't give the credit I wish I could to the individuals. I do not like needles and have never been put under anesthesia prior. I'm also prone to fainting symptoms with medical procedures. The receptionists were friendly and patient. When I was taken to the back (10 minutes early even since I arrived early) the woman was kind and listened to my concerns. The anesthesiologist listened to my concerns about needles since my veins tend to disappear and I had to fast (including water) before the surgery and she even got the IV in the first time and I dare say it was the least painful one I've ever had done. The doctor took good care of me even when I started feeling faint and had to lie back and cool down. After the surgery, the ones monitoring me were kind and helpful even after I threw up the medicine they tried to give me and gave me plenty of time to recover. I am very happy with the service I received. It was well worth the cost!
- Samantha D
There is not one thing I would have changed to make my visit any more pleasant. The many assistants that prepped me were all very attentive to my needs. Each wanted me to understand completely what would be happening. They all repeatedly checked with me to see if I had questions. The doctor also took time to explain what he would be doing and told me to let him know if there was pain and when there would be pressure. It was overall a much more positive experience than I ever anticipated. I would be happy to recommend this office highly to anyone needed to have oral surgery. Excellent treatment and care. Thank you. Josie
- Josie P
The service is great, the staff is very friendly. I would definitely recommend Face and Jaw Surgery Center.
- Madison D
I saw dr. crago years and years ago in 2002 and i really couldn’t afford my bill but you all were so awesome and said even if i paid $5 a month that would help. even after i moved to alaska and didn’t always pay on time you all were awesome and understanding. dr. crago did an amazing job that i was talking and eating like normal and had very little pain.
- kristin c
every staff member I encountered was kind professional and I honestly felt like I was being treated like family. I know its a big cliché to say that but truly was a great experience.. i 100% recommend this company.
- joshua c
My dental assistant was the BOMB.COM! I'm not talking about the nurse. I'm talking about the dental assistant actually I guess she was a surgical assistant. She was very friendly and cool. Going into this I thought I was going to be nervous, but I wasn't! I felt very comfortable and safe and had no worries! I just hope that I was polite afterwards when they woke me up. I don't remember, but my mom says I was so I hope she was right! I'm so sorry if I made anything difficult because you guys sure didn't make anything difficult for me. You guys were AWESOME!!!!!!!!! (MIC DROPPPP)
- Destiny D
They did an excellet job, I only had the most pain on the first day of recovery otherwise the staff was friendly and very helpful.
- Gunnar P
Dr. Chahal was very reassuring, all staff were very friendly, knowledgeable and caring.
- Carter O
I was treated with respect by all. Procedure was done quickly with very little pain. I must say it was a very good experience in what professional courtesy ought to be, 1. explaining procedure and after care. 2. Doctor and Assistants spent time visiting with me in casual topics,Weather, Sports and Families etc. I was not left alone for any length of time. God bless all Mike Dorsher
- Mike D
Going to the doctor is never a great experience but the folks at Face and Jaw went out of their way to make this tooth extraction as comfortable as possible.
- William G
I have not had any issues since surgery other than some undetermined reaction on the left side of my face (emergency room doctor was perplexed but an iv of steroids and an antibiotic solved it). The doctor was great at explaining everything that was going on. The procedure was very quick and I was on my way home in less than an hour. I am on the mend and happy with my procedures. Would go there again if needed!
- KATHERINE S
Great experience under the circumstances
- Kevin H
Very pleased with everything. They called to check on Things the following day.
- Kristin F
Dr. Gray and his staff are amazing. I have an irritional fear of sedation/anesthesia and when I went in to get my wisdom teeth out I was extremely terrified. Dr. Gray and his assistant were so understanding and accommodating to my hesitation they allowed me to just use local Novocain. They were so kind and let me feel like I was in control of the decision and didn't push me to do anything I wasn't willing to do but they also thoroughly explained everything so that I was at ease and made sure I was making the best decision. Dr. Gray is very approachable and so professional and kind my nerves subsided. I really appreciated the entire experience and I couldn't say enough good things about Dr. Gray and his assistant. I would 100% recommend! I will need to go back for implants later and I'm actually looking forward to it. Such a great place where everyone is helpful and kind. Thank you Face & Jaw!
- Jill K
I was very pleased with my care! I've never had surgery before and was super nervous. Everyone-office staff, nurses, doctor-was so friendly and put me at ease!
- Lauren C