Everything you need to know about wisdom teeth infection after removalWisdom teeth are the last teeth to appear in the mouth. Without enough space, they are known to cause various problems.
Removing wisdom teeth is sometimes the best way to prevent the worst from happening. Depending on the complexity of the procedure, there can be various complications, including infection.
Fortunately, these are rare and the risk of the procedure is much lower than leaving the tooth in place.
In this article, you will learn about the different complications of wisdom tooth extraction and how to recognize and prevent them.
How are wisdom teeth removed?First, your dentist will perform a clinical examination to determine your general health and current treatments to identify any potential interference with the procedure.
He will also assess the eruption and position of your wisdom teeth with an x-ray to assess the risks and take the necessary steps.
Wisdom teeth can be extracted using one of two techniques:
- Simple extraction: If your wisdom tooth has fully erupted, your dentist will remove it directly with special instruments.
- Surgical extraction: If wisdom teeth are embedded in the jawbone, the dentist will need to access the tooth first. They might need to open the gum and remove some bone around the tooth to make it easier to take out. After removal, the gum is sutured to aid healing and protect the wound.
This method is heavier than the previous one, which might result in an extended healing period and heightened discomfort after the procedure.
Infections that can occur after wisdom teeth removalAll surgery carries risks, including wisdom teeth extraction. Post-operative complications vary from person to person, depending on the complexity of the procedure, your health, and the aftercare you receive.
However, it is important to distinguish between complications and postoperative effects. The latter is a normal physiological reaction that our body triggers to initiate healing.
Infections can occur days or weeks after surgery and are often associated with throbbing pain and pus discharge with signs of inflammation, including redness, swelling, and heat sensation.
Fortunately, these are rare and often temporary. Recovery usually occurs spontaneously or with known treatments. Infections that can occur after a tooth extraction include:
1. Osteitis or bone inflammation
1. Dry socket
Alveolar osteitis, also known as dry socket is one of the most common post-operative complications after tooth extraction. Although Alveolar Osteitis is not considered an "Infection", it interferes with the healing process and delays recovery. The lower wisdom teeth are most affected.
In normal conditions, when a wisdom tooth is removed, the socket where the tooth used to be is immediately covered with a blood clot. This clot protects the exposed bone from infection and helps it to heal. A dry socket occurs when the blood clot does not form properly or breaks off.
The first few days after the extraction are the most critical, during which time you must follow your dentist's advice to avoid damaging the blood clot.
Symptoms usually appear 3 days after the procedure and include severe, constant, and spontaneous pain triggered without touching the extraction site. It can also spread to the ear and the rest of your jaw. Over-the-counter painkillers usually do not help. Other symptoms may include bad breath and taste in the mouth, and swollen gums.
2. Socket infection
In other situations, debris or a poorly treated infection can remain in the socket after surgery. This allows bacteria to grow and cause a "True Infection."
In this case, symptoms appear more quickly (a few hours after the procedure). The pain is usually less intense than in the case of dry socket.
You may notice that the socket is filled with a white stuff along with pus leakage and an unpleasant odor. Your gums may also be swollen and inflamed.
Infection of the socket can also affect your general condition, causing fever, tiredness, and swollen lymph nodes under the lower jaw.
If you think you have a socket infection, see your dentist or surgeon as soon as possible. He/she will take the necessary steps to treat the condition.
If the infection is left untreated, it can progress to the underlying jaw bone, leading to diffuse osteitis.
It occurs when the infection spreads to the soft tissues surrounding the wisdom tooth.
Symptoms may appear a few days after the procedure. These include swelling, redness, and a feeling of heat in the area.
Your general condition may also worsen, with fever, tiredness, and swelling of the lymph nodes in the neck.
Another less common form of infection is called delayed-onset infection (DOI). It occurs 3 to 4 weeks after the procedure and can have the same symptoms. DOI affects mainly the impacted lower wisdom teeth.
According to studies, its prevalence ranges from 0.7% to 5.8%. Symptoms may include swelling, pain, difficulty opening the mouth, pus discharge, and fever.
Various factors contribute to its occurrence, including poor oral hygiene, accumulation of food debris, smoking, and certain medical conditions.
The roots of the upper wisdom teeth can sometimes be close to or in contact with the sinuses. The sinuses are bony cavities in the cheek above the upper molars.
Removing these teeth can injure the sinuses, causing a condition called sinusitis.
Symptoms include pain and pressure around the eyes, cheeks, and nose, nasal obstruction, and pus leaking from the wound.
Factors that increase the risk of infection after wisdom tooth extraction
Poor oral hygienePoor oral hygiene can lead to food debris accumulation in the space left by the extracted tooth, damaging the blood clot and leading to infection.
SmokingSmoking is one of the primary causes of dry sockets. Tobacco contains toxic substances that can slow down the healing process. It is recommended to stop smoking during the first 3 to 4 days to avoid infections.
Systemic diseasesCertain systemic diseases that weaken the immune system, such as diabetes, blood disorders, and HIV, increase the risk of infections after the extraction.
If you have a systemic disease, tell your surgeon about it. He/she may prescribe antibiotics before and after the procedure as a preventive measure.
Not following your dentist's instructionsAfter wisdom teeth removal, you must carefully follow your surgeon's recommendations. If you don't, you may disrupt the healing process and increase the risk of infection. Your surgeon will advise you on oral hygiene and diet and may prescribe antibiotics depending on the situation.
AgeThe risk of infections increases with age.
Other complications of wisdom teeth removalIn addition to the infection, other complications may occur, among them:
HematomaSwollen blue, green or yellow lesions may appear after the wisdom teeth are removed. This is because a small blood vessel was cut during the procedure. The discolouration of the area usually fades within 10-15 days.
Loss of sensitivitySurgery to remove a wisdom tooth can irritate the nerves in the area. This can cause numbness in some parts of the mouth, which can last from a few days to a few weeks. This is called paresthesia.
In rare cases, paresthesia may be permanent. If you experience numbness after the procedure, tell your dentist so that it can be monitored.
Temporomandibular joint painPain in the jaw and joints after wisdom tooth extraction is common. This is due to the strain put on your jaws during the procedure.
Limited opening of the mouthAfter having a lower wisdom tooth removed, you may find that your mouth does not open as easily as it used to. This should only last a few days, but if it doesn't, see your dentist as soon as possible as it could be a more serious complication.
BleedingBleeding after the procedure is almost inevitable. It may last several hours after the procedure. However, if you are taking blood thinners or have a blood disorder, tell your surgeon. He/she will take the necessary steps to prevent excessive and uncontrollable bleeding.
What is considered normal after wisdom teeth removal?The removal of wisdom teeth can cause some post-operative discomfort, which is normal and part of the healing process. This lasts for about 1 to 2 weeks, after which you can resume your normal diet and oral hygiene routine. Post-operative effects include:
Swelling or edemaThis is a natural inflammatory process essential for healing. It occurs after any surgical procedure.
Your lips, cheeks and neck may be swollen. Typically, this peaks after 72 hours, then gradually subsides and disappears after a week.
Redness and heat sensationThey are also related to the inflammatory process. After surgery, blood vessels dilate to supply the surgical site with cells and nutrients needed for healing. Again, these reactions are normal and fade gradually over the first week.
PainDiscomfort and pain after a wisdom tooth extraction may occur in the next few hours as the numbness wears off. This pain is expected to reach its maximum around 6 hours post-procedure.
Its intensity will depend on the technique used. For example, a surgical extraction will cause more intense and prolonged pain than a simple extraction.
The pain should subside as you heal. If it does not, contact your surgeon as it may be a postoperative complication.
Treatment of infection after wisdom teeth removalThe treatment of an infection after a wisdom tooth extraction depends on the type and severity of the infection.
The options can range from a simple prescription of antibiotics to a procedure performed by your dentist or surgeon.
If your socket is infected, your dentist will clean and flush the area to remove any debris or residue. You will then be prescribed antibiotics and painkillers.
Soft tissue infection or cellulitis will be treated with antibiotics. If there is an accumulation of pus, your dentist will drain the area to relieve you.
For sinusitis, treatment consists of antiseptics and anti-inflammatories given through the nose, sometimes combined with antibiotics. The aim is to treat the inflammation or infection.
If the removal of the upper wisdom tooth has left a hole between the sinus and the mouth, it may heal on its own within a few weeks. If not, surgery will be needed to close the hole.
How to prevent infection after wisdom teeth removal?To avoid complications, it is important to follow your dentist's instructions, whether the tooth being extracted is a wisdom tooth or any other tooth. Here are some of the recommendations to follow:
About your oral hygiene
It is necessary to maintain good oral hygiene after wisdom teeth extraction to keep the bacterial load in your mouth low and thus prevent infection of the surgical site.
For the first 24 hours, you should not brush your teeth, rinse your mouth vigorously, use an alcohol solution or disturb the extraction site, as this could damage the blood clot and disrupt the healing process.
After the first day, you can brush your teeth gently with a soft-bristled toothbrush and floss your teeth with an interdental cleaner.
Five days after surgery, you can rinse your mouth with a saltwater solution to promote healing (about ½ teaspoon of salt to 8 ounces of water).
Smoking can cause dry socket due to the suction and pressure it exerts on the socket, disrupting blood clot formation. Nicotine also decreases blood flow, hindering the healing process. To prevent dry socket, it is recommended to abstain from smoking for the initial 3-4 days.
Have a rest
After wisdom teeth removal, you should rest and avoid physical activity for the first two to three days, as your body needs the energy to heal.
Adjust your diet
For the first 24 hours, choose a cold or lukewarm liquid diet, avoid sucking or drinking through a straw, and do not drink hot or spicy beverages to avoid burns. After 72 hours, choose a soft diet that requires little chewing effort and avoid hard, sticky foods that may accumulate at the surgical site. After two weeks, you can resume your usual diet.
Control your bleeding
After wisdom teeth extraction, some bleeding is to be expected for a few hours. To manage this, it is important to follow the post-operative instructions provided by your dentist. This may include biting on gauze pads for 20 minutes to promote blood clotting and avoid disrupting the clot with speaking or other actions. You should avoid rinsing your mouth aggressively, spitting or making any physical effort, as this can increase blood pressure and prolong bleeding. It is crucial to adhere to the medication regimen prescribed by your dentist during the recovery period.
- Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905714/
- Problems with erupting wisdom teeth: signs, symptoms, and management https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979926/
- Alveolar Osteitis https://www.ncbi.nlm.nih.gov/books/NBK582137/
- An Observational Cohort Study on Delayed-Onset Infections after Mandibular Third-Molar Extractions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457748/