Oral & Maxillofacial FAQs
Oral & Maxillofacial
How are wisdom teeth removed?
Oral surgery is performed either under local anaesthesia alone, (dental injections), local anaesthesia with intravenous sedation (IV or twilight sleep), or local anaesthesia with general anaesthesia (GA).
Surgery usually involves raising gum flaps to gain access to the bone which surrounds the tooth.
Some of this bone is removed with a drill (similar to the type used for dental fillings). The tooth is
usually divided up to allow it to be removed in parts. The socket is washed out and the gum is closed with dissolving stitches.
Upper wisdom teeth are often easier to remove than lower wisdom teeth.
Risks of removing wisdom teeth?
There are some risks in removing wisdom teeth. For this reason, it is best to have surgery with someone experienced in the removal of wisdom teeth and that is why you will have received a specialist referral to vit one of our oral & maxillofacial surgeons. You will hear more about these risks at your consultation, but they are summarised below.
- All patients will experience numbness in the first 24 hours after surgery, due to the local anaesthetic injections given at time of dental procedure.
- Infection is uncommon. Antibiotics and mouthwash are routinely given to try and prevent this outcome.
- Tingling or numbness of the lip, chin or tongue due to the proximity of two nerves occurs in less than 1 percent of patients after removal of lower wisdom teeth. Usually this is temporary, lasting days or weeks. Problems that can result from permanent tingling or numbness include lip-biting, reduced ability to feel food on lip, tongue-biting, altered taste and possibly alteration to speech.
- Excessive bleeding. This is very uncommon.
- Dry socket. Occurs after less than 10% of lower wisdom tooth removals. The blood clot falls out early causing the socket to become dry and painful. Occurs a few days after pulling out wisdom teeth. Normally this is easily treated. Please return to the surgery.
- Jaw joint problems. Uncommon and usually last a few weeks.
Are treatments covered by insurance?
Many treatments may be covered by your medical insurance. Dr Peter Hill at Westlake Dental Specialists is an Affiliated Provider with Southern Cross Healthcare, New Zealand’s biggest private health insurer.
For patients receiving treatment in our rooms in Westlake, prior approval and contract surgical fees can be claimed by us via Southern Cross’ Provider Web. For general anaesthesia procedures and for insurance providers other than Southern Cross Healthcare, prior approval is usually required and our friendly staff can give you advice and information at your consultation.
What should I expect after having oral surgery?
Swelling: After surgical treatment there will be swelling in the area, usually worsening for 24-48 hours and then gradually improving. Limitation of mouth opening is also quite normal for the first few days after surgery. Bruising is usually light yellowing around the area and can spread down the tissue planes into the neck.
Bleeding: If bleeding is persistent, apply pressure to the wound by biting firmly onto a gauze swab or clean rolled up handkerchief (not tissue or cotton wool) for 15 minutes by the clock. Rest in a sitting position. If bleeding continues contact the rooms or Dr Hill.
Pain Relief: Pain tablets should be taken before the local anaesthetic wears away, usually about 2-4 hours after the surgery. They should be taken regularly for at least the first 24 hours after the surgery. Usually a combination of an anti-inflammatory such as Nurofen (ibuprofen) and Panadol (paracetamol) is adequate to control pain symptoms. Both of these medications can be brought from the pharmacist.
Sedation: If you have had sedation, a responsible adult must remain with you for a minimum of 8 hours following treatment. Until the following day you must not drive a car, operate machinery or sign important documents.
Food & Drink: It is wise to avoid eating or drinking anything for the first 30 minutes after surgery. After that time a soft diet and the avoidance of very hot drinks is recommended for at least 24 hours. It is important to keep drinking even if you feel nauseous or vomit.
Mouthwash & Cleaning: You can start rinsing your mouth after 24 hours. Half a teaspoon of salt in a glass of warm water or chlorhexidine (Savacol) can be used after every meal and before bed. It is very important to keep your mouth clean as this will speed healing and reduce the chance of infection. You can begin brushing your teeth six hours after surgery but take care not to bump the wounds with your toothbrush.
Sutures (stitches): Do not lift your lip or play with your wounds. Dissolving sutures usually fall out between 5-10 days after the surgery. If you’re stitches need to be removed we will let you know and arrange a post-op appointment for this
Dry socket & Infection: If you are concerned that you are not making the post-operative progress you expected you may have a dry socket or infection. Dry socket usually occurs 3-5 days after the removal of teeth. You may notice a marked increase in pain and a bad taste from the socket. You may have infection if your swelling seems to be worsening 3-4 days after the procedure, your mouth opening is worsening and you feel unwell. In both instances it is important to make contact with the practice and we will arrange to see you.
When can I resume sports or physical activity?
It is essential that you allow yourself adequate rest time after having an oral surgery procedure. This is give your body time to heal and recover. Returning to physical activity too soon could compromise your recovery. Depending on what procedure you’ve had we advise returning to sports or physical activity anywhere between 5-7 days after surgery.
What is the expected recovery time?
Recovery time varies depending on the procedure. For patients under going wisdom tooth/teeth extractions we advised 3-5 days for recovery. For minor surgeries you may only require 1-2 days recovery.
A guidline of your recovery time will be advised at your consultation.