Wisdom Teeth

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Wisdom Teeth Cheeks Puffy
©Dan Tautan/Shutterstock.com

If you’ve had your wisdom teeth out, the picture above probably looks familiar.

When I got my wisdom teeth out around ten years ago, our insurance wouldn’t cover all four teeth. Sadly, my family was a little short on cash, so my mom decided that I would get my top wisdom teeth out, then wait until the next year to get my bottom wisdom teeth out. That way, it wouldn’t cost us any money out of pocket.

Plus, I had the experience of getting my wisdom teeth taken out… twice.

Luckily my cheeks didn’t get swollen as badly the second time around.

If you want to know why dentists usually remove wisdom teeth, read the article Why Dentists Extract Wisdom Teeth

Why Your Cheeks Get Swollen After Your Wisdom Teeth are Removed

Swollen Cheeks After Wisdom Teeth RemovalYour cheeks get puffy and swollen after your wisdom teeth are removed because your body is going through a process that will help heal the damaged tissue.  Getting your wisdom teeth taken out can be a traumatic experience for your body.  It responds by trying to heal the extraction site as quickly as possible.  Inflammation and swelling helps this healing occur.

It is important to know that the swelling is a normal, healthy response that your body is mounting due to the trauma from the extractions.

How Long Will You Have Puffy, Swollen Cheeks?

The book Contemporary Oral and Maxillofacial Surgery reports that swelling reaches a maximum anywhere from 24-48 hours after removal of the wisdom teeth.  One study has reported that cheek swelling after wisdom teeth removal peaks around 24 hours after the surgery (source.)  If the swelling is stillgetting worse three days after the extractions, it could be a sign of infection and you might want to give your dentist/oral surgeon a call.

Note that infections after routine extractions are rare. The oral surgery book listed above states, “The typical signs [of infection] are development of a fever, increasing [swelling] or worsening pain 3 to 4 days after surgery. Infected wounds look inflamed, and some [pus] is usually present.”

The puffiness and swelling will start to decrease approzimately three to four days after the wisdom teeth extraction and should completely subside about one week after the extractions.

It is normal to have more swelling in the mornings and then have it gradually subside throughout the day as you stand up and the fluid drains due to the force of gravity.

How to Reduce Cheek Swelling After Wisdom Teeth Removal

If you don’t want to look like a chipmunk after your wisdom teeth are removed, here are a few suggestions:

Dexamethasone for Relieving Swelling after Wisdom Teeth Removal1 – Ask the oral surgeon if he or she can get you some corticosteroids. There have been some studies (here’s one) that suggest that steroids can reduce cheek swelling after the wisdom teeth are removed.

The book  Contemporary Oral and Maxillofacial Surgery recommends the steroid dexamethasone to control “postsurgical edema” (which means “swelling after surgery”) and had the following to say about this subject:

Dexamethasone is a long-acting steroid and its efficacy in controlling third molar postsurgical edema is documented.  This drug can then be continued in an oral dose of 0.75 to 1.25 mg twice a day for 2 to 3 days to continue edema control.

2 – Heat applied on the third day after surgery can help reduce cheek swelling. Be sure to use water that isn’t too hot – you don’t want to damage your skin!  Heating pads and hot water pads are good suggestions.

Don’t apply heat until at least the third day after wisdom teeth extraction.

3 – Keep your head elevated. If you keep your head elevated, it is harder for the fluid to stay up in your head due to the force of gravity.  If you spend a lot of time lying down in bed,  you may find that you have puffier cheeks!

Conclusion

Do you have any questions or comments about wisdom teeth removal and its associated cheek swelling?  If so, please leave them below in the comments section.

Why Extract Wisdom Teeth?
©Milos L Jubicic/Shutterstock.com

Sometimes, wisdom teeth come in normally and provide the mouth with another set of  powerful, food-crushing molars.  Unfortunately, that is the exception and not the rule.

Why Dentists Extract Wisdom TeethIt seems like pretty much everyone has their wisdom teeth (third molars) extracted before they come in around the age of 18.  A lot of people wonder why our bodies even bother to make wisdom teeth if we just end up removing them.  That’s a good question.

One theory is that a long time ago people lost teeth a lot earlier due to poor oral hygiene and the third molars came in later in life to provide fresh, healthy teeth.  Since some teeth had already fallen out, there was room for the wisdom teeth.

Currently, wisdom teeth are usually extracted as a preventive measure so that other problems do not occur later in life.

The reasons dental professionals remove wisdom are many, but they all boil down to one main reason – there is simply not enough room in the mouth for wisdom teeth.

There Isn’t Enough Room for Wisdom Teeth

Here are a few reasons why dentists normally extract wisdom teeth:

  1. There isn’t enough room in the jaw for them to come in.
  2. There won’t be enough room in the mouth for them to come in.
  3. Due to lack of space, wisdom teeth often come in at an awkward angle and can damage adjacent teeth.
  4. If they never break through into the mouth, they can cause big problems later on.
  5. Since they are so far back, they are harder to clean.  This increases the likelihood of developing cavities and gum disease.

There Isn’t Enough Room in the Jaw for Wisdom Teeth

Wisdom Tooth Soft Tissue Impaction
You can barely see the wisdom tooth poking out of the gums. There is not enough room for it to fully erupt.

Some people have smaller bones than others.  Sometimes, the jaws are not big enough to contain all of the teeth that our bodies produce.  After taking a diagnostic x-ray, your dentist can best advise you as to whether or not you will have enough room in your jaw to allow the wisdom teeth to erupt normally.

There Won’t Be Enough Room in the Mouth for Wisdom Teeth

Sometimes wisdom teeth can’t come up far enough into the mouth to serve as functional teeth.  In some cases, the wisdom teeth only partially erupt into the mouth and can result in severe pain in the gingiva (gums) when biting.

You can see an example of this in the photo to the left.

Wisdom Teeth Come in at an Awkward Angle

Wisdom teeth usually have a tendency to be abnormal.  They sometimes look very different and often they come into the mouth at different angles due to a lack of space.

Impacted Wisdom Teeth
This x-ray shows two wisdom teeth that are coming in at very awkward angles. The upper wisdom tooth is pointing toward the back of the mouth and the lower wisdom tooth is pointing directly at the molar in front of it, which can potentially damage that tooth.

As you can see in the x-ray to the right, the upper wisdom tooth is pointing backwards and the lower one looks like it is going to run into the tooth in front of it.

Many wisdom teeth try to erupt into the mouth by pushing on the molar right in front of it.  This can make it easy for the adjacent molar to get a cavity.  It can also cause the gums to recede around that tooth.  This can sometimes severely damage the adjacent molar that both it and the wisdom tooth need to be extracted.

Wisdom Teeth Can Cause Big Problems Later On

One of my professors at dental school showed me an x-ray of a patient that never had his wisdom teeth extracted.  Even though this patient was in his 50’s, an infection had started around his impacted wisdom tooth.  This resulted in a necessary surgery that cost thousands of dollars.  This surgery could have been prevented by simply removing the wisdom teeth at an early age when the tooth and roots were small and still forming.

When a tooth is just sitting inside the jawbone for many years, it can form what is called a dentigerous cyst.  This cyst can eventually turn into cancer.

Wisdom Teeth Are Hard to Clean and Often Get Cavities

Cavity on Wisdom Tooth - Courtesy of Ildar Sagdejev

Some of the patients that I see at the dental school have their wisdom teeth.  In many cases, they complain that they are very hard to clean.  They say that it is almost impossible to brush and floss way back there.

Because of this, many wisdom teeth develop cavities.  If someone can’t clean their wisdom teeth, then it’s a good idea to get them taken out before they cause pain and problems.

In the picture to the left, you can see a young man’s teeth.  The last tooth in back is the wisdom tooth.  It looks like the very back of the wisdom tooth was very hard for this young man to clean.  Because of this, he developed a cavity and it looks like the tooth probably was extracted.

Conclusion

Do you have any questions about getting your wisdom teeth out?  Do you still have your wisdom teeth?  If so, have you had any problems with them?

Please leave any questions or comments below in the comments section, and I’ll get back to you.  Thanks for reading!