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Wisdom Teeth

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How to Reduce Swelling After Wisdom Teeth Removal
©Robert Kneschke/Shutterstock.com

Nobody wants to look like a chipmunk after getting their wisdom teeth out, but when their cheeks get swollen, most people do end up looking like a chipmunk!

While some swelling is normal after this procedure, the good news is that you have some control over your swelling.  Here are a few simple things that you can do to reduce your swelling after wisdom teeth extraction.

How to Reduce Swelling After Wisdom Teeth Extraction

Reduce Wisdom Teeth Swelling1 – Apply Cold & Heat at the Right Time

Many oral surgeons send their patients home with ice packs after getting their wisdom teeth extracted.  There is some controversy over whether or not using ice immediately following wisdom teeth extraction can actually reduce swelling.  Although it may not be proven, it probably wouldn’t hurt to try this method.  Applying heat to your cheeks has been shown to reduce swelling after wisdom teeth extraction, but you have to do it at the right time.

Here’s a time line of when you should apply cold and heat to your cheeks to reduce swelling:

0-24 hours after wisdom teeth extraction: Apply ice for 20 minutes on, then 20 minutes off.

24-48 hours after wisdom teeth extraction: Don’t apply ice or heat.

48 hours after wisdom teeth extraction: Apply heat.

Keep in mind that you shouldn’t apply ice directly to your skin.  It’s a good idea to have a cloth between the ice and your skin to avoid causing damage to your skin.  If you don’t have ice packs, you can use a bag of ice cubes or frozen vegetables.  Along the same lines, you don’t want to use water that is too hot for too long – you don’t want to burn your skin!  Heating pads and hot water pads are good suggestions.

2 – Keep Your Head Held High

Reduce Swelling After Wisdom Teeth Extraction by Keeping Your Head Up
You Can Reduce Swelling After Wisdom Teeth Extraction by Keeping Your Head Elevated

Keep your head held high – literally!  By keeping your head elevated above the rest of your body, gravity will be your friend and cause excess fluid to flow down from your cheeks and back into your bloodstream.  This is the reason why your cheeks are more swollen after a good night’s sleep.  By laying down, you don’t have gravity helping you keep your swelling to a minimum.

To use this principle to your advantage, it would be a good idea to keep your head propped up with pillows rather than laying down so that your head is at the same level as the rest of your body.

3 – Use Corticostroids

Certain studies (such as this one) show that steroids can reduce cheek swelling after your wisdom teeth get extracted.

The textbook  Contemporary Oral and Maxillofacial Surgery recommends the steroid dexamethasone to control “postsurgical edema” (which means swelling after surgery) and said the following regarding using steroids to reduce swelling after wisdom teeth extraction:

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.

There are, of course, several drawbacks to using steroids.  You may want to ask your oral surgeon if dexamethasone is a good choice for you to reduce swelling after you get your wisdom teeth extracted.  He or she will be able to help you weigh the pros and cons.

Wisdom Teeth Extraction - Don't Look Like a Chipmunk!

Why Do Your Cheeks Get Swollen After Wisdom Teeth Extraction?

This article wouldn’t be complete without mentioning the reason for your swollen cheeks.  Swelling after wisdom teeth extraction is simply a natural, healthy response that helps your body heal.  Many times, the oral surgeon has to cut through your gums and drill through bone to remove your wisdom teeth.  You would probably expect to have swelling after any invasive surgery to remove an appendage of your body, and getting your wisdom teeth out is no exception.

To learn more and to find out how long you can expect to have swollen cheeks after wisdom teeth removal, read the article Why You Get Swollen Cheeks After Wisdom Teeth Removal.

Do you have any questions, comments, or concerns about your swollen cheeks and wisdom teeth extraction?  Go ahead and write them in the comments section below.  Thanks for reading!

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Flossing Mistakes
©Prod-Akszyn/Shutterstock.com

It seems so simple to just slide some string between your teeth to clean those hard-to-reach areas.  While the idea is simple, there are a few techniques that you need to master in order to maximize the return on the time you spend flossing.

Here are ten common mistakes that people make when they floss:

10 Common Flossing Mistakes

1 – Not Flossing the Sides of Both Teeth

Flossing MistakesIf you just slide the floss down, and then pull it up, you are only getting 50% of the job done.  When you move the floss up between two teeth, you need to make sure that you are cleaning the side of both teeth.  One of the favorite places for plaque to hide is between teeth. If you’re only removing plaque from the side of one of the teeth, you could easily get a cavity on the tooth that you’re not flossing.

Find out about six common places where you are most likely to get cavities.

2 – Using the Same Section of Floss Between All of Your Teeth

When you floss you are removing bacteria from between your teeth and below the gum-line.  If you use the same section of floss for all of the teeth in your mouth, you are spreading around a lot of bacteria.  Of course you still are loosening the plaque, which has its benefits, but if you use a new section of floss each time you floss between two teeth, you will be loosening the plaque without putting plaque that you’ve already removed back in between your teeth.

3 – Snapping the Floss Down Hard Between Your Teeth

To get the floss to go between a tight contact between two adjacent teeth, try working the floss back and forth applying a firm but controlled downward pressure.

Snapping the floss down between the teeth can not only injure your gums in the short-term, but the trauma can cause your gums to recede.  Do it enough, and you’ll cause gum disease.

4 – Not Flossing Behind the Very Back Teeth

Even though there isn’t a tooth next to it, it is still important to clean behind the four teeth that are all the way in the back of your mouth (two teeth on each side in the upper and lower jaws.)  This can help remove bacteria that has made its way  between your tooth and gums.

5 – Flossing Aimlessly Without a Plan

When you floss, you need to have a road-map of what order you are going to floss your teeth in, or you can quickly become confused and miss some teeth or even a quadrant of your mouth.  It may be easiest to start in the upper right and go to the upper left, then come down to the lower teeth in the bottom left and move across to the bottom right.

However, as long as you have a plan, it really doesn’t matter which teeth you floss first.  Personally, I start right in the middle of my upper teeth and work my way back on one side and then on the other.  Then I do the same thing on the lower teeth.  Just find a “floss order” that works for you and stick to it so that you don’t forget to floss any teeth.

Dental Floss

6 – Not Flossing Around Dental Appliances

Many people don’t know that if they have fixed dental appliances in their mouth, they need to floss around them.  For example, if you have a bridge, it is necessary to use a floss threader, or get something similar to Oral-B Superfloss.

I had braces on my lower teeth when I was a teenager.  After I had them removed, the orthodontist cemented a wire that connects to each of my six lower front teeth.  This stabilizes them, but also makes it impossible to use conventional floss due to the wire.  Because of this, I have to use Superfloss or floss threaders to get under the wire so I can floss and maintain my gum health.

7 – Quitting When Your Gums Bleed

Blood may scare some people when they floss because they think that they are hurting their gums if they bleed.  You are not hurting them as long as you’re not flossing too hard (see mistake #3.)

Most likely, the reason they bleed is because they haven’t been flossed in a while and the gum tissue has become red and inflamed.  This is a condition known as gingivitis and it occurs because the body is sending more blood to the gum.  This is to help the tissue fight all of the plaque that is accumulating.  When you floss, you are removing that plaque, and since the tissue is inflamed and engorged with blood, you are causing some of the blood to leak out.  After a few days, your gums should return to health and you can floss normally without any bleeding.

8 – Not Spending Enough Time With Your Floss

Most people have 28 teeth if they’ve had their wisdom teeth extracted.  When you floss, you need to get both sides of the teeth (even the most posterior teeth – see mistake #4.)  That means that there are 56 sides that you need to get.  You should be spending a couple of seconds with each side, scraping up and down against the tooth a few times before moving onto the next surface.  That means that it will probably take you around two minutes to floss your entire mouth if you have a full set of teeth.

9 – Not Applying Pressure to the Tooth Surface

When you floss, you want to be careful to avoid using too much downward pressure so you don’t damage your gums.  However, when you are flossing against the side of a tooth, you want to make sure that you are pushing the floss against the tooth surface enough to be able to remove the plaque.

10 – Only Using Floss to Remove Food

Unfortunately, lots of people think that the only reason for flossing is to remove food that has gotten wedged between their teeth. I think many people end up doing this because they can see the food between their teeth — they can’t see the plaque.  An easy solution to this problem is to use a plaque disclosing tablet/solution to visualize the plaque on your teeth.

When you floss, your primary goal should be to scrape against each tooth to remove as much plaque as you can.  As long as you are doing this, you should be getting rid of the food between your teeth without even thinking about it.

Floss Correctly and Keep Your Teeth For Your Whole Life

By avoiding these ten common mistakes, you will be able floss more efficiently which will lead to greater oral health.  Since many cavities start out between two teeth, you will be able to prevent many cavities by regularly flossing and avoiding these ten flossing mistakes.

Do you have any questions or comments about flossing?  I’d love to hear them!  Just leave them below in the comments section.

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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!