AboutJoel S. Teig, DMD, FABOMS Expertise I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.
Experience Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.
Organizations American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons
Education/Credentials BA
DMD
Awards and Honors National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude
Question QUESTION: Dear Dr.
I had three wisdom teeth pulled last Monday by an oral surgeon. The top two were recovered very quick without any swelling, but the bottom one on the right was bleeding and my cheek was big time swelling and like a hard knot. Also I saw bruises all the way down to my neck and to bottom of the throat (outside). I went back to oral surgeon after 4 days unchanged swelling (the swelling area got harder). He opened the wound and drain some fluid off the cheek and told me that it was unusual swelling, the blood went down to the cheek. He gave me different antibiotics (clindamycin) and Ibuprofen 600mg and asked me to use warm slat rains the wound area. I did everything he told me to do, but the swelling is still there no changed and hard. Also, the warm water caused the bleeding again. Now, I am really don't know what I shall do. Is this swelling is going to go down or he needs to drain it again? (very pain to open the wound again). I stayed at home for a week already because the swelling. Dear Dr, can you please help? What is going to happen to me if the swelling is unchanged. Shall I still use warm water to raise the mouth? Thank you in advance
ANSWER: Dongwei - First of all, the effects of the salt water in reinitiating some bleeding is exactly what you want. The warm salt water pulls excessive fluids trapped in wounds. As such, the warm salt water rinses are assisting in the release of built up fluids trapped in the wound area.
Often with a large amount of internal swelling, the cause is some bleeding into the tissue from an area where the body has no access for drainage. When this occurs, the body tries to protect itself and tries to wall off with thickened tissue and this just contains the trapped fluid. That is the firm nature of the swelling.
You need to continue the warm salt water. I don't know how often you are doing it, but you should do it 5-6 times a day for at least 5 minutes. Do not put anything on the outside of your face (nothing warm or cold) as this can retard the natural drainage.
So rinse, rinse and more rinse - that is the best way to reduce the trapped fluids causing the swelling. I wish you well and hope it will resolve quickly, but it is not unusual for this to take up to 2 weeks to resolve.
Any more questions, feel free to contact me again.
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QUESTION: Dear Dr.
Thank you so much for the quick reply. I did three times salt water thing last night before went to bed. I think it is helpful. The knot is getting a little bit softer. After I slept through the night, there was big blood clot on top of the wound (1.5 cm long and 0.8 cm in width). Shall I remove it or shall I leave it as is? I removed the blood clot couple of times yesterday, it built up again, especially after sleep. I think some slow bleeding still happening. If I leave the blood clot still cover the wound, will it impact my rinse? Tomorrow, I will see this oral doctor again. What shall I tell him if he wants to open the wound again to drain the fluid? (I really don't want to do it). Shall I tell him don't open the wound and I will continue use salt water rinse? Unfortunately, I have a business trip to oversea come up next week Thursday. Shall I let him drain the fluid which may be quicker to get rid of knot? Please advise. Thank you again for your help, it makes me much better mentally. I almost gave up on the salt water thing. Very much appreciated.
Answer Dongwei - I am a little bit uncomfortable telling you too have the area drained or not drained without directly examining the area. If the dentist feels that the rinsing is not doing an adequate job in establishing drainage then surgical drainage is necessary.
So you need to go with the salt water rinsing anyway. Whether or not he redrains the area, the salt water rinses will greatly enhance drainage and speed healing.
I wish you well and hope the drainage can completely occur before your trip. If it doesn't there is no reason not to stop the rinsing even on your trip. If you have more questions, I am available. Don't worry if you build up a clot with rinsing, it is just drainage and it can be gently wiped away.
