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Oral Surgery/Hello, Dr. Tieg

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QUESTION: I am messaging you with a concern I have regarding a complicated wisdom tooth extraction.

About a month and a half ago, I had my lower right wisdom tooth removed. The whole process took about a half hour as it was a very difficult extraction, and a week later, I ended up with a painful dry socket. I had it treated and the pain subsided. But I've noticed the side of my face that I had the surgery done on is still significantly swollen. When I tilt my head back, my jawline does not look even, with the right appearing to be slightly lower than the left and the overall right side of my face noticeably puffier. My bite does not feel the same, either. The teeth on the right side feel like they touch more than the teeth on the left. In addition to the differences I am noticing in my appearance, my nose and mouth appear to be crooked now and my smile is uneven too. Additionally, I've been noticing that the left side of my face where I had no surgery done at all feels a little puffy as well. I donít have an infection as I've already been checked by my dentist for that.

The socket hole hasn't closed completely yet and the extraction site is still slightly swollen, so my questions are: Could that slight bit of internal swelling be what is causing my asymmetry and overall facial puffiness? Is it normal for the external swelling to be worse on some days than on others? Is there anything I can do to speed the healing process? And how long can I expect until I'm completely healed?  

As it has been over a month now, I am beginning to worry that this could be permanent.

Thank you for your time.

ANSWER: Danielle - First of all speeding up the healing process can be done by the use of warm salt water rinses.  Use warm salt water for about five minute 4-5 times a day, concentrating the fluids in the area of the extraction.  The internal swelling could be producing the assymetry.  The fact that the swelling is more evident on some days more than others usually indicates some type of active process.  That process could be an infection or an active inflammation.  You should be examined by a board certfied oral and maxillofacial surgeon.  In Saskatchewan there is no board certified surgeon and the closest is in Edmonton.  So you need to be evaluated by a knowledgeable doctor.  If you want the names of doctors there, get back to me and I will send you the doctors.  Get evaluated is important.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much! I will be sure to start the warm salt water rinses.
Indeed, I would appreciate the names of those doctors as I don't have the slightest idea of who I should see to be evaluated.

Answer
Danielle - The following names are board certified oral and maxillofacial surgeons in Edmonton.

1) Dr. Randall Kreutz - (780) 452-7070 - Edmonton

2) Dr. Elliott Tunis - (780) 437-6777 - Edmonton

I hope you heal with just the warm salt water, but if not, contact one of the above to examine you.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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