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Oral Surgery/facial swelling still apparent four months after wisdom tooth removal

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Question
QUESTION: Dr.,

I had my lower wisdom tooth removed about 4 months ago.  It was severely impacted.  The swelling never went down and I can still feel my cheek's thickness next to my teeth.  When I open my mouth, the cheek/jaw curve on one side is bigger than the other.  My dentist says everything healed fine and has no idea why the swelling is still there.  I don't know if this swelling is permanent or can be undone - please help.

Thanks!

ANSWER: NP -  this situation can occur if after the extraction, there was bleeding into the tissues of the face from the extraction site.  It could also be from a spasm of the jaw muscles.  A general dentist is not the appropriate doctor to diagnose this.  You need to have yourself examined by a board certified oral and maxillofacial surgeon.  Sometimes, if left alone cystic area or areas of internal scarring could produce a permanent inequality.  So it is important to have yourself examined by a board certified oral and maxillofacial surgeon.  If for some reason you are unable to find one, get back to me, tell me where you live and I will send you names of appropriate doctors near you.

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

QUESTION: Thanks for your prompt response.  Unfortunately, I do not have insurance and seeing a surgeon would be too expensive.  Are there any home remedies such as salt water rinses that could help?  Thank you.

Answer
NP - Salt water rinses could help if the swelling is due to increase fluid retention in the area from former inflammation or infection.  Do not put any heat or cold on the outside of the face.  Using hot or cold on the outside any time after oral surgery increases swelling.

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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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