Complications After Tooth Extraction

Complications may occur after tooth extraction procedure. Some complications after tooth extraction are common and some are not that common. Extraction is painless removal of tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully without any post-operative complications.  Tooth extraction complication symptoms are prolonged pain; swelling, bleeding, bruising, limited mouth opening and many others.  Various Tooth extraction complications are discussed in detail in this article.

Pain as Complication after Tooth Extraction

It is the most common complication which occurs after the tooth extraction procedure. After the tooth removal, there is bound to be some kind of discomfort and pain.  The pain and soreness may last for few days after tooth extraction.  Painkillers are given by the dentist to control the pain. Pain meds such as Ibuprofen, Tylenol, Paracetamol, Solpadeine or Nurofen Plus can be used to control the pain.  The painkillers which are prescribed by the dentist are dependent on the medical history of the patient and the effortlessness with which the tooth was extracted.

Swelling as Complication after Tooth Extraction

Swelling after tooth extraction

Swelling is other common complication after tooth extraction. Swelling after tooth extraction procedure is a normal body reaction and is indicator of normal progress of healing of tooth extraction socket. If swelling persists beyond 1week, then the patient needs to visit the dentist.  After extensive surgical interference, simple inflammatory edema appears in adjacent tissues in most of the cases. This is unavoidable and is generally commensurate with the degree of surgical trauma. Swelling usually occurs after the tooth removal.  The swelling can be there for as long as few weeks.  The swelling can be treated by using an ice-pack or by pressing a bag of frozen peas against the cheek near the tooth which is removed. This will help to lessen the swelling.  Alcohol, hot foods and drinks and work out immediately after the tooth extraction can aggravate the swelling. Warm saline rinses and hot moist compresses 1-2 days after tooth extraction will further help in reducing the swelling.

Bleeding as Complication after Tooth Extraction

Bleeding after Tooth Extraction

Bleeding is other common tooth extraction complication. Slight oozing of blood may occur for up to 24 hours after the tooth extraction. It is considered as normal. If the bleeding is continuing after tooth extraction, then the patient can put a piece of gauze pad on the bleeding socket area with equal pressure without irritating the socket.

 Gauze pack to stop bleeding

Biting on tea bags may also stop the bleeding. If there is prolonged oozing of blood even after 24 hours or incases of heavy bleeding after 1-2 hours after the tooth extraction, dentist should be consulted.

Bruising Complication after Tooth Extraction

There are some people who are more likely to bruise than others after tooth extraction. These are usually older people, people on aspirin or steroids as they tend to bruise much more easily. Intermittent ice packs should be given for the first 24 hours after the tooth extraction procedure followed with intermittent hot moist packs. It is not a gangrenous process and discoloration is due to bleeding into the tissues. Accumulation of red blood cells and subsequent break down of hemoglobin causes discoloration. The bruising can look quite prominent and might take weeks to disappear in some cases.

Limited Mouth Opening which is called as Trismus after Tooth Extraction

 This is the normal mouth opening but in Trismus, there is inability to open mouth normally

Many a time’s the chewing muscles and the jaw joints are so sore after the tooth extraction that it becomes really difficult to open the mouth. This can happen for a few days after the extraction.

In case the patient gets an infection after the tooth extraction in the tooth socket then he will not be able to open his mouth for a much longer period say as much as a week. Although Pain is the most common tooth extraction complication, trismus can become one of the more chronic and complicated problems to manage. 

Post-operative infection Complication after Tooth Extraction

A person might also develop an infection in the socket after the surgical extraction of the tooth. This usually happens about 2 – 4 days afterwards and one knows of it from the deep-seated throbbing pain, the bad breath that the person emits and the perpetual unpleasant taste left behind in the mouth. Dry socket is a painful tooth extraction complication.  This kind of an infection is more bound to happen if a person smokes, use Contraceptive Pills or are on drugs such as steroids or if the bone cutting is done during the tooth extraction.

Secondary infection that is infection several days after tooth extraction may occur. It mostly occurs after surgical removal of wisdom tooth. The patient will have fever, abnormal swelling, pain or a salty or prolonged bad taste with or without discharge from the surgical site as post tooth extraction complication symptoms in case of secondary infection . To avoid this, patient has to maintain good oral hygiene and should avoid smoking and drinking alcohol. To treat infections, antibiotics are given by the patient.

Reaction to medications given after Tooth Extraction Procedure

The pain meds and antibiotics which are given after tooth extraction may have side effects. A patient may experience nausea, vomiting, drowsiness from the medicines which are provided. Patient can consult his dentist in such cases and can tell him to change his medicines.

Numbness / Tingling /Burning sensation after Tooth Extraction

Numbness and tingling sensation occurs when the nerve is damaged or is injured during the tooth extraction. Nerves are responsible for sensation in the tongue and lips and may get affected while giving the anesthesia.  The nerves may get squashed, bruised or stretched which could result in numbness.

This kind of nerve bruising is usually not permanent but in the rarest of rare cases it might be permanent as well. The temporary phase might go on for a long time and may last from several days to several months. No one can actually say how long the nerve will take to get rid of the nerve bruising and come back to its normal mode of functioning.

Bony Flakes Complication after Tooth Extraction

Sometimes, bony flakes also known as sequestra result from the sockets of the extracted teeth and the patient can feel the roughness with the tongue in the socket area. They may cause soreness and will interfere with the healing after tooth extraction. They need to be smoothened by the dentist. At times, the gums heal on their own whereas some times it becomes imperative to smoothen the underlying bone for healing to take place. 

Bleeding into Cheeks after Tooth Extraction

Bleeding into the cheeks can result in swelling after tooth extraction which may be hard to feel.  This could also go on to result in a difficulty in being able to open the mouth and also result in bruising at that particular spot.  The swelling, bruising and mouth opening will all get better with time and come back to normal.

Periodontal damage Complication after Tooth Extraction

Periodontal damage may occur after tooth extraction. Periodontal pocket may occur after wisdom tooth extraction if the tooth is deeply impacted and there is no bone between second and third molars. To treat periodontal pocket, scaling and root planning is done. Gum surgery may be required to treat it. Gum tissue may be deteriorated after tooth extraction.

Ludwig’s Angina Complication after Tooth Extraction

It is a rapidly spreading infection of floor of mouth and is life threatening. Fascial spaces are affected in this. Difficulty in breathing, difficulty in mouth opening, swelling and severe pain is Ludwig’s angina complication symptoms.  Though it is extremely rare but one still needs to take extreme care if one gets infected by Ludwig’s angina.

Osteonecrosis Complication after Tooth Extraction

 It is a rare dental condition which may occur after tooth extraction or other invasive procedure.  In this condition, there is no sign of healing even after 8weeks of dental extraction. The gums are worn away in this condition and underlying bone is visible. This condition is mostly seen in cancer patients.

Osteomyelitis Complication after Tooth Extraction

It is a rare Tooth extraction complication. Osteomyelitis may occur after tooth extraction. There is inflammation of bone and bone marrow in this condition.  In case of acute osteomyelitis, there is severe throbbing deep seated pain present along with swelling. The teeth may be loose and pus may extrude from the socket.  Fever and enlargement of lymph nodes may be present. In case of chronic osteomyelitis, there may be fistula and sinus tract formation on skin and mucosa.

Post extraction Granuloma Complication after Tooth Extraction

This complication happens four to five days after tooth extraction. The main reason for it to occur is a foreign body in the tooth socket that starts the infection and allows it to set in. This could be the result of e.g. amalgam remnants which is from the tooth filling, bone chips, small tooth pieces, calculus etc. The way this works is that the foreign bodies aggravate the area and this goes on to stop the post-extraction healing and suppuration of the wound happens.

It is treated with debridement of the socket and removal of any and every causative agent of the infection. This is the best and only way to go about it.

Temporomandibular joint (TMJ) dysfunction after Tooth Extraction

It may occur after wisdom tooth extraction. This tooth extraction complication is unusual and is temporary. To treat this condition, anti-inflammatory medicaments, heat therapy, rest and in some cases bite splint therapy is given.


 User Comments on -  Complications After Tooth Extraction

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Posted By : Antanic on 08-Jun-2014 02:38 AM
i had my tooth removed three days ago and now i have white residue in the gum where my tooth was pulled. is this normal?

Posted By : Kate on 03-May-2014 11:09 PM
My fiance had a tooth extraction today. His molar was basically rotted away in his mouth, causing am abscess. It was pulled this am. Before it was pulled he was told he will also need a bone graft. Also yesterday when the pain started, he was afebrile... Now..12 hours later.. he has a fever of 100.9, fatigue, hes tachy, and I noted palpitations. Hes on amox.. but dose so far. Should I be worried? Im a nurse and my brain went immediately to endocarditis. But ive never really seen it and theres no literature online that stated how quickly it can set in. And thoughts?

Posted By : Harriet on 29-Apr-2014 12:58 AM
Hi. Just want to know if it is possible to have tooth extracted after 5 years of operation. My nephew had his lump under his tongue taken out. It was 1st stage cancer. Thanks for any advice.

Posted By : Lauren on 01-Apr-2014 10:40 PM
Hi I have gotten my wisdom teeth out exactly a week ago. The healing on one side is looking nice, it feels completely normal and I see a small hole that I have been able to use my syringe for cleaning. My right side however has a much bigger hole almost like the size of a tik tak or mini jelly bean. I can't fully describe what it feels like but its almost like an itchy feeling combined with a little bit of senseitivity. What does this mean and how can I fix it??

Posted By : mustafa ibrahim on 16-Feb-2014 04:58 PM
i have extraction done for my seventh upper left tooth today. It was complicated with a perforation of the maxillary sinus which was repaired immediatly with sutures. Unfortunatly, emphesyma in the face and the neck also developed which is warrying me. Could i ask about the possible fate of the emphesyma?

Posted By : bianca on 22-Dec-2013 07:14 AM
Hi, I had tooth extracted 2 days ago now, i'm also 40+1 weeks pregnant, I ended up at the hospital once the numbing wore off because the pain was unbearable, I can't take much while i'm pregnant for the pain, it has died down a little but my bottom lip and side of my face is still throbbing and going tingly is all this normal and when will the pain stop? I need to sleep :(

Posted By : sherry on 03-Aug-2013 06:24 PM
I had a wisdom tooth pulled a few days ago and the tooth next to it had a filling put in, now I can't stop biting my cheek. every time I try to eat or talk I bite my cheek. what can I do to stop biting it?

Posted By : Cyndi on 19-Jul-2013 08:15 AM
I had all my top teeth pulled and two on the bottom 2 days ago. I have noticed that I have bone fragments sticking out of my gums. Also my gums feel sort of itchy and sore. To top all that I woke up this morning and I had really bad breath and the sides of my tongue is white. I am on Amoxicillin and Hydrocodone is this normal?

Posted By : Dr. Rtiz on 18-Apr-2013 10:14 AM
Lynne, it looks like that you have sinus perforation which is causing the problem. It is because your roots were connected with the sinus. In such cases you have to be extra careful and it is better you discuss this with your dentist. This problem of sinus perforation is not very common but some times it does occur.

Posted By : Lynne Jones on 17-Apr-2013 09:22 AM
I had a complicated impacted wisdom tooth extraction 2 days ago, under local anaesthetic. The root had connected with the air sinus. I have stitches, and didn't have excessive bleeding from the mouth, but am coughing up phlegm that is coloured red. Is this to be expected?

Posted By : Dr.Ritz on 24-Nov-2012 03:47 AM

Hi VREN,Replacement of missing teeth is important as if the missing teeth are not replaced,it can lead to series of complications.Complications which can occur if the teeth are not replaced are: malalignment of Teeth,Chewing Problem, Esthetics,Loose Teeth or speech problem.When there is a missing teeth present,the adjacent teeth drift into the spaces created by the unreplaced missing teeth.So,talk to your dentist about the various options available for you to replace the missing tooth.Hope that helps.


Posted By : vren on 24-Nov-2012 01:54 AM
i had my first molar get extracted 5days ago. my gums almost closed on it. i dont have any prob now. but my fren kept saying that i need to get it replaced else i mite suffer complications.

Posted By : Dr.Ritz on 14-Nov-2012 10:30 PM

Hi SARAH,It is normal to feel pain for few days after the extraction.The pain and discomfort after the procedure depends on the procedure which is used for the extraction of the tooth.Analgesics are given after the tooth extraction to relieve the pain.If the tooth is pulled out under sedation,then steroids may be given to reduce the swelling after the procedure. Swelling after tooth extraction procedure is normal body reaction.It is a good sign and indicator of normal progress of healing of tooth extraction socket.Swelling usually lasts for 4-6 days.Normally, the swelling subsides completely in 7 days after the tooth extraction procedure.Application of cold to the operated site decreases the amount of swelling which is present after the tooth extraction procedure.Heat in the form of moist compresses should be applied after 1-2 days of tooth extraction.Do not disturb the extraction socket wound too much.Hope that helps.Good luck!!


Posted By : Sarah on 10-Nov-2012 10:10 AM
Had an infected back tooth extracted 2 days go. When the numbing wore off I was in more pain than before . I've now been put on antibiotics but the inside lower gums and floor of mouth are very swollen . What should I do

Posted By : Dr.Ritz on 24-Oct-2012 11:47 PM

Hi TONYA,Difficulty in mouth opening can occur after wisdom teeth extraction due to muscle trismus. TMJ dysfunction may also rarely occur after wisdom tooth extraction and can lead to difficulty in mouth opening. In case of muscle Trismus, patient is advised to stretch his mouth.In stretching of mouth you don’t have to wide open the mouth but open the mouth till pain is there and don’t go beyond that.If you can easily put your 3 fingers in mouth that means the opening is normal and if it is less then you have to try to open more and more gradually till you are able to put 3 fingers in the mouth.TMJ dysfunction after teeth extraction is unusual and temporary and to treat condition,heat therapy,anti-inflammatory meds and splint therapy can be given.You can continue with warm saline rinses for faster healing to take place.Keep tooth extraction socket area clean to avoid any secondary infections.It may take 3 weeks to 3 months for complete healing of wisdom tooth extraction socket to take place depending on method of teeth extraction and trauma to supporting tissues during tooth extraction.If mouth opening doesn’t seem to get better,then you can visit your oral surgeon for evaluation.Hope that helps.


Posted By : Tonya on 24-Oct-2012 03:25 PM
Tomorrow will be 1 month since i had my 2 wisdom teeth extracted. I have had may problems, 1 week after i developed dry socked and then i got a infection and i also cant open my mouth more then 1inch and a half. My dentist told me that it should go away in a few months because he had such a hard time extracting the lower one that there was so much trauma involved due to the fact that my tooth keep breaking. I just want to be able to open up my mouth and be able to floss and eat a big hamburger, and chew gum again :( Can u tell if i can do any thing to speed this process up ??????

Posted By : Dr.Ritz on 12-Sep-2012 11:33 PM

Hi LYNNE,You don't need to worry too much.You are probably suffering from cracked tooth syndrome.As you are expriencing constant dull ache in your tooth,the crack seems to be close to the pulp of the tooth.In such a case,I would suggest you to go in for root canal treatment of the involved tooth.You can try applying clove oil locally to the tooth in question, and it may sooth the pain as it is a very strong obtundent.You can also rinse your mouth with warm saline to relieve pain.For the time being,at least till you get to visit the dentist try to avoid eating anything hard or even to apply pressure to the tooth.So,have a soft diet.Also,it is better to avoid taking cold or hot beverages.I hope everything goes well for you.Good luck!!


Posted By : Lynne on 12-Sep-2012 09:28 AM
I have had a problem with a tooth for several years. X-rays showed nothing. I was told it was hairline cracks and it has been filled, and re-filled. More recently I have had an overlay (like half a cap) but still I feel discomfort with cold drinks and a constant background dull ache. Is it possible to have an underlying infection, even though x-rays show nothing? thanks

Posted By : Dr.Ritz on 10-Sep-2012 12:11 AM

Dear BILL,Swelling can be normal up to about 4 weeks after wisdom tooth removal;after that,though,swelling is a bit of a red flag that something went wrong.Swelling in your case could be due to a bone spicule or cyst that was not removed when the wisdom tooth was extracted.It can be fairly common for a dentist to miss a small piece of wisdom tooth,leaving it behind in the socket to cause an infection.Sometimes the infected area needs to be re-opened and scraped out, even if it's not caused by a cyst or bone spicule.There could also be a problem with the tooth next to the one taken out; it may have developed an infection as well (sometimes this happens if the wisdom tooth was infected before it was extracted).So,my advice for you would be to visit your dentist and request him to take an x-ray to find out cause.In the meantime, use ice on the outside of your face as much as possible, in addition to taking anti-inflammatory medications such as Ibuprofen.


Posted By : Bill on 09-Sep-2012 05:19 PM
Had my wisdom teeth removed years ago but the area still becomes swollen and irritated quite frequently. It typically happens on both sides at the same time. Immune system issue?

Posted By : Dr.Ritz on 06-Sep-2012 09:52 PM

Dear NICOLE,The prolonged bad taste in your mouth one week after the wisdom tooth extraction could be a sign of secondary infection. You should maintain good oral hygiene and should avoid smoking and drinking alcohol.You may brush your teeth but very gently,avoiding the area of surgery.Use warm saline rinses or the mild antiseptic mouth wash as prescribed by the dentist. Warm saline rinses and mouthwash should be done gently and not vigorously.If the condition persists,you can take antibiotics but only after consulting your dentist.


Posted By : nicole on 06-Sep-2012 09:14 AM
1 week post surgical extraction of 4 impacted wisdom teeth. yesterday started with an awful taste in my mouth, hoping it is just the sutures and food particles as i do not have a fever and my pain is getting better every day. should i be concerned about infection?

Posted By : Dr.Ritz on 02-Sep-2012 11:08 PM

Dear NENE, I would advise you to visit a dentist asap and get its treatment done. Dentist will most probably apply the sutures after cleaning the site. For time being take care of the area and don't allow any kind of food particles to get lodged there. Start using anti-bacterial mouthwash to kick off any bacterial accumulation in that site.


Posted By : Dr.Ritz on 02-Sep-2012 09:59 PM

Dear RIVER, Swelling after wisdom tooth extraction is normal. To reduce it apply an ice pack in the area for 15 minutes and then take it off for 15 minutes. Take ibuprofen twice daily and start with warm saline gargles. Hope the solution will reduce the swelling and if the swelling is still there then i would recommend you to visit the dentist.


Posted By : Nene on 02-Sep-2012 03:25 PM
Hey I got my wisdom tooth pulled about 2 years ago! well the lower right side of my jaw has a piece of skin that where dentist cut out my teeth that has opened and it hurts really bad will it heal or do I need to go back to the dentist

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