Incomplete Tooth Removal When a tooth is not completely removed, a portion of the root may remain permanently in the jaw bone.This is especially true when significant bone loss is present at the time of extraction because the 3rd molar is impacted directly against the 2nd molar. To mitigate this risk of longer term periodontal pocketing and infection, bone grafting may additionally be planned as part of the 3rd molar extraction process. While this is a generally pain free condition for many years, the formation of long-term periodontal pockets can occur that later becomes chronically infected on 2nd molars. Residual Periodontal Infections Incomplete healing bony and soft tissue healing can occur following extraction of 3rd molars, including failure to grow new bone on the posterior surfaces of adjacent second molars. ![]() Sometimes this bruising discoloration can extend around the eyes and down the neck and – in extreme instances – take several weeks to finally disappear. Some of this residual blood can be pushed directly under the skin and cause an extensive “bruising” appearance as this blood is removed by the body as part of the healing process. Facial Bruising Bleeding into the soft tissues after 3rd molar extractions is considered normal.Use of steroids (injection) and NSAIDs (ibuprofen) can reduce the magnitude of swelling, but will not eliminate facial swelling potential. Note that while the application of ice packs may help with pain management, it has no significant effect on reducing or controlling swelling. Reversal of swelling is expected in 4 days and complete resolution 7 days following surgery. Swelling can be immediate and generally reaches its maximum 2 days following surgery. Swelling (Edema) Post-extraction facial swelling (edema) is considered a normal consequence to having 3rd molars removed, especially when they are fully impacted.While rare, the entire crown of adjacent teeth can be fractured off. Accidental Damage to Adjacent Teeth Because of the physical pressure placed on teeth to remove them during extraction there can be minor chipping or cracking of an adjacent tooth.This is followed by nearly 50% reporting no pain 7 days following their surgery. The level of pain reported varies widely with 37% reporting mild pain, over 50% reporting moderate to severe pain. Post Operative Pain Pain following 3rd molar extractions is an expected consequence and is considered normal when the effect of local anesthesia wears off. ![]() However, if extensive bone was removed to complete the extraction procedure, then full healing may take up to 6 months. Gum tissue generally heals back to normal levels in 4 to 6 weeks.
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