It is possible for the oral cavity, alveolar ridge, buccal cortical plate, palatal cortical plate, and labial cortical plate(s) to fracture during or after the extraction of a wisdom tooth. The alveolar bone, which houses the tooth sockets, can fracture due to excessive force or abrupt, unsteady extraction movements. Such fractures may lead to significant discomfort, including persistent jaw pain, especially in cases involving impacted wisdom teeth.
In one reported case, a 25-year-old male underwent the removal of four impacted wisdom teeth under local anesthesia with Lidocaine. During the procedure, the patient suddenly wrenched his head, causing the dental drill bur (bit) to penetrate the lingual plate, leading to its fracture. This incident also severed the lingual nerve, resulting in paresthesia (a sensation of pins and needles) and contributing to prolonged jaw pain and discomfort.
Secondary Infection
Post-surgical infection following wisdom tooth removal occurs in approximately 1–2% of patients and is referred to as a secondary infection. Symptoms include fever exceeding 100°F, abnormal swelling, persistent irritation, and a prolonged bad taste in the mouth, with or without noticeable discharge from the surgical site. In some cases, infections can lead to persistent jaw pain, further complicating the healing process.
Maintaining good oral hygiene and avoiding harmful habits such as smoking and alcohol consumption is crucial for preventing complications and promoting proper healing. Infections can also develop weeks after extraction if plaque becomes trapped in the healing socket. If an infection occurs, antibiotics may be required, and in some cases, drainage might be necessary.
Periodontal Defects and Gum Deterioration
In some cases, gum pocketing can develop behind the adjacent tooth after a wisdom tooth extraction. This is especially common when the wisdom tooth was deeply impacted against the second molar, leaving little to no bone support between them. These pockets can trap bacteria, leading to inflammation, plaque buildup, and increased sensitivity in the adjacent tooth.
Studies indicate that individuals who have a healthy wisdom tooth removed may have a 48% increased risk of developing gum pockets. This suggests that wisdom tooth extraction can contribute to the deterioration of periodontal health, potentially leading to long-term localized gum issues. Additionally, wisdom tooth removal can result in prolonged jaw pain, particularly if complications such as infections, nerve damage, or gum recession arise post-surgery.
