Wisdom tooth extraction is a routine dental procedure, but it carries risks that can lead to severe complications, including jaw pain, foreign body reactions, nerve damage, and incorrect extractions. Some of these complications arise due to surgical errors, retained materials, or unexpected reactions to substances used during the procedure.
Foreign Body Reactions and Granuloma Formation
One of the lesser-known complications of wisdom tooth extraction is granuloma formation in the extraction socket. This can occur due to retained fragments of tooth, bone, or surgical materials such as bone wax. Bone wax is used to control bleeding, but it is non-resorbable and can lead to chronic inflammation, delayed bone healing, persistent swelling, and infection.
A case involved a 29-year-old woman who experienced persistent numbness in her right mental nerve, which worsened over time. She had her lower wisdom teeth extracted 11 years earlier and initially experienced numbness for a few weeks, which later resolved. However, when she started experiencing pain, a CT scan revealed a mass in the inferior alveolar canal. Surgery was performed, and a large piece of bone wax was removed. One year after the operation, her pain disappeared, and her nerve function gradually improved.
These cases highlight the importance of avoiding non-resorbable materials in areas close to major nerves, such as the inferior alveolar nerve, to prevent complications like wisdom tooth-related jaw pain.
Incorrect or Unnecessary Tooth Extractions
In some instances, errors during wisdom tooth removal can lead to the extraction of the wrong tooth or additional healthy teeth, either due to surgical mistakes or negligence.
A 20-year-old woman was referred by her orthodontist for lower wisdom tooth extraction while the upper wisdom teeth were meant to be retained for future support. However, due to miscommunication or habit, the surgeon removed both the upper and lower wisdom teeth on one side, leading to unintended complications.
In another shocking case, a 13-year-old boy was scheduled to have two wisdom teeth extracted, but instead, the oral surgeon mistakenly removed two healthy permanent teeth. These types of surgical errors can lead to significant functional and aesthetic consequences, requiring extensive corrective treatments.
Surgical Errors Due to Incorrect Radiographic Interpretation
Wisdom tooth extractions require precise imaging and diagnosis to avoid mistakes in identifying tooth position. However, errors can occur due to mislabeling of X-rays or incorrect assessment of the tooth’s location.
One such case involved a man with three impacted wisdom teeth who underwent surgery to remove them. The surgeon successfully extracted the two upper wisdom teeth but then mistakenly drilled on the lower left side, despite the only remaining wisdom tooth being on the lower right side. This error led to severe nerve damage, resulting in permanent numbness in the jaw, chin, and lower lip.
A court ruling in this case compared the mistake to a surgeon amputating the wrong limb, emphasizing the severity of such surgical errors.
Wisdom Tooth Extraction and Persistent Jaw Pain
One of the most common complaints following wisdom tooth removal is jaw pain, which can arise from multiple causes, including:
- Nerve irritation due to excessive pressure or trauma during extraction.
- Muscle strain from prolonged mouth opening during surgery.
- Infection or dry socket if the blood clot at the extraction site is lost.
- Retained tooth fragments or foreign materials causing chronic inflammation.
In some cases, wisdom tooth-related jaw pain can persist for months or even years if the underlying issue is not identified and treated. Patients experiencing ongoing pain, numbness, or swelling should seek further evaluation, including imaging studies like CT scans to rule out retained foreign bodies, nerve damage, or chronic infection.
Conclusion
While wisdom tooth extractions are common, they are not without risks. Granulomas, foreign body reactions, incorrect extractions, and misinterpretation of X-rays can all contribute to severe complications, including chronic jaw pain. Proper surgical planning, careful handling of materials, and post-operative monitoring are essential in preventing these issues.
Patients who experience persistent pain, swelling, or sensory disturbances after a wisdom tooth extraction should seek prompt medical attention to address any underlying complications and ensure proper healing.
