Possible Complications of Dentoalveolar Surgery

As with all surgery, dentoalveolar surgery has risks despite the highest standards of care and practice. If you have any concerns regarding possible complications with your surgery, ask your surgeon.

Your surgeon will discuss any potential rare complications or side effects with your surgery. You will be given information about your surgery and any potential complications (although rare) that may occur.

Although rare, the following potential complications are intended to inform you and not to alarm. There may be others that are not listed.

The area where the surgery is performed may be close to a major nerve. Your surgeon will take all the necessary care and precaution to avoid any damage to any of the nerves. If this were to occur, it can cause numbness, tingling and loss of feeling in teeth, gums, cheeks, lips, chin, tongue and around the upper jaw and lower jaw. If injured however, the nerve will generally heal. As it heals, the numbness and tingling sensation will diminish – this may take a few weeks. In some people, complete healing of the nerve may take up to 6-18 months. In rare cases, the nerve may not heal completely and numbness or altered sensation may be permanent.

In rare cases, an injured nerve may heal inadequately and pain may continue or persist without diminishing. This can happen even though the surgery was successful and all care and precaution was taken to avoid injury to major nerves. It is not known why some nerves react this way and the pain in these rare cases sometimes can be difficult to treat.

Following removal of a tooth or retained root, a blood clot will form over the jawbone. This clot is significant for healing and pain relief. If the clot is disturbed, the bone will be exposed – which is known as a “dry socket”. When this occurs, throbbing pain may last for several days. If you experience pain like this, contact your surgeon.

To help prevent a dry socket, for the first day following surgery, do not rinse or spit with force. This can loosen the blood clot and may cause slow healing. After the first day, rinse gently with warm salt water (half teaspoon in cup). For the following 2-3 days, rinse gently every four hours or more often. This will promote healing, reduce swelling and pain and minimise the risk of infection. For the first day following surgery, do not brush your teeth around the area of surgery. After the first day, brush gently. Do not smoke or use tobacco.

If an infection occurs in the gum or bone, this is generally treated with antibiotics. Inform your surgeon if you have ever experienced an allergic reaction to any antibiotic or other drug. Osteomyelitis is a bone infection caused by bacteria or other germs and can occur following dentoalveolar surgery.

Some dental treatments have been linked to a risk of endocarditis (an infection within the heart). People with rheumatic heart disease, congenital heart defects, artificial heart valves or other specific heart problems are more susceptible to this type of infection. Your surgeon will take this risk into account in the treatment of patients who may be at risk.

You may experience pain or discomfort when opening your mouth. This is fairly common following oral surgery and usually settles within a few days.

Your body temperature may be slightly higher following surgery. This will return to normal within 12-24 hours. A fever that continues longer may be an indication of infection or other problems that will require you to contact your surgeon.

Although rare, haemorrhage may occur. It may be caused by too much exertion or by vomiting. The bleeding can be stopped by placing gauze over the wound and applying pressure by biting gently on the gauze for 15 minutes. If severe bleeding does not stop, contact your surgeon.

Pressure or stretching of the lip by surgical instruments may cause bruises or small sores. This generally does not cause any problems and usually heals well.

Although rare, when a tooth or retained root is removed, a nearby tooth or filling may be chipped or loosened.

Occasionally, some people may vomit when they are recovering from an anaesthetic.

The roots of the upper teeth are close to the sinuses. In some cases, a sinus may be opened when a tooth or retained root is removed. The opening will usually heal quickly without infection. However, if an infection sets in or other problems start, more treatment may be necessary.

Removal of an impacted tooth can cause the jawbone to become temporarily weaker. This is rare and usually occurs only in the elderly.

Sometimes during difficult procedures, dislocation of the TMJ may occur in people predisposed to this problem. This can result in severe pain or in some cases, disability. If you have a history of dislocation of the TMJ or a temporomandibular disorder, inform your surgeon.

Costs will vary according to the extent of treatment. Your surgeon’s office will give you an estimate of costs involved.