Surprised at the amount of swelling after wisdom teeth removal

My son had 4 wisdom teeth removed two days ago, and from the removal his face is severely swollen on the left including his eye. I am seriously concerned could he possibly have nerve damage that is affecting his eye and! jaw which would require additional surgery? Or will anti-inflammatory medication, time, washing with warm salt water and penicillin help decrease the swelling? Thank you From Mother with frustrated son
Angela in Maryland

Angela,
You’re e-mailing me two days after this surgery, which is typically the worst day for the swelling, and then it tends to go down after that. I’m not hearing anything from you suggesting any nerve damage. The swelling comes from the surgery and always happens when you have impacted wisdom teeth removed. If the upper left wisdom tooth was a little difficult and required removing bone to get it out, as they often do, that tooth is very near the eye and the swelling will be up in the eye area. Now I can’t examine him, so I’m just going by what you are telling me. But you’re not telling me anything unexpected, really.

I would just follow the instructions of the dentist who took them out, and I would expect steady improvement. After tomorrow, if at any time his situation gets worse – the swelling increases instead of decreasing, or there is an increase of pain from one day to another, then you should tell your dentist, and your son may need additional help.

You may give some feedback to the dentist that took them out. We always tried to brace our patients for the worst, and we described a worst-case scenario of what they would experience afterwards, so they didn’t worry if that happened. It’s not smart to paint too rosy a scenario for the patient – I would put my optimistic outlook aside and describe the worst I thought could reasonably be expected. If you weren’t expecting this, maybe your dentist could use a little lesson in post-operative instructions.

– Dr. Hall

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