Tongue discomfort after wisdom teeth removal is a common side effect of the procedure. While the focus is usually on the extraction sites, the tongue can experience soreness, pain, or altered sensation in the days following surgery. This discomfort is typically temporary, lasting only a short period as the mouth begins to heal. Understanding the specific causes of this irritation can help distinguish between minor trauma and a more serious, though rare, complication.
Direct Tissue Trauma from Surgical Tools
The most frequent source of immediate tongue soreness is physical manipulation during the surgery. To maintain a clear view and access the wisdom tooth, the surgeon must retract the soft tissues of the mouth, including the cheek and the tongue. This retraction can cause bruising, stretching, or localized swelling of the tongue tissue.
Instruments like surgical retractors, suction tips, or the bur used to remove bone can accidentally rub against or pinch the tongue’s surface, leading to minor cuts or abrasions. This type of mechanical trauma results in a superficial soreness and inflammation. It usually resolves within the first week of recovery, much like a minor burn or bite.
Lingual Nerve Irritation and Injury
A primary cause of tongue discomfort involves the lingual nerve, which provides sensation to the front two-thirds of the tongue and carries taste fibers. This nerve runs close to the inner side of the lower wisdom teeth, making it vulnerable during extraction of the lower molars. Injury to this nerve is a risk, although most injuries are temporary.
The nerve can be affected by stretching, compression, or bruising from surgical instruments, often referred to as neuropraxia. Symptoms of this temporary irritation include numbness, a persistent tingling, or a pins-and-needles feeling, known as paresthesia. Patients may also experience a burning sensation or an altered sense of taste on the affected side of the tongue.
A more severe injury involves partial or complete tearing of the nerve, which can happen during an incision or while drilling bone. Sensation often returns spontaneously over a period of days to a few months. If the altered sensation or pain persists for more than a few weeks, it may indicate a more significant injury that requires prompt follow-up with the oral surgeon for assessment and potential treatment.
Relieving Post-Extraction Tongue Pain
Managing tongue pain after surgery involves gentle care and standard post-operative pain control. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the first-line defense for reducing both pain and inflammation. These medications target the swelling and discomfort caused by tissue trauma and mild nerve irritation.
Applying a cold compress or ice pack to the outside of the cheek near the surgical site during the first 24 hours can help reduce local swelling. After this initial period, warm salt water rinses, performed gently after the first day, can help keep the area clean and promote healing of any minor abrasions on the tongue’s surface.
Maintain a soft diet and avoid foods that could irritate the healing tissues, such as anything spicy, crunchy, or excessively hot in temperature. If any numbness, tingling, or pain worsens after the first few days, or if the altered sensation on the tongue persists beyond two days, contacting the oral surgeon is necessary to ensure proper monitoring and management of the healing process.