A hole in the cheek after wisdom teeth removal may be due to where the impacted tooth was located which required an incision to be made there. It may seem scary but it will heal in due time as long as you take care of it properly.
Causes of hole in cheek after extraction
Despite what you may have initially thought, there are situations which may result in a hole in your cheek after the third molar gets removed. Sometimes avoiding its occurrence is simply inevitable.
Incision design
If the wisdom tooth is located near the cheek, the likelihood of getting a cheek hole will increase. The reason is due to the incision which needs to be made in order to extract an impacted wisdom tooth.
In order to extract an impacted third molar, your dentist will need to make an incision and peel back the gum. If you look at the picture above, it is a diagram of what a potential incision design looks like. As you can see, one of the directions that the incision is made is towards the cheek.
If your dentist needs to use an incision design like this one, you'll most likely end up with a hole or opening in your cheek. Of course they will stitch it up afterwards but we're just saying there is a possibility of a small hole being there even after that.
Buccally impacted wisdom tooth
Alternatively, if you have a wisdom tooth that is buccally impacted (impacted towards the cheek), that could be another possibility. These teeth are literally trying to grow out into the cheek.
After your dentist removes the tooth, there will be a hole where it used to be. If the tooth socket happens to be near the cheek then a cheek hole you shall have.
Pre-existing hole
Sometimes for non-impacted wisdom teeth that are growing in ectopically (in the wrong direction) can cause a hole in the cheek. What you'll notice is that there will be a pre-existing hole before you even get the teeth removed. As you may have expected, if there was a hole before, there will be another one afterwards.
Don't be alarmed because your body will eventually heal up and close it.
How to treat it
There isn't necessarily any special treatment to make the hole in your cheek disappear instantaneously. They will heal up in due time but you need to be patient. However your dentist may put stitches to expedite the healing process.
Wisdom teeth stitches to cheek
If you were wondering why anyone would get wisdom teeth stitches to the cheek, this is the situation for it. If the incision had to be make near the cheek, your dentist will need to stitch it back up. It may look like they stitched your cheek but it will be necessary for it to heal faster.
Depending on the situation your dentist may be able to stitch it up in such a way that the wisdom teeth stitches will completely close the hole. In this case, your recovery will be the fastest since you can heal via primary intention.
However if your dentist is unable to close it up with sutures, there will be a residual hole. It will still heal up and close all on its own but it may take longer since it will heal via secondary intention.
Aftercare
Placing sutures is the most that your dentist can do for you. The rest will be up to you because you need to take care of the surgical site along with the sutures to ensure proper healing. It will also minimize complications if you follow the aftercare properly.
Aftercare guidelines:
Minimize chewing on that side. If you only had extractions on one side, try to chew mainly on the other side. This will minimize food getting caught up in the sutures and tooth socket.
Gently brush the area. Yes, you still need to brush your teeth even after wisdom teeth removal. Just make sure that you be extra gentle while brushing near the surgical site.
Salt water rinse. One of the best ways to keep food and debris away from the tooth socket is by rinsing with salt water. Make sure you rinse vigorously so food doesn't get stuck in the wisdom tooth hole.
Do not play with them. Keep your tongue and your finger away from the surgical site. That is one of the primary ways of introducing bacteria and causing an infection if your hands are unclean.
When will the hole close?
The hole in your cheek after an extraction should close after about 4 weeks or a month. That is how long wisdom teeth holes typically take for it to completely heal.
However if the hole is from the incision, you may notice it disappearing after about a week or two. The healing process will be expedited if you were able to get sutures placed there. Your body doesn't have to work as hard when it heals with primary intention instead of secondary intention.
What if it doesn't heal?
If it doesn't heal and close up after a few weeks, you've a complication.
Non-healing complications:
Dry socket. If a blood clot fails to form, you will get a dry socket. This condition results in very delayed healing of the surgical site. The hole in the cheek will eventually close but at a significantly slower pace.
MRONJ. If you're taking osteoporotic medication, the bone and consequently the soft tissue may not heal properly after the extraction. What you'll notice is the gums not healing over nor closing. You'll even see exposed bone!
For both of these situations you should definitely contact your dentist and have it evaluated.
Takeaway
It's not unusual to have a hole in your cheek after getting your wisdom tooth taken out. There are certain situations where you may end up with it such as the incision design, buccally impacted, or you had a pre-existing hole.
Ultimately it may just be a consequence of the extraction procedure. It wouldn't be what we would classify as a "complication" since it is not. The good news is that it will eventually heal up and close all on its own.
