Wisdom Teeth Removal

Wisdom Teeth Removal

Your back molars, also known as wisdom teeth, are the last adult teeth to emerge in your mouth. They come in on the top and bottom of both sides, usually between the ages of 17 and 21. Many people don’t have enough room in their jaws to accommodate wisdom teeth without their other teeth shifting, which can lead to a variety of problems. Most adults get four wisdom teeth-two on the top and two on the bottom behind the first and second set of molars. It is possible to have less than four wisdom teeth, have more than four (called supernumerary wisdom teeth) and some people don’t develop any at all! Most people believe the nickname “wisdom teeth” started because they erupt when a child is older-and presumably wiser. If you do have wisdom teeth, your dentist will likely recommend surgery to remove them. Wisdom teeth removal is very common, and most people fully recover from wisdom teeth surgery in three to four days.

Why should I have them removed?

Most people have their wisdom teeth removed for one of these reasons:

• Have impacted teeth
• Cause crowding of other teeth or move other teeth and make them crooked
• Grow in sideways or another undesirable position (often tilted forward)
• Only partially erupt
• Contribute to jaw pain
• Continually get tooth decay or infections (food and bacteria can get trapped when wisdom teeth partially erupt)
• Don’t have room to erupt (average human mouth can accommodate 28 to 32 teeth)
• When a tooth isn’t fully erupted, it can cause issues like pain, inflammation and infection.
• Remain completely hidden within the gums. If they aren’t able to emerge normally, wisdom teeth become trapped (impacted) within your jaw. Sometimes this can result in infection or can cause a cyst that can damage other teeth roots or bone support.
• Emerge partially through the gums. Because this area is hard to see and clean, wisdom teeth that partially emerge create a passageway that can become a magnet for bacteria that cause gum disease and oral infection.
• Crowd nearby teeth. If wisdom teeth don’t have enough room to come in properly, they may crowd or damage nearby teeth.

Some dentists recommend removing wisdom teeth if they don’t fully emerge. Many dentists believe it’s better to remove wisdom teeth at a younger age, before the roots and bone are fully formed, and when recovery is generally faster after surgery. This is why some young adults have their wisdom teeth pulled before the teeth cause problems.

When should I have them removed?

Wisdom teeth usually appear between the ages of 17 and 21. An initial evaluation of the wisdom teeth is recommended to be performed between the ages of 16 and 19. Some dentists decide to remove wisdom teeth to prevent problems later on, even if the patient is not experiencing and of the common symptoms.

Some of the symptoms of impacted wisdom teeth include:

• Jaw pain
•  Swollen, tender, or bleeding gums
• Stiffness or swelling in the jaw
• Difficulty opening your mouth

It is possible that you may never have any problems with your wisdom teeth, especially if you’re already older than 30. However, it is still a good idea to schedule an evaluation and talk with your dentist about them, as they may be causing problems without you knowing it.

What You Need to Know about Wisdom Teeth Surgery

The surgery should take about 45 minutes. Wisdom teeth removal surgery is a procedure that is typically performed by a dentist or oral surgeon. Your dentist may perform the procedure in the office. However, if your tooth is deeply impacted or if the extraction requires an in-depth surgical approach, your dentist may suggest you see an oral surgeon. An exam and X-ray will be then be take to reveal if your wisdom teeth are impacted or may cause dental problems for you in the future. (Again, not everyone has wisdom teeth, but most people have one to four.) Sometimes the procedure can be performed by your dentist in office if the wisdom teeth are not too impacted, but often you will be seen by an oral surgeon since it requires a more in-depth, surgical approach. During the surgery, you will be under anesthesia, so you do not have to worry about experiencing any pain or discomfort (you may be a bit sore after surgery). The sedation could include nitrous oxide (laughing gas) or intravenous (IV) sedation. Your surgeon will decide which sedation to use based on your comfort level as well as the complexity and number of extractions required. The surgeon will cut into the gums and remove the tooth, either as a whole tooth or in pieces. To you, the surgery will seem quick and painless, and your family or friend will be ready to take you home.

After the procedure

Most people fully recover from wisdom teeth surgery in three to four days. As you heal from your surgery, follow your dentist’s instructions on:

• Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
• Pain management. You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist or oral surgeon. Prescription pain medication may be especially helpful if bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.
• Swelling and bruising. Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
• Beverages/ Food Drink lots of water after the surgery. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
• Cleaning your mouth. Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you’ll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
• Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.

When to call your dentist or surgeon

Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:

Difficulty swallowing or breathing

Excessive bleeding

Fever

Severe pain not relieved by prescribed pain medications

Swelling that worsens after two or three days

Results

You probably won’t need a follow-up appointment after a wisdom tooth extraction if you don’t need stitches removed, no complications arose during the procedure, and you don’t experience persistent problems, such as pain, swelling, numbness or bleeding — complications that might indicate infection, nerve damage or other problems. If these complications develop, contact your dentist or oral surgeon to discuss treatment options.