Wisdom teeth extraction: causes, procedure, and recovery

Atom Edenson

Written by Atom Edenson DMD, Namrita Harchandani DMD, Peter March DDS, Matthew Stewart DDS, Jack Lawrence DMD

The mouth is generally quite small. We have room for about twenty-eight teeth. That is the amount we have before third molars come in. You could say they are additional dentition that doesn’t actually serve a purpose.

The wisdom teeth should arrive when you’re about 18. They are usually all there before you turn 25. You can expect some pain when they start to grow. Wisdom teeth are known for being problematic in terms of the direction of growth and shape.

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Reasons for wisdom tooth extraction

Types of wisdom teeth impactions

When a tooth is impacted it means it can’t freely break through to show up in the mouth. We differentiate four states of wisdom teeth:

Erupted

Erupted wisdom tooth

Picture by Authority Dental under CC 2.0 license

Soft-tissue impacted

Soft-tissue impacted wisdom tooth

In this case, the tooth is stuck under the gum only. You might experience swelling and pain. In order to remove such a tooth, a small incision in the tissue will have to be made.

You may get away with local anesthetic, but sedation is not uncommon in such a case.

Partially-bony impacted

Partially bony wisdom tooth

Picture by Authority Dental under CC 2.0 license

Fully-bony impacted

Fully bony wisdomm tooth

Picture by Authority Dental under CC 2.0 license

How to prepare for wisdom teeth surgery

The procedure of wisdom tooth removal

Surgical extraction

Picture by Authority Dental under CC 2.0 license

The process of removing a wisdom tooth has five main steps and usually takes no more than 45 minutes. Depending on whether you have this done at a dentist’s or at a surgeons office they may differ a little.

Your mouth will be numbed. If your tooth is impacted you might be sedated, too. There are different methods, depending on how deep the anesthesia needs to be. If you are going to be completely under, an anesthesiologist will have to perform this step.

Wisdom teeth surgery is necessary when the tooth hasn’t erupted. The dental professional will make an incision in your gum. If the tooth is also stuck under the bone, a small piece might also be removed.

The tooth may be cut up into smaller parts, especially if it’s in an unorthodox position. This also allows the hole in the gum and bone to be smaller.

The tooth or the parts will be removed. You might feel slight pressure, as the tooth is rocked back and forth in the socket. This widens it and allows the roots to slide out.

After extraction, you may need a few stitches. They will dissolve within a few days. In case of significant trauma to the area a non-dissolvable stitch may be used. If so, you will have to return for its removal.

You will get a gauze pad to press into the swollen area. You might experience some bleeding. It is very important to follow your dentist’s instructions after the procedure for a complication-free recovery.

Wisdom teeth removal recovery

  • DOS

  • Put ice on your gums if they are swollen

  • Bite down on gauze for two hours, changing it every thirty minutes

  • If bleeding persists, bite down on a teabag

  • Exercise your jaw lightly

  • Eat soft foods or liquids

  • Drink plenty of fluids

  • Rinse your mouth with antiseptic mouthwash

  • Brushing is not prohibited, but avoid the affected area

  • Take medication as advised by the dentist

  • Return to the office or call your doctor if you feel significant pain

  • You can eat ice cream or frozen yoghurt to numb the pain

  • DON'TS

  • Don’t drink through a straw to avoid loosening blood clots

  • Don’t brush the area for at least 24 hours

  • Don’t eat hard or sticky foods

  • Don’t smoke or drink alcohol

Stitches are usually self-dissolving. This means you won’t have to return to the office to have them taken out.

Peter March

Peter March, DDS

Mouthwash should only be used if prescribed. Rising with warm salt water is recommended.

The area might feel weird and there might be some swelling for up to three days. You might also experience some bleeding. After that, you will have a post-surgical appointment to make sure everything is going okay.

Risks and complications

An infection after wisdom teeth removal happens when bacteria have gotten inside the wound. It is rare, but can happen on occasion.

What you can do to prevent this is refrain from eating, drinking, and talking for at least two hours after the surgery. If your dentist suspects an infection is likely he or she will prescribe an antibiotic. Take it with adherence to their instructions.

Those who are over thirty-five are more likely to develop this condition. It usually happens with lower wisdom teeth that are positioned very close to the nerve in your jaw.

If your nerve is damaged during the procedure you might feel significant numbness. The areas affected can include the tongue, lip, and jaw. It will probably not affect your movement or cause speech or facial deformity.

It can last for a few days, weeks, or even months. In the worst-case scenarios, it is permanent, but it can possibly be repaired via surgery. You should contact your doctor if you suspect nerve damage.

You should expect some bleeding after an extraction. It is unavoidable, as the tissue is disrupted. The “normal” bleeding should stop around forty-eight hours after the surgery. After that, it could be a cause for concern.

Try to sit upright and avoid physical activity on the day of your procedure. You can use a moistened tea bag to “cushion” the extraction site. That makes some people feel less discomfort and the tannic acid helps constrict blood vessels.

Do not use a straw. Any suction can make the bleeding worse, this includes smoking as well. If you experience significant bleeding after two days consult with your dentist, as your stitches might have opened or ripped.

Your skull has a few hollow spaces called sinuses. Two of them are right above your upper teeth. As you age, roots of the upper molars can sometimes grow so long, they touch or even break through into those spaces.

When the tooth is removed this can create a hole. It will feel like liquids are going into your nose when drinking. It is usually not painful, but can be uncomfortable.

Most often, this hole will heal on its own. If, however, it is large, if you are a smoker, or if you drink through a straw, you might need surgery. This will involve transplanting tissue from somewhere else in your mouth.

Wisdom tooth extraction near me

FAQ

Pulling a wisdom tooth usually takes about 45 minutes. The simpler the extraction, the quicker the procedure. Sometimes multiple teeth are pulled during one appointment, which can stretch the process out.

Surgical extractions that require removing bone and stitching take the longest. Nonetheless, if the patient is not put under general anesthesia, he or she should be able to leave the office within 2 hours.

After your procedure, keep up a soft diet for at least 2-3 days. Great foods to eat after wisdom teeth removal include bread, canned fruit, ice cream, and smoothies.

Avoid anything hard or sticky. Drink plenty of fluids but not through a straw. On the third day you may want to include eggs or meat into your diet. Two weeks later you can eat whatever you want, including hard, crunchy, and sticky snacks.

This procedure is considered to be one of the more unpleasant ones at the dental office. Wisdom teeth removal pain can continue for days after your visit at dental office. Most extractions are surgical and require an incision in the gums. This irritates nerve endings and the result is soreness.

You are likely going to need OTC painkillers to decrease post-op discomfort. Your dentist will provide you with instructions as per how to take them. If you still feel pain after 10 days, you may have to come in for a checkup.

Roughly 85% of wisdom teeth should be extracted to avoid complications. Those include significant swelling and pain, bad breath and taste, damage to other teeth, and accesses.

It’s best to remove troublesome teeth as soon as they start acting up. This can make the process easier. What’s more, the older you are, the more complicated the procedure might be.

References

  1. The Prophylactic Extraction of Third Molars: A Public Health Hazard - NCBI
  2. Microsurgical repair of the inferior alveolar nerve: success rate and factors that adversely affect outcome - PubMed
  3. Complications of Third Molar Surgery - ScienceDirect