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
There are five main indications for extraction:
- the tooth is growing at a wrong angle,
- there is no room for the tooth,
- the growth of the tooth is causing crowding,
- caries or gum disease are present (it’s hard to clean the area), or
- the tooth is impacted.
About 85% of all wisdom teeth will eventually have to be extracted. Unfortunately, there isn’t much you can do about it, especially if you have already started feeling wisdom teeth pain. What’s more, the older you are, the more challenging it may be to pull them. Your best bet is to do it as soon as possible.
If you don’t have them removed you can possibly expect: - considerable swelling, tenderness, and pain, - bad breath or bad taste, - cysts, especially with impacted teeth, and - damage of neighboring gums, teeth, and bone.
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:
The tooth is not impacted at all. It has broken through the gums and is fully visible. This is a pretty straight-forward case, similar to a regular extraction.
Reasons for extracting an erupted wisdom tooth are usually overcrowding or other orthodontic aspects.
The procedure of removing an erupted wisdom tooth may take around twenty minutes. This means that only a small amount of anesthetic will have to be used.
An erupted wisdom tooth may be removed by a family dentist. More complicated cases might be referred to a specialist, most commonly an oral surgeon.
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.
This means that the tooth is partially locked in the jaw. Bone will have to be broken. If left unextracted, you are looking at high chances of swelling, pain, and oral infections.
It is likely you may need sedation. The longer the procedure, the more anesthesia you will need.
When the tooth is completely stuck in the jaw, the process of removing it is necessary.
Unfortunately, this is also the most complicated situation. A hole will have to be made in the bone and the tooth will probably be cut up into smaller parts. It is best to be sedated during this procedure. This can drive up the cost significantly.
How to prepare for wisdom teeth surgery
There are a couple of things you will need to do before the extraction. Discuss the state of the wisdom tooth you have with your dentist. A simple extraction doesn’t require a lot of preparation. Just make sure to have a big breakfast, as you won’t be able to eat for a while afterwards.
In the case of more invasive procedures, such as impacted wisdom teeth removal, there are a couple things you have to remember about. First of all, you will need to make sure you have a way of getting back home. Certain types of anesthesia make you drowsy and it could be unsafe to drive.
Ask your dentist what kind of sedation he or she plans to use. If necessary, get in touch with somebody who could assist you since you might not be able to drive home on your own.
Depending on the anesthesia, you might also have to fast for some time before your procedure to avoid nausea. You might even have to stop eating the day before. Also, make sure to ask your dentist whether you should continue taking your regular medication if you do take any.
The procedure of wisdom tooth removal
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.
Disintegration of the tooth
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
It usually takes up to a week to recover from wisdom tooth extraction. Such a time frame assumes that there are no complications and that healing goes as planned.
The best way to avoid issues and make healing smooth, is adhering to aftercare instructions.
When you leave the office keep slight pressure on the gauze pad. If you only had a local anesthetic you might be able to return to work or your daily activities. Make sure to eat soft foods, or even maintain a liquid diet that day.
Do your best to follow these wisdom teeth removal recovery tips:
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’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.
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
Wisdom tooth extraction can be complicated. Sometimes things go wrong. In such cases, you might have to visit an emergency dentist. Ignoring worrisome symptoms of a wisdom tooth could lead to complicated repercussions.
Below we have described a few of the most common cases linked to third molar extraction.
Alveolar osteitis (dry socket)
Those who are smokers, have experienced dry socket before, or who are over the age of twenty-five are at a higher risk of developing this condition. It is also likely if the extraction was complicated.
Dry socket means that the blood clots which are supposed to form in the place where the tooth was have become dislodged or disintegrated. The bone might become exposed. This can put you in danger of infection.
The symptoms include a dull or throbbing pain in the gum or jaw, a bad smell or taste, and numbness on the side of the face. You might not feel anything immediately after the extraction. The discomfort will develop over three to five days.
If this happens make sure to go back to your dentist. They will cover the hole with a medicated dressing.
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.
Paresthesia (temporary or permanent nerve damage)
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.
Hemorrhage (heavy bleeding)
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.
Sinus cavity perforation
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
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How long does wisdom teeth removal take?
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.
What to eat after wisdom teeth removal?
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.
How long does pain after wisdom tooth extraction last?
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.
What happens if I don't get my wisdom teeth pulled?
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.