Wisdom Tooth Removal

What Are Wisdom Teeth?

Wisdom teeth (third molars) are the four permanent adult teeth located in the back of your mouth, the teeth furthest away from your front teeth. They typically erupt during the late teenage years or early adulthood, which is why they’re called “wisdom” teeth. 

Why Do Wisdom Teeth Need to Be Removed?

When wisdom teeth come in, they often don’t have enough space to erupt fully. This can cause them to become impacted, meaning they’re stuck within the jawbone and gums, or grow out at odd angles and can cause a whole host of problems. 

Some common issues associated with wisdom teeth include: 

• Jaw pain: Jaw pain from wisdom teeth is often caused by the teeth pushing against adjacent teeth and causing discomfort. 
• Infection: If not removed, wisdom teeth can cause infection in the gums and other oral tissues. The most common is pericoronitis, an infection of the gum tissue around the crown of the tooth that can lead to painful swelling, redness, and even fever.
• Damage to adjacent teeth: The pressure from impacted wisdom teeth can lead to damage or misalignment of nearby teeth. If there is insufficient space to clean the area around a wisdom tooth, the second molar directly in front could be negatively impacted. The lack of space can lead to gum disease, bone loss, and decay around the tooth. 
• Cysts and tumors: Cysts and tumors are enlargements that form around the wisdom tooth. If left untreated, these cysts or tumors can damage your jawbone, teeth, and even nerves. 
• Overcrowding: Wisdom teeth can cause overcrowding in your mouth, making it difficult to clean and care for all of your teeth properly. Wisdom teeth can push adjacent teeth together, creating an environment where bacteria and plaque can build up. 

When these problems are left untreated, they can become serious oral health issues. That’s why it’s important to have wisdom teeth evaluated regularly and, when needed, removed.

Benefits of Removal

Benefits of wisdom teeth extraction include improved oral hygiene, decreased risk of infection and damage to adjacent teeth, and reduced discomfort. Patients who have their wisdom teeth removed also report:

• Less jaw pain
• Fewer headaches
• Better alignment of their other teeth
• Improved ability to chew and speak

Preparing for Removal

You will discuss your medical history with your oral surgeon at your consultation. Be sure to tell them about medications you take regularly and pre-existing conditions. Your doctor will give you pre and post-surgical instructions. Please read and follow them carefully. 

If you are receiving I.V. sedation or general anesthesia, you must:

• Arrange for a ride home after the surgery 
• Have a light supper and refrain from eating or drinking anything after midnight  

The morning of surgery:

• You may take prescription medications with a very small sip of water (oral surgeon approval required)
• Do not eat or drink anything
• Wear comfortable clothing
• Remove jewelry
• Do not wear makeup or lipstick 
• Do not wear contact lenses
• Remove dark/opaque finger nail polish

The Removal Procedure

Before the procedure begins, you will receive a local anesthetic, IV sedation, or nitrous oxide if required.

The removal process generally takes between 30 minutes to an hour, depending on how many teeth are being removed and the complexity of the surgery.

The surgeon will use specialized tools called elevators and forceps, to remove the tooth from the socket. Some teeth require sectioning before being removed, meaning the surgeon cuts the tooth into sections to make it easier to remove them. If your teeth are impacted, the surgeon will make a small incision in the gum to gain access. The gum tissue will be closed with sutures following extraction. 

Recovery

Feeling some pain and discomfort after the procedure is normal, and it will likely take a few days before you feel back to normal. You can expect swelling in the days following surgery and may also experience bleeding from the surgery site. If this occurs, bite down on a piece of gauze for 30-45 minutes. If bleeding persists, change the piece of gauze and bite down for an additional 30-45 minutes. To minimize swelling, place an ice pack to the outside of your face for 20 minutes at a time, 20 minutes on, and 20 minutes off. 

You should eat a soft diet for 3 to 4 days after surgery, eat regular meals throughout the day, and drink plenty of water. Your oral surgeon will also provide further instructions on caring for your mouth after the surgery, including when it is safe to resume normal activities such as brushing and flossing. Contact your oral surgeon immediately if you experience any signs of infection, such as fever, severe pain, or swelling. 

What Are the Risks?

Though serious complications are rare, there are risks associated with wisdom tooth removal, including infection, nerve damage, and dry socket. 

Dry socket occurs when the blood clot at the extraction site gets dislodged, and the socket then becomes exposed to air, food, and bacteria. To avoid dry socket, you must not use a straw or spit for at least 48 hours after the surgery. 

Smoking after surgery also increases the risk of complications. To minimize risk, you must follow your oral surgeon’s instructions before and after the procedure.

Frequently Asked Questions