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Overview When is wisdom tooth removal recommended? Procedure Complications Care at Medicover Hospitals Frequently Asked Questions

Wisdom teeth are also called third molars. Your wisdom teeth grow at the back of your gums and are the last teeth to come in your mouth. Wisdom teeth are the most neglected teeth because they are the last ones to erupt and the area is also difficult to clean.

Most people have 4 wisdom teeth, one in each corner. They tend to come through in the late teens or twenties. Sometimes, wisdom teeth do not come through fully (partially erupt) and get stuck (impacted) against nearby teeth or bone.

The most common problems with wisdom teeth are cavities and swelling of gums around them. Wisdom teeth are removed to avoid food and plaque deposits that lead to infection. Bacteria residing in and around wisdom teeth may contribute to systemic health problems including diabetes, heart disease, kidney disease and other health problems.

wisdom-tooth-removal

When is wisdom tooth removal recommended?

Wisdom teeth removal is recommended in the following conditions

  • Swelling
  • Pus discharge
  • Repeated history of pain and discomfort
  • Cavities in the wisdom teeth
  • Tooth positioned in an angulated manner which is likely to cause problems
  • Tooth is close to the nerve
  • Localized gum infection
  • Damage to adjacent teeth due to angulated position
  • Any numbness noticed on the wisdom tooth region or over the skin
  • Any cysts or tumors below the tooth
  • Obstruction of placement of complete or partial denture
  • Sinus pain and nasal congestion

Procedure

Before the Procedure

  • Before the wisdom tooth removal, your dentist will review and understand your medical and dental history
  • Dental x-rays (Intraoral periapical and Orthopantomograph) are taken that reveal the length, position and shape of the tooth and surrounding area of bone
  • In case of a complicated situation, your dentist may refer you to an oral and maxillofacial surgeon

During the Procedure

  • Your dentist will anesthetize your mouth with a shot of local anesthesia in the surgical field
  • An incision is made in the gum to visualize the tooth
  • The bone covering the tooth is removed until the crown portion of the tooth is exposed
  • The tooth is loosened using forceps and removed
  • If the tooth has two roots, the roots may be separated and then removed
  • The wound is irrigated with normal saline to remove the minute tooth and bone debris
  • The edges of the socket and site of bone removed are smoothened using bone files
  • The wound is closed with stitches which may either be dissolved or need to be removed by the surgeon after one week

After the procedure

  • Cotton is placed at the wound site and the patient is instructed to bite hard on it to minimize bleeding and promote healing
  • You should remove the cotton after an hour
  • You can use an ice pack on the side of your face for the first 24 hours

Post Operative Instructions

  • You should not rinse or spit for 24 hours after surgery
  • Keep tongue and fingers away from the socket or surgical site
  • Drink plenty of fluids
  • Take painkillers and antibiotics as prescribed by the doctor
  • After the first postoperative day, use salt water to rinse your mouth and flush out food debris lodging in the surgical area
  • Avoid eating from the tooth removal side and eat with the other side
  • Your diet must consist of soft foods. Do not consume spicy food items
  • Do not smoke for at least 1 week after surgery
  • Gently open and close your mouth to avoid reduced mouth opening

Complications

Wisdom tooth removal carries a small risk of complications. These may include:

  • Dry socket
  • Pain
  • Swelling
  • Paresthesia
  • Trismus

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Frequently Asked Questions

1. Do wisdom teeth need to be removed?

It depends on the path of eruption of wisdom tooth. In many instances, the mouth does not have enough space causing crowding of teeth. In such cases, the wisdom teeth need to be removed.

2. Is wisdom tooth extraction painful?

Your wisdom tooth and the region around it are numbed before the procedure. So the wisdom tooth removal is not painful. You may feel pressure when your dentist is removing the tooth but not pain. Once the procedure is complete, you will be given pain killers that begin acting before your numbness wears off.

3. What is the best age for removal of wisdom teeth?

Depending on the condition of your teeth, people of any age can have their wisdom teeth extracted. However the preferred age is between 18 to 24 years, when the root has developed to about two-thirds of its full size.

4. What are dry sockets?

Dry sockets arise due to premature loss of blood clot in the empty tooth sockets. It is the most common problem experienced by patients following wisdom tooth surgery. This is more likely in individuals who take birth control pills or smoke.

5. What is the treatment of dry socket?

As part of the treatment, a medicated dressing is placed in the empty tooth sockets. This helps relieve pain and protects the socket from food particles.

6. Is Wisdom Tooth Removal surgery painful?

Mostly not. You will be injected with local anaesthesia to numb the surgical site, so you may not feel any pain. There may be slight pain and discomfort after the procedure.

7. When can I get back to my routine activities?

You get back to your routine activities in about 2 to 48 hours.

8. Is it safe to brush my teeth after the extraction?

Remember to avoid brushing your teeth and gargling for the first 24 hours to heal faster. After a day, you may resume brushing your teeth but be gentle around the surgical site.

9. What do I do if it bleeds?

The first thing to remember is, there may be some minor bleeding for the first day or so. If you notice bleeding, do not rinse but instead apply pressure to the socket for at least 15 minutes by firmly biting on a clean cotton. If the bleeding hasn't stopped after an hour or two, call your dentist right away.

10. What is the difference between wisdom tooth removal and simple extraction?

Wisdom teeth often grow in an angulated position. Extraction may require making a cut in the gum to allow access to the tooth and remove it properly whereas simple removal is typically used when you can actually see the tooth in your mouth and remove it relatively quickly and easily.

Citations

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/wisdom-teeth
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/wisdom-teeth-extraction
https://www.mountsinai.org/care/ent/services/oral-maxillofacial-surgery/treatments/wisdom-tooth-extraction