Wisdom Tooth Removal
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.
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
