Wisdom teeth are a bit of an evolutionary holdover. We don't use them anymore, and most of us have jaws that are too small to properly hold three sets of molars.
While not everyone needs to have their wisdom teeth removed, removing wisdom teeth is commonly needed to reduce crowding of other teeth. This is a routine minor surgery that rarely has complications and will greatly improve the health of your mouth.
How is Wisdom Tooth Removal Done
Typically, the dentist will start by taking an x-ray to establish whether the tooth is impacted and how best to remove it. Wisdom tooth removal is normally done under local anesthesia. General anesthesia is only typically recommended for a complicated removal or if the patient is extremely anxious and would not be able to handle being awake. Other options might include the use of nitrous oxide or oral sedation in addition to local anesthesia.
Non-impacted wisdom teeth can be extracted normally. If teeth under the gum line need to be removed, the dentist will make a small cut in the gum to access the tooth. Occasionally, they might have to cut into the bone.
What Happens Before the Surgery
As mentioned, you will get x-rays taken to see what is going on with your wisdom teeth and to prepare for the surgery. Your dentist will discuss options for anesthesia or sedation with you.
You will need somebody to come with you to the appointment if you are going to be receiving general anesthesia or a sedative, as it will not be safe for you to drive, nor will it be wise for you to attempt to navigate public transportation. Most people are a bit groggy for a while while they recover.
Your appointment will be scheduled for a convenient time. If you are getting intravenous anesthesia, wear a short sleeved shirt as your base layer and don't eat or drink anything six hours before the surgery. Let your dentist or oral surgeon know if you are on a blood thinner and avoid taking aspirin or Advil for a few days beforehand. Avoid tobacco and alcohol for at least eight hours.
What Happens During the Surgery
Wisdom tooth removal typically takes no more than 45 minutes, even if you are having all four wisdom teeth removed. You will be sedated if necessary and then receive a local anesthetic (this is done even if you are under general).
The tooth will be removed using special instruments. In some cases it may be cut into pieces to remove it more easily. Once it is out, the surgeon may stitch the incision and then you will be brought out of sedation and moved to a recovery room, where you will spend up to an hour. You will be given gauze to bite down on to help the socket form a blood clot, which can prevent certain complications.
What Happens After the Surgery
After the surgery, you should avoid the following for 24 hours:
- Drinking through a straw.
- Rinsing your mouth.
- Drinking alcohol.
- Using alcohol-based mouthwash
- Brushing the teeth next to the extraction site.
- Using an electric toothbrush, which can cause more damage if you accidentally brush the socket.
- Drinking hot liquids
- Strenuous physical activity
Full recovery typically takes up to 2 weeks, and generally you will have some swelling and a stiff jaw. It can also result in an unpleasant taste in your mouth. You may also experience some pain. Your dentist will recommend what painkillers to take as needed. Most people should be able to manage their pain with over-the-counter painkillers. Take a day or two off work if possible and do not drive for 24 hours if sedated or 48 hours if intravenous anesthesia was used.
For a few days after surgery you should:
- Use an extra pillow if possible.
- Eat only soft or liquid food and try to chew in the front of your mouth.
- Rinse with antiseptic mouthwash or warm water with a teaspoon of salt after eating.
Many people experience a stiff jaw for seven to ten days which may make eating certain foods, such as sandwiches, difficult. Plan for this when selecting meals. Also, your dentist or oral surgeon may put you on a precautionary 7 to 10 day course of antibiotics. Finish the course and avoid alcohol until you are off the antibiotics. Eating yogurt or taking probiotics afterwards can help your system rebalanced after antibiotics.
You should watch for common complications. The most common complication is dry socket, which happens if the blood clot that forms after surgery is dislodged, exposing bone and nerves. If you experience pain at the extraction site that lingers for more than a few days, you should get your dentist to check for this, which is typically treated with pain medication and flushing until the socket has healed. More rarely, infections can occur, hence the typical use of antibiotics.
Should You Have Your Teen's Wisdom Teeth Removed?
It is always better to have wisdom teeth removed before the age of 25. At this point, the roots have not fully formed, making the extraction much easier. Teenagers tend to heal faster and recover more quickly, with fewer complications.
You should talk to your dentist or oral surgeon about whether they recommend wisdom tooth removal and when it should be done. If your dentist or oral surgeon recommends removal, it should be done even if the wisdom teeth are not impacted or causing other problems. Wisdom teeth are hard to clean and often develop decay which can then spread to the other teeth.
Be aware that not everyone has wisdom teeth. Your child may be amongst the lucky third of people that don't develop them at all. X-rays should be taken to establish whether wisdom teeth are not present or impacted such that they can't erupt (requiring more complicated surgery).
What About Wisdom Tooth Removal as an Adult?
Your wisdom teeth can be removed at any age, but it is a harder procedure and more likely to result in complications. Additionally, many people who seek wisdom tooth removal in adulthood are those who are experiencing issues caused by them.
However, the procedure is still simple, although it may take slightly longer. In some circumstances, we may recommend removing the adjacent molar and replacing it with an implant if the teeth are too entangled or if it has developed severe decay.
Some adults may have a cyst next to the impacted tooth which also needs to be removed. Larger cysts may need specific treatment, called marsupialization.
Most people should have their wisdom teeth removed, and you should talk to your dentist or oral surgeon about it regardless of your or your child's age. Removing wisdom teeth reduces decay in the back of the mouth and prevents crowding of the other teeth, which can cause issues.
Wisdom tooth removal is a simple procedure, and you can always request sedation or intravenous anesthesia if you are particularly nervous.
If you need to talk about wisdom tooth removal for you or your child, North Shore Smile Surgery can help. We offer exceptional oral surgery with thirty years of experience combined with the latest dental technology. We perform the procedure in house, rather than sending you to a hospital, and we will follow up and make sure that you are healing well and never have to worry about wisdom tooth related issues again. Book an appointment with us today!