A Wisdom Tooth Extraction is a routine surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth that are the last to erupt at the back of your mouth. If a wisdom tooth does not have room to grow, it is considered an “impacted wisdom tooth,” and this can result in pain, infection, or another dental problem. They present between the ages of 17 – 25, and often cause discomfort due to lack of room in the jaw or angle of entry.

We use X-rays to carefully assess the problem and, if necessary, plan for extraction. Wisdom teeth are usually easier to remove at a younger (17-25) age because there is a greater probability that the roots have not fully developed and the bone surrounding the teeth is typically less dense.

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Problems with Impacted Wisdom Teeth Include:

• Pain

• Trapping of food and debris behind and around the wisdom tooth

• Infection or gum disease (periodontal disease)

• Tooth decay in a partially exposed wisdom tooth

• Damage to a nearby tooth or the surrounding jaw bone

• Development of a fluid-filled sac (i.e. cyst) around the wisdom tooth

• Complications with orthodontic treatments and the shifting of teeth

 

Is Wisdom Teeth Removal Really Necessary?

It depends. We evaluate every patient on an individual basis to determine how the presence of your wisdom teeth are affecting your oral health. If you have wisdom teeth that are causing dental problems, our team will discuss the benefits of removing them.

If you have impacted wisdom teeth that are not causing dental problems (asymptomatic), we will discuss the pros and cons of preventive extraction. In either case, the decision is ultimately up to the patient.

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Can’t I just wait until my wisdom teeth hurt?

You can, but there are important benefits to removing your wisdom teeth while you are in the ideal age range(17-25) that you should be aware of:

1. Younger adults usually do not have fully formed wisdom teeth, which makes them easier to remove

2. Younger adults tend to heal and recover quickly

3. Older adults may experience more difficulty with surgery and complications after surgery.

 

What are the risks of the procedure?

Most procedures are routine and serious complications are not expected. Any problems that do happen are usually minor and can be treated. Complications can include:

• Pain, swelling, limited mouth opening, bleeding - these are all normal and improves after the first few days

• Bruising

• Infection

• Dry socket

• Damage to adjacent teeth - especially those with large fillings or crowns

• Incomplete removal of tooth fragments - to avoid injury to important structures, such as nerves

• Sinus involvement - movement of upper tooth fragments into the sinus

• Jaw fracture - extremely rare

• Nerve injury - loss of feeling, a change in feeling, or pain in the lips, chin or tongue, caused by a wisdom tooth (usually a lower one) being close to a nerve.

  • If your panoramic X-ray shows that your wisdom tooth is close to a nerve, there is about a 20% risk of temporary injury (most heal within 6 months) and about a 2% risk of permanent injury.

  • When concerned about the location of the nerve, a 3D Xray can be taken to determine the precise proximity of the root/nerve.

 

Sedation Options to Address Dental Anxiety

A wisdom tooth extraction can be a stressful experience for many patients. We offer minimal conscious sedation and oral moderate sedation to relieve anxiety and improve patient experience.

1. Minimal sedation (Laughing Gas): Depending on the dose administered, this is a relaxed state where patients can walk, talk, and breathe normally. Patients are not asleep.

2. Moderate sedation (Twilight Sedation): This is a modestly deeper sedation. Patients will be able to talk and respond to questions but will feel more drowsy. Depending on the medications used, a patient may or may not remember the procedure.

 

We use sedation for various surgical procedures and provide instructions for eating and drinking before and after treatment. Following your appointment, patients will need to return home accompanied by a responsible adult. To ensure complete safety, you will be monitored throughout the entire procedure by our team.

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Wisdom Tooth Surgery Healing Time

The healing process after wisdom tooth removal surgery can vary from 7 to 10 days. Depending on the circumstances, brushing, eating, and other actions can be resumed the next day. A follow-up visit is scheduled with your dentist to assess and assist as needed with your recovery and address any post surgical concerns.

As you heal from your surgery, we recommend that you follow your dentist’s instructions on:

• Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you do not dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.

• Pain management. You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist. Prescription pain medication may be especially helpful if bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.

• Swelling and bruising. Use an ice pack as directed by your dentist. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.

• Activity. After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.

• Beverages. Drink lots of water after the surgery. Avoid alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Avoid drinking with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.

• Food. Eat only soft foods, such as yogurt, mashed potatoes, eggs etc. for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.

• Cleaning your mouth. Do not brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. You may be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.

• Tobacco use. Avoid smoke for so for at least 48 hours after surgery — and wait longer than that if possible. If you chew tobacco, avoid use for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.

• Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.