Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
How Do I Know if I Have Wisdom Teeth?
Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon for further evaluation.
Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.
How Are Wisdom Teeth Removed?
The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position and stage of development. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Often, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
The following four impactions are commonly found in patients :
- Bone Impaction (Vertical) :
Impaction would cause pathosis inside the cheek bone or jaw bone.\
- Bone Impaction (Horizontal) :
Besides leading pathosis, horizontal placement would hurt the hard tissue of the second molar to cause toothache and cavities.
- Bone Impaction (Angular) :
Besides leading pathosis, angular placement would hurt the hard tissue of the second molar to cause toothache and cavities.
- Tissue Impaction :
The wisdom tooth almost erupts out of gum, or its half erupts out of gum to cause pseudo-pocket. Besides leading pathosis, it easily tracts food debris and causes gum irritation.
What Happens During Wisdom Teeth Removal?
Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic — the same type used to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative is desired to control any anxiety.
During the first 24 hours
- Bleeding may occur for several hours after tooth extraction. To control it, position a piece of clean moist gauze over the empty tooth socket and bite down firmly. Apply constant pressure for about 45 minutes. A moistened tea bag is an effective alternative. The tannic acid in tea helps healing blood clots to form (blood clots function similarly to scab over an open wound). Repeat this process if a small degree of bleeding continues; if heavy bleeding continues to occur, contact your dentist or oral surgeon.
- Facial swelling in the area where the tooth was extracted typically occurs. To minimize swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a schedule of 10 minutes on, followed by 20 minutes off. Repeat as necessary during this first 24-hour period.
- Pain medications, such as acetaminophen or ibuprofen, can be taken for minor pain. Your dentist or oral surgeon may prescribe more potent pain relievers, if necessary.
- Antibiotics that may have been prescribed prior to tooth extraction (to treat any active infection around the wisdom tooth to be extracted) should continue to be taken until the full prescription is gone.
- Foods should be restricted to a liquid diet until all the numbness from anesthesia has worn off. Eat soft foods for a few days. Also avoid alcohol if you’re also taking narcotic pain medication.
- Continue to brush your teeth, but avoid the teeth directly neighboring the extracted tooth during the first 24 hours. On day two, resume the gentle brushing of your teeth. Do not use commercial mouth rinses — these can irritate the extraction site.
After 24 hours
- Facial swelling in the area of the tooth extraction should be treated with heat after the first 24 hours of ice. Apply a moist warm towel to the area on a 20-minute on, 20-minute off schedule. Repeat as necessary. Keep in mind that swelling usually peaks 2 to 3 days after the procedure.
- Rinse your mouth with warm salt water (1/2 teaspoon of salt in a cup of warm water) after meals and before bed. Do not use commercial mouth rinses unless your dentist directs you to.
- Stitches, if used and if not of the self-dissolving type, need to be removed by your oral health care provider in about 1 week. If you do require stitches, ask what type you have been given.
- Watch for signs of dry socket (described below). This condition requires treatment by your oral health care provider.
- Complete healing doesn’t occur for a few weeks to a few months following the extraction. However, usually within the first week or two, enough healing has taken place for use of your mouth to be reasonably comfortable in the area of the extraction. Your dentist will explain what to expect in your specific case.
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