Wisdom Tooth Removal

Wisdom tooth extraction is a surgery to remove one or more wisdom teeth. Wisdom teeth are the four adult permanent teeth located at the back corners of your mouth at the top and bottom.

Wisdom teeth, or third molars, are the last permanent teeth to appear in your mouth. These teeth usually appear between the ages of 17 and 25. However, some people do not get wisdom teeth. For others, wisdom teeth appears normally just like their other molars with no issues.

But many people develop impacted wisdom teeth. If a wisdom tooth doesn’t have enough room to grow, we call it as an impacted wisdom tooth. Impacted wisdom teeth may or may not erupt at all.

  • It could give you pain, infection, or other dental problems such as

    • Trapping food and debris behind the wisdom tooth
    • Infection or gum disease (periodontal disease)
    • Tooth decay in a partially erupted wisdom tooth
    • Damage to a nearby tooth or surrounding bone
    • Development of a fluid-filled sac (cyst) around the wisdom tooth
    • Complications with orthodontic treatments to straighten other teeth

Most of the times you may need to have it pulled out. Extraction of wisdom teeth can be performed by a dentist or oral surgeon. To avoid possible future problems, some dentists and oral surgeons recommend the extraction of wisdom teeth even if the impacted teeth are not currently causing problems.

We cannot recommend the value of extracting impacted wisdom teeth that aren’t causing problems (asymptomatic). Because, it’s difficult to predict the future problems with impacted wisdom teeth. Even though it is not painful, it could still harbor disease. If there isn’t enough space for the tooth to erupt, it’s often hard to get to it and clean it properly. Serious complications with wisdom teeth happen less often in younger adults. Older adults may experience difficulty with surgery and complications after surgery. Therefore, we can advise you to do it as much earlier in your life.

Most wisdom tooth extractions don’t result in long-term complications. However, removal of impacted wisdom teeth requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:

  • Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
  • Infection in the socket from bacteria or trapped food particles
  • Damage to nearby teeth, nerves, jawbone or sinuses

We do perform the procedure in the Cayo Dental office located at Kandy. If your tooth is deeply impacted or if the extraction requires an in-depth surgical approach, you will be treated by our Oral and Maxillofacial surgeons. In addition to making the area numb with local anesthetic, we may suggest sedation to allow you to be more comfortable during the procedure.

  • You may want to ask

    • How many wisdom teeth need to be removed?
    • What type of anesthesia will I receive?
    • How complicated do you expect the procedure to be?
    • How long is the procedure likely to last?
    • Have the impacted wisdom teeth caused damage to other teeth?
    • Is there a risk that I might have nerve damage?
    • What other dental treatments might I need at a later date?
    • How long does it take to completely heal and return to normal activity?

A wisdom tooth extraction is almost always performed as an outpatient procedure. This means that you go home the same day. You’ll receive instructions from our staff on what to do before the surgery and the day of your scheduled surgery.

The following things are important to keep in mind.

If you want you can make arrangements for someone to drive me home after the procedure. If not our staff will drive you to your home safely.

You are supposed to arrive at the clinic at least 30 mins prior to your appointment. You don’t need to avoid eating food or drinking fluids. That means no need of fasting. However, sometimes we may ask you to take some prophylaxis medicines before the surgery. You can have most of your regular medication before the surgery. However, we may advise you to stop certain drugs which may cause excessive bleeding or such other problems with your surgery. Therefore, do not forget to inform us about all your medical problems and drugs you are having at your first visit with us.

We may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level.

Local anesthesia. We may administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, we will likely apply a gel or spray to your gums to numb them. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.

Sedation anesthesia. In some conditions, we may give you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don’t feel any pain and will have limited memory of the procedure. You’ll also receive local anesthesia to numb your gums.

General anesthesia. In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Our surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You’ll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.

  • During wisdom tooth extraction, we do the following steps:

    • Makes an incision in the gum tissue to expose the tooth and bone
    • Removes bone that blocks access to the tooth root
    • Divides the tooth into sections if it’s easier to remove in pieces
    • Removes the tooth
    • Cleans the site of the removed tooth of any debris from the tooth or bone
    • Stitches the wound closed to promote healing, though this isn’t always necessary
    • Places gauze over the extraction site to control bleeding and to help a blood clot form

If you receive sedation anesthesia or general anesthesia, you’re taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.

As you heal from your surgery, follow the instructions below on:

  • Bleeding.

    Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed.

  • Pain management.

    We will be prescribing required pain killers to you depending on your condition.

  • Swelling and bruising.

    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. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink 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 or applesauce, 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.

    Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you’ll 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.

    If you smoke, don’t do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it 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, we will schedule an appointment to have them taken out.

Call us at any time if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:

  • Difficulty swallowing or breathing
  • Excessive bleeding
  • Fever
  • Severe pain not relieved by prescribed pain medications
  • Swelling that worsens after two or three days
  • A bad taste in your mouth not removed with saltwater rinsing
  • Pus in or oozing from the socket
  • Persistent numbness or loss of feeling
  • Blood or pus in nasal discharge

You probably won’t need a follow-up appointment after a wisdom tooth extraction if:

  • You don’t need stitches removed
  • No complications arose during the procedure

If complications develop, contact us to discuss treatment options.

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