Wisdom Teeth Removal Guide

Wisdom Teeth Removal Guide
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Wisdom Teeth Removal GuideClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Why Remove Wisdom Teeth?
  2. Signs
  3. Preparing for Surgery
  4. Removal Procedure
  5. After Surgery
  6. Self-Care Tips
  7. Dry Socket
  8. Risks
  9. Frequently Asked Questions
  10. References

Wisdom teeth, or third molars, are the last teeth to grow into place during normal human development. For most people, eruption – the dental term for a tooth coming in – happens between the ages of 17 and 25.

Because they come in so late in life compared to other primary teeth, wisdom teeth often do not have the space they need to fully emerge from the gums. When they arrive in a mouth that is already crowded with other teeth, wisdom teeth can damage the other teeth, gums and bone around the new teeth.

The location of wisdom teeth, all the way in the back of the mouth, also makes them difficult to keep clean. That, in turn, makes them more prone to cavities.

If your wisdom teeth are causing problems for you, they can be removed through oral surgery. This procedure is very common and easy to recover from if you follow your surgeon’s directions.

Why Are Wisdom Teeth Removed?

Dentists remove wisdom teeth when they are causing problems in your mouth or if they are likely to do so in the future.

Because of crowding or because of the size of your jaw, your wisdom teeth may tilt at odd angles inside the jawbone. Such leaning can prevent the wisdom teeth from rising fully above the gumline like the rest of your teeth.

Instead, they may stay mostly beneath the gums and push against the teeth closest to them, becoming impacted. Pain and tooth damage can follow.

Even if your wisdom teeth have enough room to erupt fully, you may find it hard to keep them clean enough to avoid decay. Your toothbrush and floss may not easily reach the back of your mouth, and you may miss some spots in that area during your oral hygiene routine. Pieces of food may get trapped between your wisdom teeth and your second molars, making tooth decay even more likely.

If your wisdom teeth develop cavities, your dentist will likely want to extract them and not fill them. Removal is also an option if the dentist thinks the new teeth are already showing signs of decay from cavities.

Signs It Is Time to Have Your Wisdom Teeth Removed

Any of the following signs may indicate that your wisdom teeth need to be removed:

  • Pain in the back of your mouth
  • Trapped food around or behind your wisdom teeth
  • Signs of infection or gum disease around the teeth
  • Damage to the teeth or bone around your wisdom teeth
  • The presence of a cyst (a fluid-filled sac) around one or more of your wisdom teeth
  • A new and unpleasant taste or smell in your mouth
  • Difficulty opening your jaw
  • Lack of space in your mouth for tooth realignment using orthodontics

Sometimes dentists also recommend removing asymptomatic wisdom teeth to prevent future dental problems.

If you are experiencing any of these symptoms, make an appointment with your dentist. They will examine your mouth to determine if your wisdom teeth pose a problem or if they show signs of decay.

They will also take X-rays to pinpoint the positioning of the wisdom teeth under your gums and check for signs of structural damage.

Preparing for the Surgery

Should your dentist want to remove your wisdom teeth, there are things you can do to prepare for it. Educate yourself about the procedure, gather the names and doses of all the medications you take and line up transportation to and from the dentist’s office.

Learn about Wisdom Teeth Removal
Be certain that you understand exactly what will happen during your surgery, as well as the risks involved. If you are not sure about any aspect of the procedure, ask your surgeon about it before the day of procedure arrives.
List Out Your Medications
Give your oral surgeon a list of all medications you are currently taking, including any natural supplements. Some medications (such as blood thinners) can make wisdom tooth surgery significantly more dangerous. Your surgeon may direct you to stop taking these for a few days before your procedure.
Find a Ride Home
Arrange for someone to take you home after your surgery. Because the anesthesia that will be used during the procedure, it will not be safe for you to drive yourself or use public transit. If no friends or family are available, you will have to wait in your oral surgeon's office until the anesthesia wears off.

The Removal Procedure

Before your surgery, your dentist will explain the procedure to you in detail, including all risks involved. They will also give you a list of instructions to follow once you get home from the procedure. They should include any special instructions you must follow because of your unique health profile. (For example, you may have to avoid blood thinners for several days post-procedure.)

Sedative
If you are anxious about your wisdom tooth surgery, your surgeon may give you an oral sedative prior to your procedure. This will make it easier for you to tolerate the surgery.
Getting to the Tooth or Teeth
Your surgeon will begin the procedure by establishing clear access to one of your wisdom teeth. Depending on how much of your tooth is visible, your surgeon may make a small incision in your gums to access the tooth. If the tooth is fully impacted, they may also remove a small piece of your jawbone.
Removing the Tooth

Once the tooth has been exposed, your surgeon will firmly grasp it using special tools and rock it back and forth in its socket. This loosens the socket and prepares the tooth for extraction. You may feel some pressure during this part of the procedure, but you should not feel any pain.

Your surgeon will then begin to remove your wisdom teeth from your jaw. Because wisdom teeth are very large, many surgeons use a drill to divide the tooth into pieces first. This makes it easier for them to get the tooth out without damaging the surrounding tissues.

Cleaning the Socket

Finally, your surgeon will clean the extraction site, which is now an empty socket, and stitch it closed if needed. They will also place a piece of gauze over the site to soak up some of the blood and promote faster healing.

This process is repeated as many times as necessary. Some people only get some of their wisdom teeth removed, but it is more common to have all four removed at once.

After Surgery

Immediately after your wisdom tooth surgery, you should have a clear plan of action. It is this:

  • Rest. Avoid strenuous or stressful activity for a few days, taking extra time to sleep if you need to.
  • Take your medication as prescribed. If you miss a dose, it will be much more difficult to control the pain later one.
  • Take the full course of any antibiotics your doctor prescribes. Do not stop taking your medication early even if you are feeling better.
  • Call your oral surgeon if you have issues. You may experience excessive bleeding, tear your stitches or develop sign of infection (fever, swelling or pus).

In addition, there are a few things you should not do while you are recovering. Do not:

  • Drive. You should not attempt to drive or operate heavy machinery right after your wisdom tooth surgery. You will either be in pain or you will have painkillers in your bloodstream. Both can affect your judgement.
  • Touch the extraction sites with your fingers or tongue. It will be tempting to feel the emptiness. Resist that urge. The best thing you can do is let healing happen without any intervention.
  • Exercise or do anything strenuous. The last thing you want to do after having your wisdom teeth removed is get your heart racing and increasing your blood flow. You could dislodge the blood clots that have formed over your empty tooth sockets. Instead, lay low and rest. Enjoy the break that your dentist has mandated.
  • Use heat to soothe your pain. Heat will only increase your bleeding and may make your pain worse.
  • Smoke or drink alcohol. Both will make it harder for your extraction sites to heal.

Tips for Self-Care

There are several things you can do at home to make yourself more comfortable and speed the healing process after your surgery. Give yourself time to heal.

Take 1 or 2 Days Off Work or School

Many – if not most – adults have had their wisdom teeth pulled, and they understand the bleeding, pain and swelling that comes with the procedure. Bosses and teachers will understand about your need to take time away.

Besides, odds are you will experience swelling in your face and jaw, and you may not like what you see in the mirror for a few days. You may want to stay home and letting the swelling subside.

Keep Saltwater on Hand

Rinse your mouth gently with warm salt water several times a day. This will disinfect your extraction sites.

Drink Plenty of Fluids

Drinking copious amounts of water will keep your body hydrated and speed your healing.

Use Ice Packs

If you are experiencing pain, apply an ice pack or cold compress to your jaw for up to 20 minutes at a time.

What Is Dry Socket and How Can You Avoid It?

Dry socket is an extremely painful condition that occurs when the blood clot that forms over your newly empty tooth socket gets dislodged. This is most likely to happen in the 3 to 5 days immediately following your surgery.

  • Do not drink through a straw for at least one week after your wisdom tooth surgery. The suction could dislodge the blood clot at your extraction sites.
  • Eat only soft foods for the first few days after your surgery. When you feel ready, reintroduce semi-hard foods like chicken, fruit and rice. Avoid hard or sticky foods for at least two weeks and try not to chew too close to your extraction sites.
  • Do not smoke. Smoking slows the healing process and can disrupt clot formation.
  • Clean your mouth carefully. Brush your teeth as usual but be gentle around each extraction site. If you use salt water or antibacterial rinses, spit the rinse out slowly when you are done.

Risks and Potential Complications

Some potential complications of wisdom tooth removal include:

  • Dry socket
  • Infection around the extraction site
  • Excessive bleeding
  • Nerve injury in the face or head. This can lead to tingling, numbness, or loss of function. These problems are usually temporary but sometimes they are more serious. Either way, have it checked.

Frequently Asked Questions

How long does it take to recover from wisdom tooth removal?
It takes most people around 2 weeks to fully heal from wisdom tooth removal surgery. You should begin to feel significantly better in 2 to 3 days.
Is wisdom tooth removal painful?
You will feel some mild to moderate pain for a few days following your surgery. If your pain lasts any longer than that, you may have developed complications that will require additional care from your dentist.
What are some do’s and don't's after wisdom tooth removal?

After you get your wisdom teeth removed, do:

  • Take time to rest and let your body heal.
  • Take your medications as prescribed.
  • Keep your mouth and your extraction sites clean.
  • Stick to soft foods.

Do not:

  • Fiddle with your stitches or the extraction site.
  • Use a straw.
  • Take aspirin for your pain. It will thin your blood and make it harder for a clot to form.
  • Smoke. It will make it harder for your mouth to heal properly.

References

Dry socket. (January 2017). Mayo Clinic.

Impacted wisdom teeth. (March 2018). Mayo Clinic.

Wisdom tooth extraction. (January 2018). Mayo Clinic.

Tooth Extraction: Care Instructions. (October 2020). Alberta Health Services.

Wisdom Tooth Extraction. (March 2020). HealthLink BC.

Overview: Wisdom Tooth Removal. (May 2021). National Health Service (NHS).

Procedures: Wisdom Teeth. (2022). Canadian Association of Oral and Maxillofacial Surgeons.

Wisdom teeth removal: When is it necessary? (December 2016). Mayo Clinic.

Wisdom Teeth Extraction. (2022). Johns Hopkins Medicine.

Wisdom Tooth Extraction. (October 2020). University of Michigan Health.

Wisdom Teeth Extraction: What to expect after the operation. (2022). The Royal College of Surgeons of England.

Wisdom Teeth. (2022). MouthHealthy.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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