Wisdom teeth

Wisdom teeth are the third and final set of molars that emerge, usually during your late teens to early twenties. For some people the wisdom teeth emerge through the gums and have enough room to grow in naturally. These are rudimentary teeth that do not participate in the chewing process and have less then 5% of occlusal load.

Wisdom teeth problems

For most people, wisdom teeth often cause problems as they are trying to protrude through the gums.Erupted wisdom teeth are proven to cause crowding of lower anterior teeth and causing significant periodontal problems of 2nd molars – wisdom teeth neighbors. It also can destroy the bone that surrounds 2nd molars due to erupting forces from wisdom teeth.

When a wisdom tooth is impacted the tooth is coming in at an angle and not straight through the gum line. This can cause pain, the tooth can come in unevenly, or the tooth may only emerge partially.

Impacted wisdom teeth can cause structural damage to the jaw and other teeth. They can also provide a place for bacteria to gather since they are hard to reach and clean. These potential problems make it necessary to remove impacted wisdom teeth so that larger problems do not arise. Routine x-rays during a dental exam can reveal if you will need to have your wisdom teeth removed.

Why it is important to remove wisdom teeth?

A wisdom tooth is extracted to correct an actual problem or to prevent problems that may come up in the future. When wisdom teeth come in, a number of problems can occur:

Your jaw may not be large enough for them, and they may become impacted and unable to break through your gums. Your wisdom teeth may break partway through your gums, causing a flap of gum tissue to grow over them. Food and germs can get trapped under the flap and cause your gums to become red, swollen, and painful. These are signs of infection.

More serious problems can develop from impacted teeth, such as infection, damage to other teeth and bone, or a cyst. One or more of your wisdom teeth may come in at an awkward angle, with the top of the tooth facing forward, backward, or to either side.

Extraction of wisdom teeth

Before removing wisdom teeth, local anesthetic is usually used to numb the area where the teeth will be removed. An IV conscious sedation may be used and is highly recommended, especially if several or all of your wisdom teeth will be removed at the same time. This prevents pain in the whole body, cause the patient to sleep through the whole procedure. The patient will be required not to eat or drink after midnight on the night before surgery, so the patient will be prepared for the iv sedation.

If the patient has any infections, surgery will usually be delayed until the infection has cleared up. The patient may have to take antibiotics to help heal the infection.

To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. He or she will separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove.

After the teeth ares removed, the stitches may be needed. Some stitches dissolve over time and some have to be removed after a few days. The patient will be told whether the stitches need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.

After wisdom teeth removal

In most cases, the recovery period lasts only a few days. Take painkillers as prescribed by your dentist or oral surgeon. The following tips will help speed the recovery.

Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. Call your dentist or oral surgeon if you still have bleeding 24 hours after your surgery.

While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.
Do not lie flat. This may prolong bleeding. Prop up your head with pillows.

Try using an ice pack on the outside of your cheek for the first 24 hours. You can use moist heat-such as a washcloth soaked in warm water and wrung out-for the following 2 or 3 days.

Relax after surgery. Physical activity may increase bleeding.

Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing.

After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain.

Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. In addition, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.

Avoid rubbing the area with your tongue or touching it with your fingers.
Continue to brush your teeth and tongue carefully.
The stitches will be removed after a few days, if needed.

Wisdom teeth removal recovery

The recovery usually is very standard which will include mild swelling in 48 hours after the extraction. But due to premedication drugs used before the procedure the pain cascade is lessened what makes recovery less painful. In 2-3 days patients are able to be back to their routine activities. And in 5-7 days can be back to exercising regime. However, soft diet, Peridex rinses and antibiotics are prescribed till the soft tissue will completely heal.

What to expect after wisdom teeth removal?

Pain and swelling in your gums and tooth socket where the tooth was removed. Bleeding that won’t stop for about 24 hours.
Difficulty with or pain from opening your jaw (trismus). Slow-healing gums. Damage to dental work, such as crowns or bridges, or to roots of a nearby tooth. A painful inflammation called dry socket.

Numbness in your mouth and lips after the local anesthetic wears off, due to injury or inflammation of nerves in the jaw. Numbness will usually go away, but in rare cases it may be permanent. Dental surgery may cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. People who have difficulty fighting off infections may need to take antibiotics before and after dental surgery. Such people include those who have artificial heart valves or were born with heart defects.

What To Think About

If your wisdom teeth are not causing problems, it may be difficult to decide whether to have your wisdom teeth removed to prevent possible dental problems later in life. Consider the following:

You may never have any problems with your wisdom teeth.

• It is rarely harmful to your health to have your wisdom teeth removed, but there are slight risks involved with any surgery.
• In younger people (late teens and early 20s), the wisdom tooth’s roots are not fully developed and the jaw bone is not as dense, so it is easier to remove the tooth. The easier it is to remove the tooth, the easier your recovery is likely to be.
• Most problems with wisdom teeth develop between the ages of 15 and 25.
• If you are older than age 30, you have only a small risk of having problems with your wisdom teeth. Few people older than 30 develop problems that require removal of their wisdom teeth.
• Medical insurance does not always cover this procedure.
• If you have a medical condition that may get worse over time and your teeth may cause problems, consider having your wisdom teeth removed while you are healthy.
• Possible complications include dry socket (alveolar osteitis), infection, bleeding, and numbness, but the overall chance of complications is less than 2% (2 in 100 people). The risk is slightly higher if you have wisdom teeth removed from the lower jaw than from the upper jaw.
• Women who decide to have their wisdom teeth removed should try to schedule the surgery for the end of their menstrual cycle (usually days 23 through 28). There seems to be less risk of dry socket during this time.