Wisdom Tooth Extraction

Extracting wisdom teeth is a common dental procedure to remove one or more wisdom teeth (the four permanent adult teeth at the back of your mouth). If your wisdom tooth does not have enough space to grow, it becomes impacted, resulting in infection, pain and other dental issues, making removing the tooth necessary. Wisdom tooth extraction is a surgical procedure that requires the attention of an oral surgeon or dentist. Most dentists and oral surgeons recommend removing the wisdom tooth even when it is not impacted to prevent problems in the future. Why is a wisdom tooth extraction necessary? Wisdom teeth, also called third molars, are the last permanent teeth to come in, and they usually grow between 17 – 25 years. However, some persons do not develop wisdom teeth, and some have their wisdom teeth erupt normally, like the other molars, so they cause no problems. Many people have impacted wisdom teeth which may not erupt or erupt partially. A wisdom tooth is impacted if it:

Grows at an angle towards the second molar
Grows at an angle towards the back of your mouth
Grows at a right angle to other teeth, making the wisdom teeth appear as though it’s lying down within the jaw bone
Grows up or down like other teeth but remains within the jawbone

Problems with impacted wisdom teeth: If you have impacted wisdom teeth, it may likely cause the following problems.

Pain
Gum disease or infection
Damage to the surrounding bone or teeth
Food and debris trapped behind the wisdom tooth
Decay in partially erupted wisdom tooth
Complication during orthodontic treatments for straightening the teeth
Development of fluid-filled sac (cyst) around the wisdom tooth

Preventing future dental problems: Some dental professionals are against extracting impacted wisdom teeth that do not cause symptoms. However, it’s difficult to know if an impacted wisdom tooth will cause problems in the future. Below are some reasons for preventive wisdom tooth extraction.

Wisdom teeth without symptoms can still harbour disease
Older adults may find having surgery difficult and experience difficulty dealing with complications after surgery
Serious complications from wisdom teeth occur less in younger adults
If your wisdom tooth does not have sufficient space, it may be difficult to get to the tooth and clean it

Risks: In most cases, wisdom tooth extractions don’t cause long-term complications, but impacted wisdom tooth removal may require surgery which involves making an incision in the gum tissues and removing bone. The following are complications from wisdom teeth removal, but they rarely occur.

Infection in the socket resulting from trapped bacteria and food particles
Painful dry socket or exposure of the bone from loss of blood clot from the tooth socket after the surgery
Damage to surrounding nerves, jawbone, teeth or sinuses

Preparing for wisdom tooth extraction: You may have your wisdom tooth extraction in your dentist office, but if the tooth is severely impacted or the extraction requires surgery, your dentist may refer you to an oral surgeon. The dentist or oral surgeon will give you a local anaesthetic before the procedure and may suggest administering a sedative to make you more comfortable during the tooth extraction. While preparing for your wisdom tooth extraction, consider asking your dentist or oral surgeon the following questions such as how many wisdom teeth you need to remove, how long will the procedure take and how long healing will require. Preparing for surgery In most cases, tooth extraction is an outpatient procedure, so you can go home on the same day after the procedure. Your dentist or surgeon will advise you on what to do before and after the surgery. The instructions will cover your medication, including prescribed and over-the-counter medication, foods to eat, and your oral hygiene routine. During the procedure Your oral surgeon or dentist may administer a local anaesthetic, sedation anaesthetic, or general anaesthetic, depending on how complex the wisdom tooth extraction is and comfort level. During the procedure, the dental professional will:

Make an incision in your gums to expose the bone and wisdom tooth
Remove the bone restricting access to your tooth root
Divide the wisdom tooth into sections to make it easier to remove
Remove the tooth
Clean bone or tooth debris from the site of the removed tooth
Stitch the wound to aid healing, although this is not necessary in some cases
Place gauze on the extraction site to control bleeding and help the formation of a blood clot

After the procedure: If your dentist administered a sedative or general anaesthetic, you would need to stay in a recovery room after the procedure. If you have local anaesthesia, your recovery period will likely be in the dental chair. Ensure you follow your dentist instruction for recovery. The instruction may include:

Take an over-the-counter pain medication such as acetaminophen or prescription pain medication to manage the pain
Use an ice pack to ease the bruising and swelling
Avoid spitting so you don’t dislodge the blood clot in the tooth socket and replace the gauze on the extraction site after the procedure
Rest for the remaining part of the day after your surgery, but you can resume your normal activities the next day.
Avoid strenuous activities within the first few days after the procedure
Drink plenty of water but avoid alcohol, hot, carbonated or caffeinated beverages
Eat only soft foods in the first 24 hours after the procedure, then subsequently, semi-soft foods but avoid chewy, hot, spicy, or hot foods
Avoid smoking, especially within the first 72 hours after the procedure
Don’t brush your teeth within the first 24 hours after the procedure, but you can resume your normal oral hygiene afterwards

When to call your dentist: Ensure you call your oral surgeon or dentist if you experience the following symptoms after your wisdom tooth extraction.

Fever
Pus or blood in your nasal discharge
Pus in the tooth socket
Excessive bleeding
Severe and persistent pain
A bad taste in your mouth
Swelling that worsens after 2 – 3 days
Persistent numbness
Difficulty breathing or swallowing

These symptoms are usually signs of an infection, nerve damage or other serious complications that need immediate attention. If you have impacted wisdom teeth or are concerned about your wisdom teeth coming in, visit Smile Clinic London to see a dentist or call 020 7139 8611 to schedule an appointment for a check-up.