With an oral examination and x-rays of the mouth, we can evaluate the position of the wisdom teeth and predict if there may be present or future problems. Studies have shown that early evaluation and treatment results in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.
What are Wisdom teeth?
From babyhood to adolescence, teeth erupt in stages. By the age of eighteen the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom.
Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth, also known as molar teeth, are used to grind food up into a consistency suitable for swallowing.
The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as “wisdom teeth.”
Why Should I Remove My Wisdom Teeth?
Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. In most cases they can cause pain, infection and other instances of discomfort.
They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully. These poorly positioned impacted teeth can cause many problems. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection, the result: swelling, stiffness, pain and illness.
The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth.
The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth.
What is the treatment?
After a thorough examination and evaluation of the x-rays wisdom teeth that impacted and/or those that pose a potential risk for future problems will be surgically removed. Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.
What should I expect after surgery?
Everyone heals differently. When the surgery is completed, swelling and tenderness in the face and neck are common, as is bruising. Ice packs and pain medications prescribed will help, but if you have any questions or are concerned about what you are experiencing, contact our office. Here are some helpful tips:
- Bite gently on the gauze pad periodically, and change pads as they become soaked with blood.
- 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. Apply for 15 to 20 minutes at a time every hour for the first 24-48 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. You can make your own salt water by mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (240 mL)] of warm water.
- Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. Also, smoking decreases the blood supply and can bring germs and contaminants to the surgical area and greatly increases chance of infection at the surgical site/s.
- Avoid rubbing the area with your tongue or touching it with your fingers.
- Continue to brush your teeth and tongue carefully.
The oral surgeon will remove the stitches after a few days, if needed.
Some of the possible complications are dry socket (alveolar osteitis), infection, bleeding, and numbness. After a tooth is extracted a blood clot forms in the tooth socket and seals the area so that it can heal. A dry socket occurs during the first five days after extraction, when the blood clot breaks down or is dislodged, it exposes the bone and nerves of the tooth. Only 2 to 5% of people will develop a dry socket.
A dry socket is very painful! To ease the pain, a dentist will rinse out the empty socket, remove any debris and apply medicated dressings to protect the area and decrease the pain. They will prescribe an antibiotic to prevent infection and a painkiller to decrease discomfort. With proper care and rest a dry socket should heal in 7 to 10 days.