What is Wisdom Teeth Removal?

By the time you are a teenager, most of your teeth will have come in – but not all of them. Most people have a set of wisdom teeth, also called third molars, that will not come in until you are between 17 to 25 years old.

Wisdom teeth can cause trouble because they often do not erupt (appear) in a way that is beneficial to your jaw or other teeth. In fact, they are often useless and will cause pain or infection if they are not removed.

Your wisdom teeth may become "impacted," which means that they grow in sideways, point toward the back of the mouth, or may even be totally encased in bone. They can also develop cavities. There often is not enough room for them. Not everyone gets wisdom teeth and some other people never have a problem with them.

Symptoms that wisdom teeth need to be removed include:

• Stiffness of the jaw
• Pain in the back of your mouth
• Inflammation and swelling
• Gum disease at the back of the mouth

The best time to remove them is before you turn 26. At this time, the roots have reached their full length, which places them close to the nerve. The nerve sends signals to and from the brain to your jaw, chin, and tongue, and removing them can be difficult. Because of the difficulty, wisdom teeth surgery is often conducted by an oral surgeon.

Some people do not have problems while they are younger, but problems later on could make it more difficult to remove. The jaw bone becomes harder, teeth could be fractured, and nerve damage could result in problems with eating, speech, and numbness. To prevent this, some dentists will remove healthy wisdom teeth. X-rays will reveal whether or not they will likely cause problems later.

Before going to your appointment for wisdom teeth removal, you will discuss with the dentist what type of anesthesia you want. You can choose between local anesthesia, IV sedation, or general sedation. With local sedation, you will likely get a shot of Novocain and possibly nitrous oxide (laughing gas).

Oral surgeons are able to remove one or more wisdom teeth at the same time. They often will remove two on the same side, but can remove all four if desired. When four are to be removed, it is usually performed under general anesthesia.

During the wisdom tooth extraction, the surgeon will first make an incision to reveal the bone and tooth. Any bone that is in the way will be cut or broken away. Once exposed, the tooth will be broken into pieces so that it can be more easily removed, and then the pieces are taken out. The site is cleaned of all remaining debris from the tooth or bone. If necessary, the site may be stitched closed, which will help the healing process. Gauze is placed over the site to limit bleeding and soak up excess blood. It will also help a clot to form.

If you took an oral anesthesia, you may be in the recovery room for at least an hour before you can go home with the appointed driver. If you had laughing gas, you could drive yourself home after just a few minutes of recovery. The patient with IV sedation will also need an appointed driver. Nausea and vomiting may occur as the anesthesia wears off.

After the wisdom teeth removal, you want to leave the gauze in your mouth for at least half an hour, and then discard it. There may be slight bleeding afterward. You can also expect there to be some swelling of your face (possibly with discoloration), cheeks, eyes, and side of your face.

Other things you need to know about the recovery period:

• Expect pain after the anesthetic wears off – a painkiller will be prescribed.
• Antibiotics will also be prescribed.
• Avoid vigorous rinsing of your mouth until the next day. One the second day, rinse your mouth out five or six times a day with a cup of warm water and a teaspoon of salt in it.
• You may experience the following symptoms afterward: fever, dizziness, stiffness of your jaw muscles, and a sore throat with pain when you swallow.
• Brush your teeth, but gently around the site.
• Do not use a straw to drink from.
• Eat regular meals (soft foods), but chew with your teeth on the other side. Drink plenty of fluids, but avoid hot drinks.
• Avoid smoking and strenuous exercise.

In general, you want to take it easy for about a week. Most people can return to work in a day or two, but avoid strenuous activities. Over-the-counter medications are usually sufficient after the pain prescription runs out.

When there are ongoing problems, be sure to call the surgeon. You are likely to have pain for two to seven days after the surgery. Complications may arise if the blood clot at the site is disturbed or becomes displaced.

Getting your wisdom teeth removed can be a good idea. Five benefits that you will get from it include:

• Prevents overcrowding – they often crowd your other teeth, which can knock them out of alignment.
• Prevents damage to your nearby teeth – wisdom teeth often damage other teeth as they come in. This can create cavities and the need for other extractions.
• Prevents inflammation and gum disease – wisdom teeth are hard to keep clean, which can lead to becoming inflamed and getting gum disease.
• Prevents cysts and tumors from developing – cysts and tumors often develop around a wisdom tooth in the jawbone.
• Prevents pain – as wisdom teeth come in, they often create a lot of pain due to pushing on other teeth, inflammation, and more.