Wisdom teeth – or third molars – are the last teeth to come in, and the ones least needed for good health. They may not erupt, or emerge from you gums, until your late teens or early twenties – if they erupt at all. Most often, they remain impacted, or trapped in the jaw bone and gums, usually because there is not enough room for them in your mouth. Our jaws are smaller than those of early humans, who needed large jaws and more teeth for their tougher diets. We don’t need that extra chewing power anymore. In fact, wisdom teeth often do more harm than good; because of this, your dentist may recommend removing them and refer you to a specialist for care.
Most people have all four wisdom teeth, one in each corner of their mouth, but each tooth may be at a different stage of eruption or position of impaction. Since wisdom teeth develop over a period of many years, harmful changes in you mouth may be gradual. However, these changes could result in sudden and severe pain. Sometimes problem wisdom teeth can cause tangible symptoms like pain and swelling; or, you may not feel any symptoms at all. However, pain is not always an indicator that something is wrong in your mouth. Wisdom teeth, especially, can cause serious problems without any symptoms at all
Gum disease – bacteria and food get trapped around a wisdom tooth and can infect the gum tissue in the very back of your mouth.
Crowding – a wisdom tooth can push on adjacent teeth, causing them to become crooked, or even damage them structurally.
Decay – wisdom teeth are hard to clean due to their location, and therefore become very susceptible to tooth decay.
Tumours and Cysts – if the sac that hold the tooth remains embedded in the bone, it can fill with fluid, forming a cyst that can erode the surrounding jawbone.
An oral and maxillofacial surgeon or your dentist can remove (extract) a wisdom tooth. The procedure often can be done in the dentist's or surgeon's office. You may have the surgery in the hospital, especially if you are having all your wisdom teeth pulled at one time or if you are at high risk for complications.
If you have any infections, surgery will usually be delayed until the infection has cleared up. Your doctor or dentist may have you take antibiotics thelp heal the infection.
Before removing a wisdom tooth, your dentist will give you a local anesthetic tnumb the area where the tooth will be removed. A general anesthetic may be used, especially if several or all of your wisdom teeth will be removed at the same time. A general anesthetic prevents pain in the whole body and will cause you tsleep through the procedure. Your dentist will probably recommend that you don't eat or drink after midnight on the night before surgery, syou are prepared for the anesthetic.
Tremove 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 tthe bone and then remove the tooth. Sometimes the dentist will cut the tooth intsmaller pieces tmake it easier tremove.
After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have tbe removed after a few days. Your dentist will tell you whether your stitches need tbe removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.
What To Expect After Surgery
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 your 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 tbite the inside of your cheek or lip, or your tongue
• Dnot 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 tyour diet as healing progresses.
• Dnot 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 treduce swelling and relieve pain.
• Dnot 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 tthe surgery area.
• Avoid rubbing the area with your tongue or touching it with your fingers
• Continue tbrush your teeth and tongue carefully.
Your dentist will remove the stitches after a few days, if needed.
After a wisdom tooth is removed, you may experience:
• 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 texisting dental work, such as crowns or bridges, or troots of a nearby tooth.
• A painful inflammation called dry socket, which happens if the protective blood clot is lost tosoon.
• Numbness in your mouth and lips after the local anesthetic wears off, due tinjury or inflammation of nerves in the jaw.
• Rare side effects, including:
• Numbness in the mouth or lips that does not gaway.1
• A fractured jaw if the tooth was firmly attached tthe jaw bone.
• An opening intthe sinus cavity when a wisdom tooth is removed from the upper jaw.
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.
Anesthetic (local and/or general) almost always is used during the extraction procedure. All surgeries, including oral surgery, that use general anesthetic have a small risk of death or other complications.