It is common for patients to eventually hear their dentist suggest that their wisdom teeth need to be removed. In some cases, the patient will be referred to an oral surgeon for the procedure. Most patients take just a few days to recover as it is a somewhat minimally invasive procedure.
The wisdom teeth are a third set of molars which are located in the back of the mouth. In most cases, these teeth erupt when patients are around 17-25 years old. They are often initially detected on an X-ray. The following are common reasons for having these teeth extracted:
1. Impacted: due to their location in the back of the mouth, they often do not erupt properly. It can be painful to have the teeth trapped in the gums or jawbone
2. Bad angle: when the teeth come in at a bad angle, they can press against or even shift the other teeth
3. Insufficient Room: The jaw simply does not have enough space to accommodate another set of molars
4. Gum Disease or Cavities: Because of their location, the wisdom teeth can be especially difficult to clean
Prior to surgery, the oral surgeon will meet with the patient to talk about the procedure and discuss the following:
* Health history
* Medications and prescriptions
* Discuss questions regarding the extraction
* Review the type of anesthesia being used
* Discuss instructions following the procedure, including transportation and recovery
The extraction of the wisdom teeth should take about 45 minutes. One of the following types of anesthesia will be used:
1. General: Drugs are administered through an IV or mask. The patient will be asleep throughout the procedure. It may take about an hour after surgery to fully wake up.
2. IV sedation: The patient’s mouth will be numb and drugs will be administered through an IV which will make the patient drowsy. It is possible to sleep through the entire procedure.
3. Local: The mouth is numb using a shot of local anesthetic like novocaine, lidocaine or mepivicaine. Nitrous oxide, or laughing gas, may also be used to help the patient relax or sleep during surgery.
The doctor may need to make incisions in the gums or bone to extract the teeth. Sutures will be used to close the wounds and they should heal relatively quickly. In most cases, dissolvable stitches are used which do not need to be removed. Gauze pads are often placed in the mouth to aid in recovery and soak up any blood.
As with many types of medicine, patients can respond differently to the various types of anesthesia. The doctor will advise if you need to arrange for transportation following the procedure. Most patients have minimal discomfort following the surgery. There may be some swelling and slight discomfort for a few days, however, it should be very manageable. It may take a few weeks for the mouth to heal completely.
It is critical for patients to follow the post-procedure instructions provided by the doctor to ensure a quick and smooth recovery. Below are some of general guidelines which patients should follow:
* Avoid hard, crunchy, or sticky foods
* Be gentle in opening and closing the mouth while exercising the jaw
* Brush the teeth a day after the procedure, use a soft brush and be gentle; avoid the incisions
* Consume soft foods such as soup, pasta, mashed potatoes, and rice
* Contact the doctor right away in case of a fever or persistent pain and swelling
* Do not smoke as it can cause complications and delay the healing process
* Do not use straw as it can loosen blood clots and cause painful dry sockets
* Drink plenty of liquids
* Gently rinse the mouth
* Place an ice pack on the face to reduce swelling and bruising
* Take the prescribed medication to minimize pain and swelling
* Use a moist heat for a sore jaw