Wisdom Teeth Removal: Purpose, Recovery, What to Expect, and More
Wisdom teeth removal surgery, also called a wisdom tooth extraction, is a dental procedure used to remove a tooth from the third set of molars, commonly called your "wisdom teeth." The surgery is often used when the tooth becomes impacted.
Wisdom teeth removal is typically performed while the patient is under mild anesthesia. Recovery from wisdom teeth extraction can take up to six weeks, but most people can go back to normal activities in a day or two.
What Is Wisdom Teeth Removal Surgery?
Not everyone has wisdom teeth, but most people have one to four that usually come in between the ages of 17 and 25. The teeth can often become impacted, meaning there is not enough room for them to break through the skin and erupt. By having the tooth removed, you can prevent damage to the surrounding teeth.
Wisdom teeth removal surgery is typically performed by a dentist or oral surgeon. The surgery involves cutting into the gum and removing the tooth either as a whole tooth or in pieces.
To prevent pain, you’ll be given anesthesia either as a gas or intravenously (into a vein). Your doctor will decide which to use based on the complexity of the procedure, your comfort level, and the number of teeth that need to be extracted.
Risk and Contradictions
Wisdom tooth surgery in younger people is usually easier to perform than in older people who are at higher risk of complications.
In younger people, the bone is more flexible and elastic, making the tooth easier to extract while reducing the risk of bone fracture and nerve injury.
Wisdom tooth extractions are best done between the ages of 18 and 21, but the dentist will decide when it should be done based on a thorough diagnosis, including dental X-rays.
Purpose of Wisdom Tooth Removal Surgery
A dentist will recommend wisdom tooth removal surgery if an examination reveals that your wisdom teeth are impacted or could potentially cause problems in the future.
Beyond impaction, a few reasons for wisdom tooth extraction include:
Infection
Signs of tooth decay
Damage to surrounding teeth
Periodontal issue
Bone loss around the underlying socket
How to Prepare
Your dentist will tell you how to prepare for the surgery and recovery afterward. They’ll also discuss which type of anesthesia they intend to use and why.
The cost of wisdom teeth removal surgery will depend on the level of impaction and the number of teeth that are being removed. Check with your insurance provider to determine your benefits, including what will be and will not be covered.
You can prepare for recovery by buying soft or liquid foods that are easy to eat. These include smoothies, applesauce, oatmeal, yogurt, congee and other foods that don't require chewing.
Food and Drink
Follow your dentist’s directions about eating and drinking before surgery. Instructions vary depending on the type of anesthesia used.
If you are getting intravenous anesthesia, you won’t be able to eat or drink anything after midnight the night before the procedure. This ensures your stomach is empty in the unlikely event the anesthesia causes vomiting.
Medications
The risk of bleeding problems can increase with certain medications, such as:
Advil (ibuprofen)
Aleve (naproxen)
Aspirin
Warfarin
Plavix (clopidogrel)
You may need to stop these anywhere from four to seven days before surgery.
You should also avoid tobacco and alcohol for at least eight hours before the surgery.
Let your dentist know about any prescription or over-the-counter drugs, vitamins, or supplements you take. They will let you know if you can continue taking them or need to temporarily stop for several days.
What to Expect on the Day of Surgery
Arrive at least 15 minutes prior to your appointment to settle in and fill out any necessary forms. Your dentist may also want to perform additional X-rays.
During the Surgery
Here are the general steps to performing a wisdom tooth extraction:
Sedation: If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask fitted over your nose to inhale the anesthesia.5 If intravenous (IV) sedation is used, a needle is placed in the vein in your arm to administer the sedative.2
Local numbing: After administering sedation, your surgeon will start numbing the wisdom tooth and gums with a local anesthetic delivered by injection.
Tissue resection: Using a scalpel, the surgeon will remove (resect) gum tissue to better expose the wisdom tooth.
Bone resection: An impacted wisdom tooth may be fully or partially covered with bone. In such cases, a high-speed tool can drill through and remove the covering bone.
Loosening and sectioning: After the wisdom tooth is fully exposed, various surgical instruments can gently loosen it from connective tissue in the tooth's socket. The surgeon may cut the tooth into sections for easier removal.6
Tooth extraction: Once loosened and sectioned, the surgeon will use instruments specially designed to extract the tooth.
Closure: Stitches are used to close the wound. Today, most oral surgeons use dissolvable stitches that don't need to be removed.7
After the Surgery
The dentist will provide gauze for you to bite down on to help blood clot in the area. Immediately after surgery, you may feel mild effects of the anesthesia, including nausea, dizziness, and shivering.
After surgery, you may feel groggy and swollen. You should not feel much pain immediately, but it will probably increase as the anesthetic wears off in the hours following the surgery.
Wisdom Teeth Removal Recovery
For the first 24 hours after the surgery:
Avoid rinsing your mouth vigorously or drinking through a straw.
Don’t drink alcohol or use mouthwash with alcohol.
Avoid brushing your teeth next to the extraction site.
Use a soft manual toothbrush rather than an electric one.
Some pain, bleeding, and swelling are likely for several days following the surgery. You may not be able to open your mouth completely during this time.
The extraction site can take up to six weeks to heal, but most people can resume normal activities within the next day or two.
Healing
Your dentist will give you extra gauze to take home. If you start to bleed after the gauze is removed, fold another piece into a pad, moisten it with water, and hold it over the bleeding until it stops.
It is important to avoid alcohol for at least 48 hours following surgery, especially if taking prescription pain medication.
You would also need to avoid strenuous activity for a week after the surgery. The increased blood pressure may cause the wound to break open and bleed.
Smoking should also be avoided as it directly irritates the wound and can cause blood vessels to constrict, impeding the healing process.
If non-dissolvable stitches are used, you will need to have them removed at your dentist's office around 14 days after the surgery.
Coping With Recovery
Over-the-counter pain medicines such as Tylenol and Ibuprofen are usually effective for pain after a wisdom tooth extraction. You can also try putting a cold compress on your face to help with swelling.
Eating and Drinking
In the first 24 hours after surgery, you should eat only soft foods like applesauce and yogurt. You can then move on to semi-soft foods like eggs, soft bread, and oatmeal over the next day or two.
Until you've fully healed, avoid foods that are spicy, acidic, chewy, or crunchy.
Complications
Complications of wisdom teeth removal surgery include:
Dry Socket (a painful condition caused when the blood clot in the tooth socket gets dislodged, exposing bone and nerves)
Shooting nerve pain
Sinus infection
Infection
Symptoms of Dry Socket
Symptoms of dry socket include:
Severe pain radiating out from the socket toward the neck or side of the face
Visible bone in the extraction site
Bad breath
Bad taste in the mouth
When to Call Your Dentist
Call your dentist right away if you have excessive bleeding or symptoms of dry socket.
Seek immediate care if you have signs of infection, including:
High fever with chills
Worsening swelling of the gum or face
Pain that doesn't improve with medication
A pus-like discharge from the wound
Summary
Wisdom teeth removal is a common and safe dental procedure, performed on thousands of patients in Canada a year.
Recovery from a wisdom tooth extraction takes around six weeks, but you can usually return to work in a day or so. Pain can be treated with over-the-counter drugs like Tylenol or Advil. Alcohol should be avoided for at least 48 hours, and smoking should ideally to stopped until the wound is fully healed.
Call your dentist if you have excessive bleeding or signs of infection such as high fever, chills, increased swelling, and a pus-like discharge
Reference
Watson, S. (2023, May 26). Wisdom teeth removal. Health. https://www.verywellhealth.com/how-are-wisdom-teeth-removed-1059378