Wisdom Teeth Extractions
Reasons for removal
Wisdom teeth are the third molars in the back of your mouth that grow in around adulthood—yet rarely without pain or other problems. While some individuals never develop wisdom teeth at all, those who do frequently require their extraction. Sometimes, the teeth are misaligned or don’t have the necessary space to develop properly. When this happens, they will need to be removed to avoid further complications. If left misaligned or impacted, the teeth may become infected and/ or develop a painful cyst.
When to have surgery
It is most ideal to have wisdom teeth removed before the age of 25 because your bone is less dense and healing is optimal. Most individuals prefer to have the procedure completed under IV sedation for maximum comfort, typically scheduled in the morning because of the 8 hour fasting requirement. Thursday and Friday mornings during school and work breaks are the most common times to have wisdom teeth removed so there is adequate time for healing.
Procedure
First, your dentist will numb the gum with a local anesthetic. Once you’re comfortable, the dentist will gently loosen the tooth by rocking it back and forth. Often, a drill will be used to remove a little bone from around the tooth. After the tooth becomes sufficiently loosened from the gum, the dentist will extract it. The socket is then cleaned out and packed with a dissolvable dressing to help decrease bleeding. If indicated, dissolvable stitches may also be placed. Finally, gauze may be placed over the socket to prevent excess bleeding. You may be asked to bite down on the gauze, holding it in place while a clot forms.
After an extraction
If you have been sedated for your procedure, you may not drive for 24 hours. If you have been prescribed a narcotic pain medication, you also cannot drive while taking this. If an antibiotic mouth rinse is prescribed, do not begin using until the day after your procedure to avoid stimulating further bleeding. If an antibiotic was prescribed, make sure to take as directed and until completely gone to help prevent infection.
Swelling is also a normal part of post-operative healing and can increase for 2-3 days following any surgery, slowly resolving after this. You may apply an ice pack to the area for 20 minutes at a time for the first 24 hours; this will help minimize pain and swelling during this time. After 24 hours, you may switch to warm, moist heat.
You should begin taking pain medicine as soon as you feel the local anesthetic start wearing off. For mild to moderate pain, ibuprofen (Advil® or Motrin®) may be taken. Ibuprofen bought over the counter comes in 200mg tablets: 3 tablets may be taken every 4-6 hours as needed for pain. You may alternate with 2 Extra Strength Tylenol® as needed (example: 12 PM—Ibuprofen, 3 PM—Tylenol, 6 PM—Ibuprofen, 9 PM—Tylenol). For severe pain, the prescribed pain medicine should be taken as directed with food. Tylenol may be in the prescribed pain medication; therefore, do not take Extra Strength Tylenol when taking prescribed pain medication. Do not take any of the above medications if you are allergic or have been instructed by your doctor not to do so.
Hydration and nutrition are important for healing following surgery. You may be more comfortable with a soft diet initially. Avoiding hard, crunchy foods such as chips, nuts and crackers for the first week or two is ideal. Stick to cold and/or soft foods and liquids while you are numb. Remember to always eat prior to taking any pain medication to avoid nausea. Return to a normal diet as soon as possible unless otherwise directed.