Wisdom Tooth Extraction Guide: What Should You Expect?
/What Are Wisdom Teeth?
Most adults have four wisdom teeth: one in each of the back corners of the mouth. While these molars are actually permanent teeth, by the time they erupt they often get stuck against other teeth because there’s not enough space for them to come through normally. This failure to emerge properly is called an impaction and can cause pain, inflammation and infection.
Some people never develop wisdom teeth. For other lucky individuals, the wisdom teeth grow in normally, just as their other molars did, and cause no problems. However, many, if not most people develop impacted wisdom teeth that erupt only partially or not at all. The wisdom tooth can grow at an angle under the gum line, pressing against healthy teeth and gum tissue. Poor alignment of wisdom teeth can crowd or damage adjacent teeth and even the jawbone itself.
Wisdom teeth are not something that can be dealt with on an at-home basis using straightening kits from internet vendors like SmileDirectClub. These services claim to solve dental and orthodontic problems without the need for medical expertise, but patients should be forewarned. Wisdom teeth require special attention and often an extraction, which of course must be done by a skilled dentist or oral surgeon.
What Is Wisdom Tooth Extraction?
Wisdom tooth extraction is a procedure to remove one or more of the wisdom teeth. When a wisdom tooth causes pain, infection or other dental problems, you’ll likely need to have it extracted. To prevent future problems, some dentists and oral surgeons even recommend preventive extraction even if wisdom teeth aren’t currently causing problems.
The case for pre-emptive wisdom tooth extraction is compelling and worth considering. Even if it’s not already causing pain, an impacted wisdom tooth may grow at odd angles next to adjacent teeth or the back of the mouth. It can stay trapped under the gum line like a ticking time bomb waiting to cause pain and oral damage. In most cases, the tooth will need to be extracted, and for many, sooner is better than later.
Extract Them Now or Wait?
As your wisdom teeth make their way through your gums, your dentist will help you make the best oral care choices. When patients reach the age where wisdom teeth can be problematic, it’s imperative that a dental expert monitor your mouth for signs of potential issues. These include:
Wisdom Teeth That Haven’t Erupted Properly
Poorly erupted wisdom teeth can grow too close to the molars next to them, making it impossible to floss between the two teeth. This puts adjacent teeth at risk for cavities and decay.
Wisdom Teeth That Aren’t in the Right Position for Healthy Eruption
When a wisdom tooth is misaligned as it erupts (a common condition), the emerging tooth can allow food to become trapped. This gives cavity-causing bacteria a place to grow, threatening nearby healthy teeth.
Wisdom Teeth That Have Only Partially Emerged
A wisdom tooth that breaks through the gum but doesn’t grow in further gives bacteria a place to enter the gums and creates conditions for infection. This can lead to pain, swelling and stiffness in the jaw.
Wisdom Teeth That Don’t Have Room to Come Through
By the time people are the age for wisdom teeth to come through, their other teeth are already in place. A wisdom tooth trying to break through can crowd or damage neighboring teeth, affecting chewing function and aesthetics.
An Impacted Wisdom Tooth That Has Formed a Cyst
These fluid-filled sacs can infect the roots of nearby teeth and even damage the bone that supports the teeth. Their potential damage can also spread beyond the teeth into the sinus areas.
How Will I Know When It’s Time to Extract?
It’s difficult to predict future problems with impacted wisdom teeth. Moreover, it’s normal to experience some discomfort when wisdom teeth finally do begin to erupt. However, the signs of an impacted wisdom tooth are unmistakable. Patients will likely need an impacted wisdom tooth extracted when they experience one or more of the following problems:
Pain from the erupting wisdom tooth
Food and debris collecting near the eruption
Gum disease or infection near the wisdom tooth
Tooth decay in a partially erupted wisdom tooth
Development of a cyst near the eruption
Most dentists recommend impacted wisdom teeth be removed when the roots are between one to two-thirds formed. X-rays taken by your dentist will reveal the stage of the wisdom teeth and help you formulate a plan for extraction. Waiting too long to take these teeth out makes the extraction more difficult and can increase the risk of complications, such as potential damage to your nerves and sinuses.
Wisdom Teeth and At-Home Cosmetics
Cosmetic dentistry and orthodontic aesthetics have enjoyed increasing popularity in the past several years thanks to new techniques and technologies. These improvements should always be guided by a dental or orthodontic expert rather than attempted as at-home treatments. This caution is particularly true when wisdom teeth may erupt during orthodontic treatments such as braces.
When wisdom teeth finally start to emerge, they can disrupt the alignment of nearby teeth. This can serve to undo the effects of at-home aesthetic treatments that have not taken the individual’s whole oral condition into account. When using an at-home orthodontia kit, there’s no expertise available to identify underlying conditions, such as a wisdom tooth that’s ready to erupt or growing in poorly.
There’s nothing more frustrating than months spent on fixing a smile only to have the work undone by an unforeseen wisdom tooth. In many cases, the at-home kit has to be abandoned until the wisdom tooth or teeth have been extracted, resulting in a waste of time and money as well as frustrated expectations. Expert oral care throughout your orthodontic journey is essential for creating your ideal smile.
What Can I Expect During the Procedure?
Wisdom tooth extraction is done on an outpatient basis at your dentist or oral surgeon’s office. Patients may feel woozy from the procedure or from anesthetics, but they return home right after the extraction. Many dentists and oral surgeons will recommend that family or a friend drive the patient home after the procedure for safety’s sake.
During the procedure to remove one or more wisdom teeth, your dentist or oral surgeon will use one of three types of anesthesia, depending on the complexity of the extraction and your individual comfort level. From simplest to most intensive, these are the three levels of anesthetic:
Local Anesthesia
Your dentist or surgeon will apply a substance to your gums to numb them. Then, one or more pain-blocking injections will be made near the site of each extraction. Patients are awake during the extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain during the procedure.
Sedation Anesthesia
If the extraction will be especially complex, your dentist or oral surgeon may apply sedation anesthesia through an intravenous line in your arm. The patient is not consciousness during the procedure and will have limited memory of it.
General Anesthesia
In especially difficult or complex situations, such as one where multiple wisdom teeth will need to be removed, an oral surgeon may call for general anesthesia. Medication to knock you out is applied through the nose or the arm and the patient is unconsciousness throughout the proceedings.
How Does the Procedure Work?
If the wisdom tooth hasn’t come through the gum, your dentist will make a small incision in the gum to access it. A small piece of any bone covering the tooth may also need to be removed. The tooth may be cut into smaller parts to make it easier to remove through the opening. There’s less need to make an incision if the tooth has broken through the gum.
In most cases, for a single wisdom tooth, the patient is only under local anesthesia. In these cases, you’ll feel some pressure just before the tooth is removed. Often the dentist or oral surgeon needs to widen the tooth socket by rocking the tooth back and forth before taking it out. How long it takes to remove the tooth will vary. Simple procedures can take a few minutes, but it can take longer than 20 minutes if it’s more complicated.
What Is Recovery Like?
Depending on the severity of the case, it can take up to 2 weeks to fully recover after having wisdom teeth removed. During this time, patients may have a swollen mouth and cheeks. This will be worse for the first few days but will gradually improve. A stiff, sore jaw is not uncommon, and these effects will wear off within 7 to 10 days.
Also, depending on the severity of the case, the recovering patient may feel some pain for a few days. This will vary in intensity and length depending on whether the extraction was difficult or complicated. Your dentist or oral surgeon may prescribe pain medication, but in most cases, simple over-the-counter ibuprofen is the best painkiller to take after having wisdom teeth removed.
In broad strokes, the healing process from a wisdom tooth extraction will follow a pattern:
First 24 hours: Blood clots will form around the extraction point
2 to 3 days: Any swelling of the mouth and cheeks will improve
7 days: Your dentist will remove any stitches
7 to 10 days: Residual jaw stiffness and soreness should go away
2 weeks: Any mild bruising on the face that may have occurred will heal
Time to Take Action
When a wisdom tooth becomes impacted, the damage has already been done and must be addressed by your dentist. Regular checkups and X rays will help you and your dentist keep abreast of potential upcoming problems with wisdom teeth. This lets you make plans and minimizes the chance of pain and possible complications.
Wisdom teeth can cause serious oral problems. Even when they seem to be erupting properly, they cannot be aligned by an at-home straightening kit. An expert such as your dentist needs to take thorough X-rays and work with you to formulate a plan for wisdom tooth management. He or she can also advise you on cosmetic straightening treatments that will be more effective than any self-guided methods, such as the ‘straightening of the month clubs.”
Your smile and oral health are too important to be left to amateurs. For expert care on wisdom tooth extraction and cosmetic enhancement of your smile, make an appointment with Mas’ood Cajee DDS MPH, in Manteca, CA today!
