Wisdom tooth extraction surgery is a procedure to remove a third set of molars, which usually appear between the ages of 17 and 25. Most people have at least one impacted wisdom tooth, which means that there is not enough room for it to grow naturally . By removing wisdom teeth, either because a plug was found or because they could cause problems, you can ensure that they do not damage the surrounding teeth and bones.
What is wisdom tooth extraction surgery?
Surgery to remove wisdom teeth is an outpatient procedure usually performed by a dentist or dental surgeon.
The dentist will recommend this surgery if the exam and x-rays show that your wisdom teeth are damaged or may cause dental problems in the future. (Not everyone has wisdom teeth, but most have one to four.)
The surgeon cuts the gum and removes the tooth in whole or in parts. You will be under anesthesia, which may include nitrous oxide (laughing gas) or intravenous (IV) sedation. Your surgeon will decide which sedative to use based on your comfort level and the complexity and number of extractions required.
Surgery to remove a wisdom tooth before age 20 is usually easier than surgery at a later age. Although age does not prevent wisdom teeth from being removed, it can make things difficult.
In young people, the roots of the teeth are not fully formed, so they are easier to remove and heal faster. As it ages, the roots become longer, curved, and more difficult to extract .
Complications of wisdom tooth extraction surgery can include :
- A dry socket is a painful condition that can occur if a blood clot after surgery dislodges from the extraction site, as a result of which the bone and the nerves underneath are exposed.
- Irritated nerves
- Sinus problems
The purpose of wisdom tooth extraction surgery.
Your dentist will monitor the development of your wisdom teeth during routine visits and with dental X-rays. They can talk about their removal if they are affected or may cause problems, such as the following :
- Damage to surrounding teeth
- Bone loss
- Loss of a tooth
Your dentist may recommend that you have wisdom tooth extraction surgery, even if you are not experiencing any current symptoms, to prevent potential problems before they start. Because wisdom teeth are in an area that is difficult to clean, maintaining good oral hygiene by leaving them in place can be difficult .
You may be referred to a dental surgeon for the procedure. The surgeon will schedule a preoperative consultation to review your dental records and take additional X-rays to confirm the extent of your surgical needs .
Call your dentist or surgeon if you have a dental emergency such as severe pain, fever, or loose teeth. Don't wait for the date of your surgery.
How to prepare
Ask your surgeon about any concerns you have before the procedure. They can tell you what to do a few days before surgery and how to plan your recovery time after surgery. They can also talk with you about the type of anesthesia that will be used and how you will feel after surgery.
The cost of wisdom tooth extraction surgery will depend on the degree of retention and the number of teeth extracted. Check with your dentist, surgeon, and insurance company about your benefits and what will be covered.
You can prepare for recovery by buying soft or liquid foods that are easy to eat after surgery. These include smoothies, applesauce, oatmeal, yogurt, and other foods that are easy to eat without chewing .
The operation to remove wisdom teeth is done in a dentist or dental surgeon's office .
What to wear
Wear loose, comfortable clothing for the procedure. If you are injecting intravenous anesthesia, wear a short-sleeved shirt or a shirt that can be easily rolled up. During the operation, you will not need to change anything.
Food and drink
Follow your surgeon's instructions on food and drink before surgery. Instructions may differ depending on the sedative you are using.
If you are given intravenous anesthesia, you will not be able to eat or drink after midnight before the procedure, so your stomach will be empty.
The risk of bleeding can be increased with medications such as aspirin, Coumadin (warfarin), and Advil (ibuprofen).
Inform your doctor and dentist if you are taking any medications before your dental surgery. They will tell you if you can continue taking your current medications or (and when) you should stop taking them in preparation for your surgery.
To avoid complications, tell your doctor about all your medications, including prescription or over-the-counter medications, vitamins, or other supplements.
Make sure you bring all the necessary documents and your dental insurance card.
Your surgeon will likely recommend that someone drive you home after surgery, as you will feel weak after anesthesia. If you wish, this person can wait for you in the waiting room.
Lifestyle changes before surgery
Avoid tobacco and alcohol for at least eight hours before surgery .
What to Expect the Day of Surgery
Be on time for your dental surgeon appointment. If necessary, your healthcare professional can take the x-ray of your teeth again on the day of your surgery.
During the operation
The operation should take about 45 minutes. You should not feel pain or discomfort with the anesthesia. Depending on the type of sedation used, you may be asleep or awake during the operation.
Here are the steps for a typical procedure:
- Sedation: If you are taking nitrous oxide (laughing gas), a small mask will be placed over your nose to inhale the sedative, which will keep you awake but relaxed. If intravenous (IV) sedation is selected, an assistant will insert a needle into a vein in your arm to inject sedation throughout the operation. This is generally considered the most convenient option when you pass out, and you are unlikely to remember the procedure afterward.
- Numbness: After sedation, the surgeon begins by numbing the wisdom teeth and surrounding tissues.
- Tissue Removal: The surgeon removes any gum tissue that covers the area where the wisdom tooth is located to access the tooth.
- Bone removal: An impacted wisdom tooth may be partially or fully covered with bone. In this case, a high-speed handpiece is used to drill and extract the bone covering the tooth.
- Tooth loosening and splitting: When the dentist can see the impacted wisdom teeth, various surgical instruments are used to gently separate them from the connective tissue in the tooth socket. The surgeon can also cut the tooth into pieces to facilitate extraction.
- Tooth extraction: After a wisdom tooth has been loosened or completely dissected, it is ready to be extracted. The surgeon will use surgical instruments specifically designed for the complete extraction of the tooth.
- Points: Now that there are no wisdom teeth, the surgeon can suture to close the area. This is sometimes necessary when retained wisdom teeth are removed or when the doctor believes that the patient heals better with sutures.
After the operation
After the procedure is completed, the IV or nitrous oxide infusion is stopped and you slowly recover from sedation.
The dentist will give you a piece of gauze so that you can bite into it so that the blood in the area can set. Immediately after surgery, you may feel mild effects of anesthesia, including nausea, dizziness, and tremors .
You will be taken to the recovery room, where you will be watched. Once the specialist determines that you are stable and breathing normally, you will be allowed to go home. You usually spend less than an hour in the recovery room.
After surgery, it will feel broken and swollen. You may not feel severe pain right away, but it is likely to get worse as the local anesthetic wears off a few hours after surgery.
In the first 24 hours after surgery:
- Avoid vigorously rinsing your mouth and drinking through a straw.
- Do not drink alcohol or use alcohol-based mouthwashes.
- Do not brush your teeth near the extraction site. Use a soft, hand-held toothbrush that is softer than an electric one .
Some pain, bleeding, and swelling in the mouth and cheeks may persist for several days after surgery. You may not be able to open your mouth fully during this time .
The extraction site can take up to six weeks to heal, but most people can return to normal activities the next day. However , avoid strenuous activity for a week after surgery to avoid pulling out the blood clot.
Avoid smoking during the healing process.
Your dentist or surgeon will give you an extra gauze that you can use at the extraction site at home.
If it starts to bleed after removing the gauze, fold another piece of clean gauze over the gauze. Dampen a pillow with warm water and gently hold it between your teeth in the extraction area. Avoid chewing gauze. Keep it on for about 30 minutes and replace it if it is soaked in blood .
Your dentist may also recommend that you soak the tea bag and bite down gently for 30 minutes to stop the bleeding. Tea contains tannins, compounds that can constrict blood vessels to stop bleeding.
In a 2014 study, researchers gave patients a plain gauze or gauze soaked in green tea extract to apply to the gums after tooth extraction. They found that green tea extract gauze was more effective in stopping bleeding than regular gauze .
As you recover, watch for symptoms of dry socket, including:
- Severe pain from the hole into the neck or side of the face.
- Visible bone at the extraction site
- Bad smell or taste in the mouth
Contact your surgeon immediately if you have any symptoms of dry socket, heavy bleeding, or severe pain.
Over-the-counter pain relievers such as Tylenol (acetaminophen) and Advil (ibuprofen) are often effective for pain after wisdom tooth extraction. You can also try placing an ice pack or a cold, damp kitchen towel on your face to relieve swelling and pain .
In some cases, your surgeon may prescribe pain relievers, which may include opioids such as hydrocodone and oxycodone. These medications may be safe if used as directed for a short time. It is important to follow the surgeon's instructions because misuse can lead to overdose, dependence, or death .
Food and drink
Your dentist will advise you on what and when to eat after surgery. The soft tissues in your mouth are likely to be tender for several weeks. You can usually start eating soft or liquid foods and gradually add more solid foods as you feel ready. Avoid spicy, acidic, chewy, or small, hard foods (such as nuts, seeds, and muesli) that can cause irritation.
Your dentist may recommend that you gently rinse your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) after meals, being careful not to expel any blood clots .
Get the word of drug information
Wisdom tooth extraction is a common dental procedure and complications are rare. For a successful recovery, it is important to strictly follow the postoperative instructions received, especially during the first seven to ten days after the procedure. Take the time to ask any questions you have to fully understand how to take care of yourself during this time.