MINOR ORAL SURGERY
Removing Impacted Teeth
Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt (to come out into the oral cavity). They usually come in when a person is in their late teens or early twenties. It is not uncommon for wisdom teeth to erupt even when you are in your forties!
As wisdom teeth are the last permanent teeth to come in or erupt, there is often not enough room left in your mouth to accommodate them. Some may emerge partially in the oral cavity and some may have an unfavourable position which will then lead to episodes of pain and inflammation ranging from mild to very excruciating pain. If a patient is presented with pain and swelling, it is best to get it checked with a dentist to check the positioning of the tooth to see if they need to be removed.
You may ask us about the positioning of your wisdom teeth. We may take an X-ray periodically to check the presence and alignment of your wisdom teeth. We may also decide to send you to a specialist oral maxillofacial surgeon for further evaluation if it is extremely complex. We will advise you and answer all your questions.
We may recommend that your wisdom teeth be removed even before problems develop. This is done to avoid a more painful or complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, the recovery and healing times tend to be longer.
How easy it is to remove your wisdom teeth depends on their position and stage of development. We will be able to give you an idea of what to expect during your pre-extraction examination.
A wisdom tooth that is fully erupted through the gum can be removed as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Often for a tooth in this situation the tooth will be extracted in small sections rather than removed in one piece, this minimises the amount of bone that needs to be removed to get the tooth out.
Even if the wisdom teeth are erupted, the tooth (or teeth) still may need to be removed. After surgery you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur. We will ensure that you are well before you leave the clinic.
Remember, if the wisdom teeth are impacted and embedded in the bone, we will make an incision into the gums and remove the tooth or teeth in sections. Some pain and swelling may occur, but it will normally go away after a few days. However, you should call us if you have prolonged or severe pain, swelling, bleeding, or fever.
Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future. Once surgery is completed, swelling and tenderness in the face and neck are common. Ice packs and pain medications prescribed by us will help. If you have any questions or are concerned about what you are experiencing, you can always ask us as we will be calling you to check that you are comfortable the next day after the surgery.
• Do not rinse your mouth for the first 24 hours immediately following a tooth extraction
• Stick to a soft or liquid diet (milk, ice cream, mashed potatoes, porridge) the day of and the day after a tooth extraction, gradually progressing to eating other easy-to-chew foods. Chew with teeth that are far from the extraction site.
• Brush and floss the other teeth as usual, but avoid the teeth and gum next to the extraction socket.
• After the first 24 hours for at least five days after extraction, gently rinse the socket with mildly warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed.
In addition to the above aftercare considerations, tooth extraction aftercare also involves avoiding certain foods and activities.
• Avoid anything that might dislodge the blood clot and delay or prevent normal healing.
• Do not smoke, vigorously rinse or spit, engage in strenuous activities. You may drink through a straw for at least two days after an extraction if needed.
• Stay away from hot liquids, foods that are crunchy or contain seeds or small grains, alcohol, and carbonated soft drinks for 2 to 3 days after tooth extractions.
• Do not brush your gums. Use homemade water-and-salt washes to keep your gums clean.