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Wisdom Teeth: What to Do When They Cause Problems

Wisdom teeth are notorious for causing problems. Also referred to as third molars, they’re found in the very back of the mouth, near the entrance to the throat, and are typically the last of the 32 adult teeth to erupt. The problem is, most people don’t have enough space to accommodate a third set of molars, so they rarely erupt properly and become functional teeth.

Instead of developing into normal, healthy teeth, wisdom teeth often become impacted, or stuck, partially below the gumline. Even when they erupt fully, they rarely come in straight and, more often than not, they wind up crowding the other teeth. 

When to Have Wisdom Teeth Removed

Most people develop their third molars between the ages of 17 and 25, so it’s best to have them removed during early adulthood. Problems with third molars are common enough that some oral surgeons recommend removing them before they even erupt. However, some patients elect not to have their wisdom teeth removed, preferring to take a wait-and-see approach.

No matter how patients feel about wisdom tooth removal, some circumstances require extracting one or more third molars. If a wisdom tooth becomes impacted, it can lead to serious secondary problems with infections and crowding. Removing these problematic third molars in advance can help to prevent:

Gum Infections

Impacted or only partially erupted wisdom teeth create a breeding ground for bacteria. Gum infections can lead to pain, swelling, problems with swallowing, and difficulty chewing.

Cyst Formation

Cysts are fluid-filled sacs that develop inside a patient’s jawbone as a result of wisdom tooth impaction. Over time, they can expand, damaging adjacent parts of the jawbone and nearby teeth.

Crowding of Other Teeth

Most people don’t have enough room in their mouths for wisdom teeth. Even when they erupt properly and come in straight, they can crowd other teeth throughout the mouth, making it harder for patients to keep them clean.

 

How to Prepare for the Appointment

The first step is to schedule a consultation with an oral surgeon who can perform the wisdom tooth extraction. During this consultation, the surgeon will explain the procedure and patients will have a chance to ask any questions they may have.

It’s important to avoid eating or drinking for at least six hours before the appointment if a general anesthetic or sedative will be used. Patients should still take prescription medications. However, consuming foods or liquids before undergoing anesthesia can increase the risk of complications. Patients who do not need conscious sedation or general anesthesia don’t need to avoid food and drinks.

On the day of the surgery, most patients take medications to minimize pain and swelling. Even if they do not plan to be sedated, patients should still bring a parent or another responsible adult to the appointment. Most extractions take only 30 to 60 minutes, at which point the patient will be able to go home to recover.

 

What to Expect During Recovery

Once the local anesthesia wears off, patients may experience pain, swelling, and discomfort. Most of the time, these post-operative symptoms can be managed using over-the-counter anti-inflammatories like Ibuprofen, but patients may also be prescribed other painkillers, especially following more complex wisdom tooth surgeries. Here’s what to expect during each stage of the recovery process:

  • First day: blood clots will form
  • Two to three days: the swelling should be going down
  • One week: a dentist can remove the remaining stitches
  • Seven to ten days: the patient should be free from soreness and swelling
  • Two weeks: the wounds should be healed

Post-Op Care

The most important part of post-op care for wisdom tooth extractions is keeping blood clots in place. The clots start to form almost immediately after the surgery and they help to prevent excess bleeding, protect against infection, and allow new tissue to grow. Dislodging them can lead to a painful condition known as dry socket, which will require an emergency visit to a dentist for care. To keep the blood clots in place, patients should avoid these activities for at least 24 hours:

  • Brushing near the extraction site
  • Using mouthwash
  • Consuming hot drinks
  • Using straws
  • Chewing
  • Smoking
  • Using straws
  • Drinking alcohol

Stick to liquids and soft foods for the first day, and avoid chewing gum or eating sticky candy for the first two to three days after the surgery. Otherwise, just follow the oral surgeon’s guidelines and look for signs of infection such as a fever, severe pain, or excessive bleeding. Infections are rare when patients keep the area clean and follow the best practices described above.

Frequently Asked Questions

Don’t be afraid to ask questions at the pre-surgical consultation. Many patients are nervous, and addressing concerns in advance is the best way to alleviate anxiety about this common procedure. Patients can also find answers to some of the most frequently asked questions about wisdom tooth removal below.

Is Wisdom Tooth Removal Painful?Wisdom tooth removal, itself, should not be painful since patients will be given anesthesia before the procedure. Once the anesthesia wears off, some pain or discomfort is normal. However, most patients can manage their pain and soreness effectively using over-the-counter medications.

Should I Get 2 or 4 Wisdom Teeth Removed?
Most oral surgeons recommend that patients have all four of their wisdom teeth removed, even if only one or two of them are actively causing pain. Wisdom teeth are notorious for causing dental problems, so even if those third molars haven’t erupted yet, it makes more sense to remove them than it does to take a wait-and-see approach.

Can I Get My Wisdom Teeth Out Without Anesthesia?
Most patients do not require general anesthesia or sedation for wisdom tooth removals. Oral surgeons can use local anesthesia for basic wisdom tooth extractions. However, more complex surgeries may require some form of sedation.

Does Removing Wisdom Teeth Change Face Shape?
People’s wisdom teeth are located in the backs of their mouths, where their jawbones are very dense. As a result, taking them out does not have any noticeable impact on jaw or face shape.

Are You Asleep for Wisdom Teeth Removal?
In most cases, patients are awake but numb for the extraction procedure. Those with dental anxiety can also receive a conscious sedation anesthetic. Conscious sedation may or may not put people to sleep, in literal terms, but it usually prevents the formation of conscious memories.

 

Schedule a Consultation Today

Wisdom tooth removal isn’t as scary as many people think. It’s a standard procedure with a low rate of complications and a quick recovery time. Don’t put off removing wisdom teeth until they become severely impacted. Schedule a consultation with an oral surgeon to discuss options today.