When there is insufficient space for wisdom teeth, they can cause a number of problems. When they are partially erupted, the opening around the teeth often allows food and bacteria to impact and grow without the possibility of cleansing. The result of this non-cleansable space is gum infection, swelling, and pain. The most serious problems occur when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
Video: Wisdom Tooth Removal
There are some complications that can occur with wisdom tooth removal. A very infrequent, but significant complication in certain presentation is damage to the nerve within the lower jaw that gives sensation to the lip, chin, and tongue. In rare instances this nerve can be injured. Should this injury happen, it is frequently temporary, and resolves over a period of weeks to months. In extremely rare instances, permanent altered sensation could be had.
Dry sockets is the premature loss of a blood clot in a large socket a few days after surgery. This complication is most commonly associated with lower wisdom teeth and seems to occur with greater frequency in people who smoke or are taking birth control. Patients with dry sockets can experience a deep ache and often bad breath. The pain from this complication can be managed through follow-up with the surgeon and the application of dressings.
When the upper wisdom are directly situated against the sinus, their removal can result in a communication between the sinus and the mouth. Often this communication will close spontaneously while following particular home-care instructions.
Video: Impacted Third Molar
Dental extractions are generally straightforward out-patient procedures in which the patient can remain awake but increased levels of sedation can be used at the patient’s request. We will always use local anesthetic to numb your tooth. During tooth removal, you may feel pressure, which is normal. Your comfort is our top priority, so if you feel any sensation other than pressure, please let us know right away. Some teeth may require sectioning when they are firmly fixed in the jaw or the root is curved. In this case, the doctor will simply section the tooth into smaller pieces to allow for complete removal. Depending on the procedure, full recovery can take anywhere from days to weeks.
Video: Surgical Extraction
The healing process begins by forming a stable blood clot. A clot forms best by biting down on gauze for 30 minute intervals, evaluating the gauze, and reapplying gauze to the site if some bleeding remains. You may have to cycle through several sets of gauze and pressure to form a non-bleeding clot.
After the clot is had, it is important not to agitate or disturb the clot site. Often we find that suction through straws, drinking, smoking, sharp hard foods, and vigorous swishing dislodge patients’ clots. To heal and reduce pain as best as possible, we recommend you refrain from these activities for a week. Additionally, vigorous exercise for the first 48 hours should be avoided to keep a stable clot.
We recommend you take plenty of fluids and eat nutritious, soft, foods after the tooth extraction. You can resume your normal dental hygiene after 24 hours around everywhere but the surgical site —please do not attempt to clean the surgical site out with anything other than a gentle cleansing of saline water. To make saline water combine ¼ teaspoon of salt with 1 cup of water.
Please use pain and antibiotic medications as directed. Feel free to call our office if the medication doesn’t seem to be relieving the pain significantly, if your pain gets worse four days or more after the extraction, or you appear to be having an allergic reaction.