The extraction of your wisdom teeth depends on your position and stage of development. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that bursts completely through the gum can be removed as easily as any other tooth.
However, a wisdom tooth that is located under the gums and embedded in the jaw will require an incision in the gums and then removal of the portion of bone above the tooth. Often, for a tooth in this situation, the tooth will be removed in small sections rather than in one piece to minimize the amount of bone that needs to be removed to extract the tooth.
Extraction is easier in young people, when the roots of the wisdom teeth are not yet fully developed and the bone is less dense. In older people, the recovery and healing time tends to be longer.
Process:
The wisdom teeth are removed under local anesthesia. Before the wisdom teeth are removed, the teeth and surrounding tissue will be numbed with a local anesthetic medication. If necessary, in addition to the local anesthetic, you and your dentist or oral surgeon can decide on a sedative to control any anxiety.
edative medications that may be selected include nitrous oxide, also known as “laughing gas,” an oral sedative (eg, Valium), or an intravenous sedative (given by injection into your veins).
Recovery
After your wisdom teeth are removed, the speed of your recovery depends on the degree of difficulty of the removal (a simple removal of a fully erupted tooth versus an impacted tooth in the jaw). Overall, this is what you can expect.
During the first 24 hours
- Bleeding can occur for several hours after tooth extraction. To control this, place a clean, wet piece of gauze over the empty tooth cavity and bite down firmly. Apply constant pressure for about 45 minutes. A moistened tea bag is an effective alternative. The tannic acid in tea helps to heal the formation of blood clots (blood clots work similar to the scab on an open wound). Repeat this process if a small degree of bleeding continues; If it continues to cause heavy bleeding, contact your dentist or oral surgeon. Avoid rinsing or spitting for 24 hours after tooth extraction, avoid “sucking” actions (for example, don’t drink through straws or smoke), and avoid hot liquids (such as coffee or soup). These activities can dislodge the clot, causing dry development (see below).
- Facial swelling in the area where the tooth was removed usually occurs. To minimize swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a 10-minute schedule, followed by a 20-minute break. Repeat as needed during this first 24 hour period.
Pain medications, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil), can be taken for mild pain. Your dentist or oral surgeon can prescribe more powerful pain relievers, if needed.
Antibiotics that may have been prescribed prior to tooth extraction (to treat any active infection around the wisdom tooth to be removed) should be continued until the full prescription is completed.
Food should be restricted to a liquid diet until all numbness from anesthesia has disappeared. Eat soft foods for a few days. Also avoid alcohol if you are also taking narcotic pain medicine.
Continue brushing your teeth, but avoid teeth directly adjacent to the extracted tooth for the first 24 hours. On the second day, resume gentle brushing of your teeth. Do not use commercial mouthwashes as they can irritate the extraction site.
After 24 hours
- Facial swelling in the tooth extraction area should be treated with heat after the first 24 hours of ice. Apply a warm, wet towel to the area on a 20-minute, 20-minute break. Repeat as necessary. Note that the swelling usually peaks 2 to 3 days after the procedure.
- Rinse your mouth with warm salt water (1/2 teaspoon salt in a cup of warm water) after meals and before bed. Do not use commercial mouthwashes unless your dentist tells you to.
- Stitches, if used and not of the automatic dissolution type, should be removed by your oral health care provider in approximately 1 week.