Everyone’s Favorite Dental Procedure: Wisdom Tooth Extraction

By Alexis O.
Managing Editor
Most teenagers and young adults have those pesky little teeth way in the back of their mouths that serve absolutely no purpose and can end up ruining their gorgeous, gleaming smiles. While the lucky ones never have to worry about getting these teeth removed, the more common, unlucky folks must go through treacherously painful surgery followed by an even more brutal recovery process. While it is most definitely not one of the worst occurrences that could happen to a person, it is definitely up there on the “not so much fun” list of things to do.
If a wisdom tooth does not have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, one will likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon. Some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth are not causing problems, as a preventive measure against potential future problems. An impacted wisdom tooth may grow straight up or down like other teeth but stay trapped within the jawbone, grow at an angle toward the next tooth, grow at a right angle toward the other teeth, or grow at an angle toward the back of the mouth.
If one chooses not to remove his or her wisdom teeth, it is difficult to predict future problems. Older adults may experience difficulty with surgery and complications after surgery. However, symptom-free wisdom teeth could still harbor disease, but serious complications rarely occur in young adults. Fortunately, most wisdom tooth extractions do not result in long-term complications. Some problems may occur include dry socket, or exposure of bone when the post-surgical blood clot is dislodged from the site of the surgicalwisom teeth AO 2 wound (socket) — a complication that delays healing and causes pain; damage to nerves that results in altered sensation in the lower lip, tongue or chin; infection in the socket from bacteria or trapped food particles; weakening of the lower jawbone; and damage to sinuses near the upper wisdom teeth. As terrible as all these complications may sound, younger patients are usually better off and less likely to encounter these obstacles.
Thankfully, a wisdom tooth extraction is almost always performed as an outpatient procedure. This means that one goes home the same day. One’s doctor or oral surgeon may use one of three types of anesthesia. The appropriate anesthesia for a person depends on the expected complexity of the wisdom tooth extraction and the patient’s own comfort level. The doctor or oral surgeon administers the sedation anesthesia through an intravenous line in the patient’s arm. Sedation anesthesia suppresses consciousness during the procedure so that the patient does not feel any pain. The patient will also receive local anesthesia to numb his or her gums.
When the day finally arrives, the surgeon first makes an incision in the gum, creating flaps to expose the tooth and bone. Next, the surgeon removes any bone that blocks access to the tooth. If that is not needed, the tooth is divided into sections if it is easier to remove in pieces. Then the tooth is removed. After the site is cleaned, the anesthesia wears off, and the patient wakes up.
After the surgery, the patient should plan to rest for the remainder of the day before resuming normal activities the next day. For at least a week after the procedure, the patient should avoid strenuous activity that might result in dislodging the blood clot from the socket. One should drink lots of water after the surgery. He or she should not drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. The patient should not drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket. The patient should only eat soft foods, such as yogurt or applesauce, for the first 24 hours. One should be eating semi-soft foods when they can be tolerated. Hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound should be avoided. One may be able to manage pain with a prescription pain medication — given by the doctor or oral surgeon — or an over-the-counter pain reliever, such as acetaminophen (Tylenol). Holding a cold pack against the jaw also may relieve pain.
Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that the blood clot is not dislodged from the socket. Replace gauze over the extraction site as directed by the dentist or oral surgeon. Swelling and bruising of the cheeks usually improves in two or three days. Use an ice pack as directed by the dentist or surgeon. This procedure is usually required for everyone and very common, so anxiety and fright should not be an issue. Patients should keep themselves comfortable, and recovery will rapidly run its course.

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