The wisdom tooth is the last of your permanent teeth to erupt. It usually appears between ages 12 and 15 years old, but can appear at any time during childhood or adolescence. If you have a missing tooth in this area it may be due to an abscessed tooth that has not yet erupted. This condition is called impaction. Impacted wisdom teeth are painful because they irritate nerves inside the jawbone. They also cause swelling around the face which makes eating difficult.
What happens if wisdom teeth are not removed?
If left untreated, impacted wisdom teeth will continue to grow into the gum tissue surrounding them causing pain and inflammation. The bone beneath the gums becomes infected as well. Eventually, the infection spreads through the body resulting in serious health problems such as heart disease, diabetes, stroke, kidney failure, liver damage, and even death.
How do I know if my Wisdom Teeth need removal?
Impacted wisdom teeth should never remain in place for more than 3 months without being treated by a dentist. You might notice one or two symptoms:
- Pain when chewing food
- Swelling on the cheek near where the tooth would normally sit
- Difficulty sleeping
- A bad taste in the mouth
- Bad breath
- Bleeding from the gums
- An unusual amount of pus coming out of the nose or ears
- Loss of appetite
Removing Wisdom Teeth
If you do decide to remove one of these impacted wisdom teeth, there are several ways to go about doing so:
The most common way to extract impacted wisdom teeth is through surgery. A small incision will be made on either side of the gum line where the tooth sits. Once the tooth is exposed, it will then be removed using forceps. Afterward, stitches will be placed over the wound site. Recovery from surgical extraction takes anywhere from two weeks up to three months depending upon how severe the infection was when the tooth first became impacted.
An alternative method for removing impacted wisdom teeth is by performing root canal therapy. Root canal therapy involves cleaning out all pulp material within the tooth’s roots. Then, filling materials such as gutta-percha points are used to seal off the empty space left behind after the procedure. In some cases, if the tooth cannot be accessed with endodontics, it may need to be extracted surgically.
Another option for extracting impacted wisdom teeth is laser-assisted removal. Laser-assisted removal uses high-powered lasers to break down hard tissue surrounding the tooth without damaging soft tissues like gums and bone.
Extraction under local anesthesia
For patients who prefer less invasive options, extraction under LA is often recommended. During this type of procedure, numbing medication is administered before the tooth is pulled. Local anesthesia works best for minor procedures like wisdom tooth removal. However, general anesthesia must be considered for more complicated situations. General anesthesia requires sedation to help relax the patient while he/she sleeps. Sedatives work well for children, however, adults should consider other methods of pain relief including prescription medications.
Aftercare Tips after Wisdom Tooth Removal
Wisdom tooth removal is typically performed under local anesthesia. You’ll likely experience mild discomfort following the procedure. Most people feel better right away, although some individuals may require additional pain medicine. Your dentist will provide instructions regarding proper oral hygiene techniques after the procedure.
He or she will also give you specific guidelines on what foods to avoid until healing occurs. Healing times vary based on individual factors but generally take 2–3 days. It’s important that your mouth heals properly in order to prevent any complications.
- Avoid brushing near the area where the tooth has been taken out. Brushing can cause bleeding which could lead to a recurrence of swelling.
- Do not eat anything cold. This includes ice chips, popsicles, etc. These items can irritate the remaining nerve endings causing further irritation and inflammation.
- If possible, rinse your mouth thoroughly at least twice daily with warm saltwater. Salt helps cleanse the mouth and kill bacteria.
- Use only over-the-counter analgesics as prescribed by your doctor. Never use aspirin unless directed by your physician. Aspirin can thin the blood and increase the risk of internal bleeding.
- Take care to keep the wound dry. Moisture encourages bacterial growth.
- Keep the jaw closed during meals so food does not get trapped between teeth. Food particles lodged between teeth can become infected leading to abscesses.
- Rinse your mouth frequently with an antiseptic mouthwash. Antibacterial rinses are available from most drug stores. Be sure to follow directions carefully. Some products contain alcohol which dries up mucous membranes making them susceptible to infection.
- Limit caffeine intake. Caffeine stimulates saliva production which increases flow through salivary glands resulting in increased sensitivity around the surgical site.
- Don’t smoke cigarettes.
How to sleep after a tooth extraction
If you have had an impacted wisdom tooth removed, it’s normal to wake up feeling groggy and sore. The first thing you need to do when waking up is to drink plenty of fluids. Try drinking clear liquids such as juice, soda, tea, broth, soup, milk, coffee, and hot chocolate. Water is always recommended because it doesn’t aggravate the gums. Other things you might want to try include:
- Taking Tylenol or ibuprofen for pain relief. Ask your dentist if this medication would be safe before taking it.
- Using a heating pad or applying heat packs to reduce swelling.
- Eating soft foods like applesauce, pudding, yogurt, mashed potatoes, bread, toast, rice cakes, crackers, cheese, and bananas.
- Sleeping on your back rather than side sleeping. Side sleeping puts pressure on the cheekbone areas which causes more swelling.
Complications of Wisdom tooth removal
The most common complication associated with wisdom tooth extractions is postoperative hemorrhage. Hemorrhaging usually begins within 24 hours after surgery and lasts about 1 week. The amount of bleeding varies greatly among patients. Bleeding tends to be heavier when there is an injury to the gums surrounding the impacted tooth. In addition, if the gum tissue is injured it takes longer for the body to heal than normal. Other potential problems include:
This often starts immediately following the operation and continues for several weeks. Symptoms include fever, chills, swollen lymph nodes, pus formation under the skin, redness, tenderness, and foul odor. Treatment involves antibiotics and possibly draining fluid collections.
Severe discomfort lasting more than 3 months. Causes include bone damage, nerve damage, muscle spasm, scarring, and poor dental health.
Painless but may last 2–3 days. It occurs because the pressure on nerves causes local edema.
Am inability to open the jaws fully due to tight muscles that prevent opening. Usually resolves spontaneously without treatment.
Pain caused by damaged pulp inside the root canal. Can occur anytime after the procedure.
Dry Socket Syndrome
This condition results from insufficient blood supply to the socket area where the tooth was removed. This leads to slow healing and possible loss of the alveolar ridge. Dry socket syndrome is characterized by painful inflammation, redness, ulceration, and necrosis of the tissues. If left untreated, these conditions lead to further complications such as infection of the bone, sinus tract infections, and sepsis.