Wisdom Tooth Extraction – Safety, Procedure, Recovery

Wisdom Tooth Extraction – Safety, Procedure, Recovery

Wisdom teeth extraction is the dental procedure performed to remove the third molar tooth/teeth (wisdom tooth) from the patient’s mouth. 

Fun Trivia: Did you know that by the age of 13 all humans get 28 out of their 32 permanent teeth? 

But what about the remaining four teeth which complete the set of 32 permanent teeth? Dr Vikram Pandit – MDS (Oral and Maxillofacial Surgeon) explains that the last 4 teeth erupt between the ages of 17 – 25 and are popularly known as “Wisdom Teeth”. 

There are many misconceptions about Wisdom Teeth and doubts in the minds of patients that Dr Vikram Pandit, Pandit Clinic’s expert Oral and Maxillofacial Surgeon will be addressing through this blog. This blog aims to answer all FAQs about wisdom teeth and wisdom tooth extractions.

What Is A Wisdom Tooth?

Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth.  This generally occurs between the ages of 17 and 25, a time of life that has been called the “ Age of Wisdom ”.

Anthropologists note that the rough diet of early humans resulted in the excessive wear of their teeth. Normal drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence. 

On the other hand, the modern diet is much softer. Also, access to dental care on time has led to the rise of orthodontic tooth straightening procedures which produce a fuller dental arch. And yes, while they do create a fuller dental arch these procedures don’t leave room for the wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.

How Do I Know When My Wisdom Tooth Is Coming In?

Wisdom tooth begin coming in during the adolescence years. For some people they erupt early in their teens while for some they may erupt in their twenties.

Another peculiar fact about wisdom teeth is that not necessary all four of them will erupt at the same time.

Typically patients feel pain, swelling, headaches and heightened discomfort at the back of the jaw.

In some cases, patients also have gum infections when the wisdom tooth is coming in.

Hence, I advise patients to visit a dentist immediately when they see symptoms of wisdom tooth coming in.

What Are The Dental Issues Caused By An "Impacted" Wisdom Tooth?

Wisdom teeth which erupted to the earlier (pre-modern) human were not a dental issue since the diet required these late erupting teeth to compensate for the wear and tear of the other teeth. 

But in today’s day and age, wisdom teeth seem to become a cause for many dental health issues if not treated on time. One of the main reasons being that the modern jawline does not have enough space to accommodate these late-erupting teeth. The lack of space in the dental arch for eruption and growth is known as “impacted tooth”. 

Following are the issues caused by an impacted tooth: 

  • Growing at an angle toward the next tooth (second molar)
  • Growing at an angle toward the back of the mouth
  • Growing at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
  • Growing straight up or down like other teeth but stay trapped within the jawbone

In a lot of cases I have seen the impacted wisdom tooth/teeth cause a high amount of pain and oral care problems to the patients.

How Serious Is An Impacted Tooth?

Impacted teeth can be painful and lead to dental infections.

They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. 

Rarely, if a cyst is not treated, a tumour may develop from its walls and a more serious surgical procedure may be required to remove it.

Hence, I urge you to visit a good dentist as soon as you feel pain/discomfort when the wisdom tooth begins to erupt. Timely treatment is the safest way forward.

Do All Wisdom Teeth Need To Be Removed?

Now this question doesn’t have a one-size-fits-all answer. As an Oral and Maxillofacial Surgeon I can firmly states that whether or not a wisdom tooth needs extraction should be decided on a case to case basis. Every patient has a unique case and as such, the dentist in question needs to understand and treat him/her accordingly. 

The second aspect to this question is understanding why wisdom tooth extraction may be necessary in a large number of cases. Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it.

As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age.

No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

Please keep these facts in mind when you seek treatment for wisdom teeth.

What To Ask Your Dentist About Wisdom Tooth Extraction?

I have prepared a list of questions which you can ask your local dentist when going for a wisdom tooth extraction treatment. The answers to these questions will help you in making informed choices and remove the fear of the treatment from your mind: 

  1. How many of my wisdom teeth are impacted? 
  2. How many wisdom teeth will you be extracting? Is it necessary to extract all of them? 
  3. Has the impacted tooth caused/will cause serious damage to the adjacent teeth/gums? 
  4. Apart from wisdom tooth extraction will I be needing any other dental treatments as a consequence of this? 
  5. Is the wisdom tooth extraction procedure safe? 
  6. How long does the wisdom tooth extraction procedure take? 
  7. Will I be administered with anaesthesia for the procedure? If yes, then will it be local or general? 
  8. Should I bring a friend or a family member with me to take me home safely after the procedure? 
  9. What should I expect for the recovery from the wisdom tooth procedure? 
  10. How long will the recovery take and when will be able to resume my normal daily activities? 
  11. Should I be doing any special preparations for the wisdom tooth extraction surgery? 

Some of these questions may appear trivial but when you get the right answers you will be much more reassured and calm in the days leading up to the procedure.

What To Expect Before The Wisdom Tooth Extraction Surgery?

Consultations and detailed discussions on the wisdom tooth extraction procedure with your dentist before you step in for the treatment are a must. 

At Pandit Clinic in Pune, I explain everything related to wisdom teeth and the wisdom tooth extraction procedure to the patient during the consultation. Dental X-Rays are taken to confirm the diagnosis and all queries that arise in the mind of the patient are resolved. 

My aim is to help the patient in making an informed decision regarding his own treatment. He also uses the time leading up to the surgery to eliminate any pain/discomfort the patient may be dealing with due to the eruption of the wisdom tooth by prescribing pain killer medicines and changes to diet.

  • Effects of Anesthetics

The length and the time you experience numbness varies, depending on the amount and the type of the anaesthetic used. 

While your mouth is numb, you’ll want to be careful not to bite your lip, cheek or tongue. For this reason, it is important that you do not have any foods that require chewing while your mouth is still numb. 

If you have liquids it is important to not use a straw as the pressure created my dislodge the clot and cause fresh bleeding. The numbness should subside in a few hours.

  • Bleeding

Your dentist may place a gauze pack on the site to limit the bleeding and confine the blood while clotting takes place. This pack should be left in its place for about 30 – 45 minutes after you leave the dentists office. Do not chew on the pack, just hold it gently.

After the pack is removed you may experience some bleeding, If so follow these instructions :

  1. Fold a piece of clean gauze thick enough to bite on. Dampen the gauze with warm water and hold it on the extraction site.
  2. Apply moderate pressure by closing your teeth firmly over the gauze pad. Maintain this pressure for 30 min.
  3. Do not suck on the extraction site or disturb it with your tongue.
  4. A slight amount of blood may leak from the wound till the clot forms. Do not panic. However, if it is heavy bleeding contact your dentist.

Here is how you can take care of the clot that will help heal your wound faster:

  1. Do not smoke, consume alcohol, drink with a straw or rinse vigorously for the next 24 hrs.
  2. Avoid mouth wash or aerated drinks or alcohol.
  3. Do not clean next to the bleeding socket for the rest of the day. However,  floss and brush other teeth thoroughly.
  4. Limit strenuous activity for the next 24 hrs.
  • Medication

If your dentist has prescribed medicines to control infection and pain, use them as directed. Call the dentist if the pain is not controlled, do not self medicate.

  • Swelling and Pain

You can help reduce swelling that may occur after extraction by applying a cold ice pack on your face for about 30 min. at regular intervals. If your pain and swelling does not reduce over a prolonged period or you suffer from nausea, severe pain, bleeding or fever, contact your dentist immediately.

  • Diet

Eat a healthy but soft nutritious diet, drink plenty of fluids and keep yourself fit. Try chewing from the opposite side. Start solid food consumption slowly and when you feel comfortable.

  • Follow up

Make sure you follow up after your extraction when instructed, even if you feel fine.

Thank you for reading this blog! 

We hope it helped to grow your understanding of wisdom teeth and wisdom teeth extraction. 

If you have any further questions Dr Vikram Pandit (MDS – Oral and Maxillofacial Surgery) will be happy to help you. Please send us an email at panditclinicindia@gmail.com

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Dr. Vikram Pandit

Dr Vikram is a well trained Oral and Maxillofacial surgeon. He completed his international fellowship in Craniofacial Surgery from Taiwan. His areas of interest include Oral surgeries, management of wisdom teeth, maxillofacial trauma, corrective jaw surgery, cleft lip and cleft palate. He has also trained in surgeries for Obstructive sleep apnea (OSA) and snoring.