When a tooth becomes decayed or fractured to the point where a restoration cannot treat it, then many times extracting the tooth is the only treatment to prevent further damage or infection to the surrounding area. Some extractions are called "simple" or "non-surgical" extractions when a tooth is removed without having to manipulate or remove gum or bone. In some cases, a surgical approach is needed to remove small amounts of gum and bone tissues around a tooth in order to remove it. We provide both treatments, however the extractions of impacted wisdom teeth are usually referred to an oral surgeon for treatment.
Extractions of Third Molars (Wisdom Teeth)
Before removing a wisdom tooth, the oral surgeon will give you a local anesthetic to numb the area where the tooth will be removed. Intra-venous sedation may be used, especially if several or all of your wisdom teeth will be removed at the same time. Sedation prevents pain in the whole body and will make you groggy or cause you to sleep through the procedure. Your oral surgeon may recommend that you don't eat or drink after midnight on the night before surgery, so you are prepared for the anesthetic.
To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. He or she will separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the oral surgeon will section the tooth into smaller pieces to make it easier to remove.
After the tooth is removed, you may need stitches. Some sutures dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your sutures need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.
What To Expect After Surgery
In most cases, the recovery period lasts only a few days. Take painkillers as prescribed by your dentist or oral surgeon. The following tips will help speed your recovery.
Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. Call your dentist or oral surgeon if you still have moderate-severe bleeding 24 hours after your surgery.
While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.
Try using an ice pack on the outside of your cheek for the first 24 hours. You can use moist heat-such as a washcloth soaked in warm water and wrung out-for the following 2 or 3 days.
Relax after surgery. Physical activity may increase bleeding.
Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing.
After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain.
Do not smoke for at least 3-5 days after your surgery. The sucking motion can loosen the clot and delay healing. In addition, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.
Avoid rubbing the area with your tongue or touching it with your fingers.
Continue to brush your teeth and tongue carefully.
Your dentist will remove the stitches after a few days, if needed.
Why It Is Done
A wisdom tooth is extracted to correct an actual problem or to prevent problems that may arise in the future. When wisdom teeth come in, a number of problems can occur:
Your jaw may not be large enough to accommodate them, and they may become impacted and unable to erupt through your gums.
Your wisdom teeth may erupt partially through your gums, causing a flap of gum tissue to grow over them. Food and bacteria can become trapped under the flap or operculum and cause your gums to become red, swollen, and painful. These are signs of infection.
More serious problems can develop from impacted teeth, such as infection, damage to other teeth and bone, or the development of a cyst.
One or more of your wisdom teeth may come in at an awkward angle, with the top of the tooth facing forward, backward, or to either side.
How Well It Works
Wisdom tooth removal usually is effective in preventing:
Crowding of the back teeth.
A wisdom tooth becoming stuck in the jaw (impacted) and never erupting through the gums.
Red, swollen, and painful gums caused by a flap of skin around a wisdom tooth that has only partially come in.
Gum disease and tooth decay in the wisdom tooth, which may be harder to clean than other teeth, or in the teeth and jaw in the area of the wisdom tooth.