Wisdom teeth are also called third molars because they are literally the third and last set of molars to develop. Most people have four wisdom teeth, two on each arch. However, some people never develop these large molars, while others have fewer than four.
Why do we have wisdom teeth?
Our prehistoric ancestors needed third molars to chew and digest hard foods like bark, nuts, and roots. In modern society, we consume a much softer diet. Not only are third molars unnecessary now, but they can create problems ranging from pain to infection.
If your wisdom teeth are impacted, they may never emerge from the gums. Impacted wisdom teeth often grow at an angle and push against neighboring teeth roots, which can damage second molars.
When should third molars be removed?
As a guideline but not a hard rule, Drs. Aiken and Shessel recommend wisdom teeth extraction for patients in their late teens or early twenties. The procedure poses the least risk and the most prompt and complete recovery for this demographic.
In this age group, the bone around wisdom teeth is somewhat soft, and third molars are developed enough for safe extraction. Furthermore, young adults may not yet have experienced the shifting of teeth that’s common with wisdom tooth eruption.
Why should wisdom teeth be extracted?
It’s not essential to have wisdom teeth extracted if they cause no problems. However, there are many good reasons to remove third molars. These include:
Jaw pain and headaches
Jaw stiffness
Tooth impaction
Damage to neighboring teeth roots
High incidence of decay
Gum disease around the tooth
Mouth too small to accommodate third molars
Orthodontic issues develop
To prevent potential future oral health problems
What does third molar extraction involve?
As respected oral surgeons in the Atlanta and Dunwoody areas, Drs. Aiken and Shessel have removed over 40,000 wisdom teeth! They have the procedure down to a fine science.
Your X-rays will help the oral surgeon diagnose a need for extraction. They also provide complete visualization of the jawbone, the third molars, and surrounding teeth and nerves.
If you need wisdom teeth removed, first the surgeon will administer anesthetic, nitrous oxide, and/or possibly sedation. (You’ll talk with the surgeon prior to surgery to determine whether sedation will be used.) To remove un-erupted teeth, an incision is made in the gums, and access is created in the jawbone so that the surgeon can reach the tooth.
A large third molar may be sectioned before removal. Average-sized and smaller wisdom teeth may be removed whole. The surgeon will use dental pliers to remove the tooth and all of its roots. You should feel pressure, but not pain, as the tooth is extracted. In total, the surgery can take up to 20 minutes; complex cases may take longer.
Next, the extraction site may be stitched with dissolving sutures to promote healing, while also protecting the site from food particles that could lead to infection. A stitch is not always necessary.
We will pack the site with a dressing, which should be changed when soaked through. Biting down on the dressing will help staunch bleeding.
A blood clot needs to form at the extraction site. Be careful not to dislodge the clot! Some, but not all, patients will need a prescription for antibiotics to take before or after the procedure.
Will I be uncomfortable during my procedure?
No. Our oral surgeons are trained to provide three levels of pain management drugs. You can opt for:
Local Anesthesia
Nitrous Oxide
General Anesthesia
After the procedure, your oral surgeon recommends an injection of Exparel at the surgical site for excellent post-operative pain management. A single dose of this non-opioid drug controls pain for a few days post-surgery, when patients need it most.
In addition, you’ll avoid the potential negative effects of opioids, including nausea, vomiting, constipation, and the risk of addiction. Exparel will control pain at the surgical site, instead of affecting your entire body as opioids do.
How should I prepare for my surgery and recovery?
Fill all of your prescriptions before your surgery date. Your oral surgeon may prescribe special mouthwash to use a few days prior to your surgical appointment to reduce bad bacteria in the mouth. You may also receive a prescription for antibiotics. The surgeon will instruct you on how and when to take the antibiotics.
Schedule a few days off work for the procedure and recovery. If you hold a job that requires physical exertion, like carrying over 10 pounds or activity that elevates your heart rate, you will need to take more than a few days off. The surgeon will provide guidelines for you to follow.
Prepare your recovery area on a bed or sofa with pillows. You’ll need to elevate your head for the first day or two, to help reduce swelling. Stock the area with your TV remote, tablet, books, and other low-energy activity supplies to entertain yourself while recovering.
Stock your fridge and pantry with soft foods, like yogurt, ice cream, smoothies, broth, and mashed potatoes. You’ll start with these foods, then add soups, pasta, oatmeal, etc. Within the first four or five days, you can resume your regular diet.
What should I expect during recovery?
For the first 48-72 hours, your mouth and cheek may be swollen, bruised, and tender or painful. Ice wrapped in cloth should be applied on the cheek over the surgical site to reduce swelling and pain.
If you opt for an Exparel injection, you’ll experience much less discomfort. If you did not get the injection, the surgeon will instruct you on how to use an over-the-counter NSAID for pain relief. Also, keep your head elevated for 24 hours, even while sleeping. This helps swelling subside.
Consume only soft foods, plenty of water, and nothing hot. Chew foods on the side of your mouth opposite from the extraction site.
About 24 hours post-surgery, you should gently rinse your mouth with mouthwash. After 48 hours, you may gently brush your teeth but do not disrupt the surgical site.
As the pain subsides and the blood clot dissolves, you can resume regular brushing and flossing. Do not use teeth whitening systems during recovery. You may wear your night guard or TMJ appliance if it doesn’t interfere with the surgical site.
You may have a sore jaw for about a week, as well as an unusual or unpleasant taste in your mouth. Some patients experience numbness and tingling on the face, tongue, and lips, though this side effect is rare.
Don’t use a straw, smoke, or touch the blood clots that form on the surgical sites. These clots are part of your body’s natural healing process. Leave them in place.
The first few days after surgery, you’ll need to relax, rest, and ice your face. Don’t lift over 10 lbs., which means in addition to not carrying groceries in from the car, don’t hold children or pets during this period.
Wisdom Teeth Extraction Consultation or Second Opinion
If you experience pain in the very back of your dental arches, if you find cleaning your third molars to be difficult, if they develop significant decay, or if you want to avoid potential issues with your wisdom teeth, call Oral Surgery Specialists of Atlanta at 404-846-4793. We have office locations in Dunwoody and Atlanta.
We are also happy to provide second opinions regarding wisdom teeth removal and other oral surgeries.
