Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.
In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.
There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:
Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.
Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.
Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.
Reasons for wisdom teeth extraction & removal:
While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including: Damage to nearby teeth, Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth. Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
Instructions for Self-care Following a Tooth Extraction
The initial healing period usually takes one to two weeks, and you’ll likely experience some swelling for the first forty-eight hours.
Before the procedure began, you were given an anesthetic to ensure your comfort. This anesthetic typically leaves your lips, teeth and tongue feeling numb after the appointment. For this reason, you should avoid chewing for two hours following surgery, or until the numbness has completely worn off.
Pain and swelling:
Some discomfort after the wisdom teeth extraction & removal is normal. An over-the-counter pain reliever is usually sufficient. You may be given a prescription for a stronger pain reliever if we anticipate you may need it. To avoid nausea, do not take pain medication on an empty stomach.
You can also decrease pain and swelling by applying an ice pack — twenty minutes on, twenty minutes off — for the first 24 hours following the extraction. (Frozen peas or corn in a large zip lock bag works well and are more comfortable than crushed ice)
We will give you a supply of gauze sponges to place over the extraction area, in case it continues to bleed. Fold the gauze in 4 and moisten it slightly with water. Bite firmly on the gauze for 30 – 45 minutes (don’t keep removing it to see if the bleeding has stopped). After 30 – 45 minutes remove the gauze. If the area is still bleeding repeat this procedure. Change the gauze pads as necessary every 30 – 45 minutes until the bleeding stops completely. You can also bite gently but firmly on a moist tea bag for twenty minutes. Be sure to call our office if bleeding persists or increases. It is not unusual to see some “pink” in your saliva for a few days after your surgery.
A blood clot will form in the extraction site, and this clot is vital to the healing process.
To keep the clot intact:
Avoid touching the extraction site with your tongue or fingers.
Do not drink liquids through a straw for the first 48 hours or “suck” on the wound site. This can create negative pressure inside the oral cavity and can disturb the blood clot, which may cause bleeding, slow healing and/or bone pain called a dry socket.
If you smoke, refrain from doing so for 24 to 36 hours.
Refrain from drinking alcohol for the first 24 hours.
Blowing your nose or sneezing violently can also dislodge the blood clot and impair healing, so if you have an upper respiratory infection or suffer from allergies, be sure to have the appropriate sinus medication on hand.
Rinsing and brushing:
Do not spit or rinse your mouth vigorously for first 24 hours of surgery.
After twenty-four hours of the procedure, you can rinse gently with mouthwash or a warm saltwater solution. (Dissolve one teaspoon of salt with one cup of warm water. Gently swish the solution around the affected area, and spit carefully.) You should do this two to three times each day for the week following the extraction.
You may brush your teeth and tongue after the surgery. Be careful of the surgical site. You need to keep the area around it as clean as possible, but you do not want to disturb actual site.
Do not drink or eat hot foods the first day, as you may dissolve or loosen the healing blood clot. Eat, warm or cool, soft, nutritious foods.
Start with liquids and very soft foods for the first 24 – 48 hours following the surgery. Nourishment is important to the healing process. Limit your diet to soft foods like yogurt, lukewarm soft soups, ice cream, and soft cooked eggs, mashed potatoes etc. After a couple of days, if you feel up to it, progress to other foods. Avoid hard, crunchy foods (i.e. potato chips and nuts) for at least 72 hours.
Make sure you are drinking enough liquids each day (8 glasses of water or fruit juice)
If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
Relax as much as possible and avoid all strenuous activities for the first twenty-four hours following surgery.
Contact us for more information on wisdom teeth extraction and removal in Vancouver or for a FREE consultation session.