Wisdom Tooth Extraction

Wisdom tooth extraction

What is Wisdom tooth extraction?
Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.

If a wisdom tooth doesn't have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, you'll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.

To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren't currently causing problems.

Why it's done?
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don't have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

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

Problems with impacted wisdom teeth

You'll likely need your impacted wisdom tooth pulled if it results in problems such as:

Pain
Trapping food and debris behind the wisdom tooth
Infection or gum disease (periodontal disease)
Tooth decay in a partially erupted wisdom tooth
Damage to a nearby tooth or surrounding bone
Development of a fluid-filled sac (cyst) around the wisdom tooth
Complications with orthodontic treatments to straighten other teeth

Preventing future dental problems

Dental specialists disagree about the value of extracting impacted wisdom teeth that aren't causing problems (asymptomatic).

It's difficult to predict future problems with impacted wisdom teeth. However, here's the rationale for preventive extraction:

Symptom-free wisdom teeth could still harbor disease.
If there isn't enough space for the tooth to erupt, it's often hard to get to it and clean it properly.
Serious complications with wisdom teeth happen less often in younger adults.
Older adults may experience difficulty with surgery and complications after surgery.

Risks:
Most wisdom tooth extractions don't result in long-term complications. However, removal of impacted wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:

Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
Infection in the socket from bacteria or trapped food particles
Damage to nearby teeth, nerves, jawbone or sinuses

How you prepare?
Your dentist may perform the procedure in the office. However, if your tooth is deeply impacted or if the extraction requires an in-depth surgical approach, your dentist may suggest you see an oral surgeon. In addition to making the area numb with local anesthetic, your surgeon may suggest sedation to allow you to be more comfortable during the procedure.

Questions to ask:
Questions you may want to ask your dentist or oral surgeon include:

How many wisdom teeth need to be removed?
What type of anesthesia will I receive?
How complicated do you expect the procedure to be?
How long is the procedure likely to last?
Have the impacted wisdom teeth caused damage to other teeth?
Is there a risk that I might have nerve damage?
What other dental treatments might I need at a later date?
How long does it take to completely heal and return to normal activity?

Preparing for surgery:
A wisdom tooth extraction is almost always performed as an outpatient procedure. This means that you go home the same day.
You'll receive instructions from the hospital or dental clinic staff on what to do before the surgery and the day of your scheduled surgery.

When to call your dentist or surgeon?
Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:

Difficulty swallowing or breathing
Excessive bleeding
Fever
Severe pain not relieved by prescribed pain medications
Swelling that worsens after two or three days
A bad taste in your mouth not removed with saltwater rinsing
Pus in or oozing from the socket
Persistent numbness or loss of feeling
Blood or pus in nasal discharge

Results:
You probably won't need a follow-up appointment after a wisdom tooth extraction if:

You don't need stitches removed
No complications arose during the procedure
You don't experience persistent problems, such as pain, swelling, numbness or bleeding — complications that might indicate infection, nerve damage or other problems
If complications develop, contact your dentist or oral surgeon to discuss treatment options.