Wisdom Tooth Removal

Wisdom teeth (or third molars) typically appear in late adolescence or early adulthood, between the ages of 17 and 25. Most people have four wisdom teeth, some may have less, or in rare cases, not at all.

Wisdom teeth emerge at a time when a person is considered to be more mature and wiser (in most of the cases! ), hence the name wisdom teeth. However, these teeth often get impacted, misaligned or growing in at wrong angles. As a result, dentists recommend to extraction them to prevent pain, infection, and other oral health problems.

Why do we extract wisdom teeth?

Wisdom teeth need to be extracted for several reasons:

Impaction : We have smaller jaw size comparing to our ancestors, due to changes in our diet. As a result, wisdom teeth are getting more and more likely to become impacted, meaning that they don’t fully emerge out of the jaw bones.

Impacted wisdom teeth can cause pain and swelling in the gum around the tooth ( pericoronitis). They can also push against neighboring teeth, causing alignment issues and cavities at the neck of the tooth in front of them (2^nd molar). Periodontal pockets can appear between wisdom teeth and 2^nd molars, causing bone resorption and ultimately the extraction of both 2^nd and 3^rd molars.

Infection and Gum Disease: Wisdom teeth are at the very back of the mouth, making them very difficult to clean properly, leading to infection, gum disease, and dental cavities.

Tooth misalignment: Wisdom teeth can exert pressure on existing teeth, leading to crowding and shifting of the teeth in your mouth. Wisdom tooth removals are always recommended after orthodontic treatments.

Cysts and Tumors: impacted wisdom teeth inside their tooth sacs which are buried completely inside the bone can cause cysts or even tumors, potentially leading to more serious health problems.

Steps of wisdom tooth removal?

Examination: Before the extraction, your dentist will examine your mouth and take X-rays to determine the position of your wisdom teeth and the best approach for removal.

Injection: Local anesthesia is administered to numb the tooth and its surrounding area

Extraction: The dentist will then proceed with the extraction. An incision in the gum tissue to get to the tooth may be made if it’s impacted or hasn’t fully erupted. The tooth may be cut into smaller pieces to be taken out easier.

Stitches: to close the incision after the tooth is removed

Instructions on post-operative care, including pain management, diet, and oral hygiene.

Follow-up: to ensure proper healing and remove stitches.

Wisdom tooth extraction is a safe and routine procedure. Discomfort or pain are common during recovery and vary from person to person.

What is CBCT? Why is it recommended for wisdom tooth extraction?

CBCT (Cone Beam Computed Tomography) record radiography images in 3 dimensions. It can assist wisdom tooth extraction in several ways:

A 3D image of the teeth and their surroundings: highly detailed 3D images of the jaws, teeth, and surrounding structures can be obtained with CBCT. This allows dentists to see a comprehensive view of the area, including the exact position of the wisdom tooth in relation to adjacent nerves, bones, and other structures.

Precise Treatment Planning: CBCT scans help planning wisdom tooth extractions more accurately. They show the tooth’s orientation, its proximity to vital structures, and whether it’s impacted (partially or fully submerged in the jawbone). This information aids in developing a customized and minimally invasive extraction plan.

Reduced Complications: A clear view of the surgical site can help minimize the risk of complications during the extraction, such as nerve damage or damage to adjacent teeth, leading to safer and more predictable outcomes.

Enhanced Patient Comfort: Better pre-operative assessment and surgery plans result in smoother and less traumatic extractions, less post-operative pain and faster recovery times for patients.

Overall, CBCT imaging is an essential tool in dentistry, especially in complex procedures like wisdom tooth extractions.

CBCT images show that my wisdom tooth is closed to the nerve. What does it mean?

It means that the tooth’s roots are close to the inferior alveolar nerve, which supply the lower jaw. This nerve provides sensation to the lower lip, chin, and tongue.

Some potential risks and complications during extraction if your teeth are close to the nerve:

Nerve Damage: can result in temporary or, in rare cases, permanent numbness or altered sensation in the lower lip, chin, or tongue on the affected side.

Surgical Difficulty : Wisdom teeth close to the nerve require a more complex surgical approach to avoid complications

Is it compulsory to take antibiotics after wisdom tooth extraction?

It depends on several factors:

If there is a higher risk of infection.

The patient belongs to high-risk category (e.g., heart conditions, artificial joints, immune suppression)

If there is already an active infection in the area around the wisdom tooth.

Antibiotic after wisdom tooth extraction is not recommended in all cases. If antibiotics are prescribed, take them as directed, even if you start feeling better after 2-3 days to prevent the development of antibiotic-resistant bacteria.

How many days will it hurt after wisdom tooth extraction? What should I do when it hurts?

Pain and discomfort after wisdom tooth extraction can vary from person to person and depend on several factors, including the complexity of the extraction, your pain tolerance, and how well you follow post-operative care instructions.

Immediate after wisdom tooth extraction (1-3 Days): It’s common to have the most pain and swelling in the first 1 to 3 days after the extraction. During this time, you should avoid heavy physical activities, and follow your dentist’s instructions for pain management.

Following Days (4-7 Days): Pain and swelling begin to subside. However, some discomfort may persist for a week or more, especially if the extraction was a difficult one.

To manage pain and promote healing, you should:

Take Pain Killers. ( Algoflex, Cataflam)

Applying ice packs helps reduce swelling and relieve discomfort. Use them for 20 minutes on your cheek near the surgical area.

Rest: Make the healing process quicker.

Soft Diet: Foods like yogurt, mashed potatoes, and soup for few days. Avoid hot, spicy, and hard foods.

Oral Hygiene: Follow your dentist’s instructions

No Smoking and Alcohol

Follow-Up Appointments

Pain should gradually decrease as you heal. If you experience severe or worsening pain, persistent bleeding, signs of infection (fever, pus), or any other concerning symptoms, contact your dentist immediately.

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