For many people, the prospect of wisdom teeth removal can be daunting. Tooth extraction is high up on the list of dental procedures that can cause anxiety, due to the invasive nature of the procedure. This can be especially true for older children, where it may be their first experience of serious dental surgery.
Dr. Choi has extensive experience in helping patients remove their wisdom teeth. His calm demeanor and gentle process helps alleviate anxiety and ensures patients are as comfortable as they can possibly be, at all times.
Much of the anxiety caused by the thought of wisdom tooth removal can often be removed with some basic information about the procedure. For your convenience, we have compiled a comprehensive guide on the treatment below. We will explain why the procedure is needed, what you can expect, and answer many of the most frequently asked questions Dr. Choi receives.
If you think you or your child may need their wisdom teeth removed, give Dr. Choi a call at 214-592-0692 to book a dental examination and get his expert opinion.
Wisdom teeth are usually removed in younger people between the ages of 15 and 25. However, it is possible to have them removed at any age. Dentists usually prefer to do the procedure as early in life as possible. This is due to the root of the tooth not being fully developed yet. This makes extraction easier, and as such the chance of complication and infection is lower.
When a dentist recommends wisdom tooth removal, it is occasionally quite a surprise to many people (who are usually initially unaware of the reasoning behind the recommendation). Often times, the wisdom teeth are not causing any issues when they are removed, which can cause confusion.
The logic behind the removal much of the time is preventative, if the teeth are not removed, much more serious complications can occur in the future. The corrective actions for these complications all involve removing the wisdom teeth (and additionally require further treatment). So it is generally accepted that the best course of action in most cases is to pre-emptively remove them. Some of the complications are listed below, they are not mutually exclusive, and it is not uncommon for a patient to experience several of them at the same time.
An impacted wisdom tooth is the technical term dentists use to describe wisdom teeth coming through in a mouth that does not have room for them. When this happens, the wisdom teeth can damage other teeth as they force their way through. This can cause significant pain.
While the wisdom teeth are erupting through the gums, they will be partially exposed for a reasonable amount of time. During this time, the area affected by the eruption can become difficult, or near impossible to clean properly. This is true even with the most rigorous and comprehensive dental hygiene routines. As such, they can become breeding grounds for bacteria, and infection is not uncommon.
In serious cases of wisdom tooth impaction, tumors and cysts can start to form from the stresses and forces that are being constantly applied by the eruption. When this happens, the cysts and tumors can cause permanent damage to the gums and mouth.
The procedure for removal of wisdom teeth is reasonably simple for a dentist. They are almost daily occurrences for experienced dental surgeons, and nearly all procedures go as planned.
Prior to the extraction, your dentist will perform a full dental examination to assess the current situation of your oral health. If you have an infection caused by the wisdom tooth, then you will be prescribed antibiotics. You will then have to wait until the infection has cleared before extraction can begin.
Once the dentist is happy you are free from infection, the first step of the process is to administer a local anesthetic. This will totally numb the mouth and remove any chance of you experiencing pain during the procedure. General anesthesia can be utilized in some special circumstances. This is mainly done when several teeth need to be extracted in the same appointment. If you are going to be anesthetized with general anesthetic, you will usually be asked to avoid all eating and drinking the day of the procedure.
Once you are anesthetized, the dentist will then use a scalpel to open up the gum around the area of the wisdom tooth. He will then remove any bone that may be obstructing extraction, and start removing the connective tissue commonly attached to wisdom teeth. Once the wisdom tooth is ready, it will then be pulled out of the mouth.
After extraction stitches are occasionally required to prevent infection. Sometimes these stitches will need to be removed by the dentist at a future appointment. Other times dissolvable stitches can be used which remove themselves over time.
If you are under general anesthesia, you will be unconscious and as such you will feel, and experience nothing but peaceful sleep. You will wake up and the procedure will be completed.
Dentists know that wisdom tooth extraction can be an uncomfortable process for many people, so they are usually very liberal with their use of local anesthesia. They ensure your mouth is as numb as it can possibly be to reduce the chances of pain to a minimum. However, while pain is unlikely, discomfort is unfortunately common.
There are usually lots of loud noises throughout the procedure from suction and drills that are unpleasant for some people. You will feel vibrations, and pushing, and pulling up until the moment of extraction. However, discomfort during this part of the procedure is minimal.
The main discomfort is often found at the moment of extraction. Wisdom teeth are secured very strongly to the gums and jaw bone, and a large amount of force is required to remove them. This means patients will feel the dentist pulling on their tooth with significant force. There is no getting around that it’s an unnatural, uncomfortable feeling.
We hasten to add that there is usually no pain whatsoever, just discomfort. In most cases, it’s a momentary sensation and the tooth is extracted very quickly.
The mouth is incredibly quick at healing itself from all kinds of injury and trauma. Discomfort will subside rapidly after you have had your wisdom teeth removed. Within a few days, the healing process is basically complete. However, despite the speed of recovery, the healing process is very important. If you do not take care of the extraction site, reasonably serious complications can and do happen.
The information below should be treated as a general overview. Dr. Choi will advise you specifically on what you should, and should not do after extraction.
In the days immediately following surgery you may notice some swelling and pain around the affected area. Some amount of bleeding is normal in the first 24 hours. Your dentist will provide you with gauze pads to soak up the blood, which should be changed intermittently. If you experience bleeding for longer than 24 hours, this can be an indication of further complications, and your dentist should be contacted immediately.
Swelling can be reduced by regularly applying ice packs wrapped in cloth to the cheek for the first 24 hours after surgery. By 48 hours, the swelling should have reduced to near insignificant levels. It is often recommended that patients take it easy after having their wisdom teeth removed. This means keeping physical activity and exercise to a minimum, as it can encourage bleeding.
Many people think that using a straw to drink through is a good idea after having their wisdom teeth removed. This is an old myth that does more harm than good. Dentists never recommend you use a straw to drink through until the healing process has well and truly completed. This is because drinking through a straw can create suction in the mouth, and can dislodge the blood clot over the extraction site. This delays healing and causes more bleeding. In the worst scenarios, it can lead to what is known as a dry socket (more on this later).
To assist the healing process, it’s a good idea to regularly swish your mouth out gently with warm salt water several times a day. This helps speed up the healing process, removes pain, and reduces swelling. It’s important to remember you should not be too forceful with the salt water. This can again, dislodge the blood clot and cause the issues we mentioned above. Be as gentle as possible.
Do your best to avoid hot, caffeinated, or carbonated drinks after surgery as they can interfere with the healing process. Additionally, you should do your best to eat soft food that does not require much chewing to avoid dislodging the blood clot at the extraction site.
If you have been administered local anesthetic, you should not eat anything for the first 2 to 3 hours after the procedure. The numbness in your mouth makes it highly likely that you will bite (and damage) your cheek and tongue accidentally.
Smoking is strongly advised against for at least the first 72 hours after surgery, ideally refraining for longer is even better. The suction created in your mouth while sucking on a cigarette can dislodge the blood clot in a similar manner to sucking on a straw. Additionally, the chemicals that are present in cigarettes delay the healing process and can even cause infection. Some smokers who have their wisdom teeth removed opt to try and quit smoking at the same time, due to the no smoking restriction.
You will usually still be advised to brush your teeth and tongue reasonably normally. However, you should give special attention to the area around the extraction, and avoid it as much as possible to prevent dislodging the blood clot.
Providing you do not need stitches removed, and you do not experience complications during recovery, a follow-up appointment is not usually necessary.
Many of the do’s and don’ts we have listed above have centered around trying to avoid one main thing – the dislodging of the blood clot. This in itself, delays the healing process and can lead to infection and complications. One of the most serious of which is a dry socket.
Dry sockets can happen with any kind of tooth extraction, but they are most common after wisdom teeth have been removed. They are a painful inflammation of the extraction site and should be avoided at all costs. The pain experienced from a dry socket is far worse than anything related to the extraction itself.
If a patient gets a dry socket, they can expect to experience extreme pain that extends from their jaw, all the way through to their ear. This pain can last for many days (up to a week in some cases) and the socket itself can produce a very unpleasant smell.
Dry sockets are slightly more common in women than in men. This is commonly attributed to the hormone estrogen. Some dentists recommend that women schedule wisdom teeth removal towards the end of their menstrual cycle if they are using birth control. This is commonly thought to minimize the risk of a female patient suffering from a dry socket.
If you experience severe pain 2 days after you have had your wisdom teeth extracted, then you may have a dry socket. You should contact your dentist as soon as possible for examination and treatment. (Dry sockets are usually treated with antibiotics and pain medicine).
Many people will probably know of someone who needed to go to a hospital to have their wisdom teeth removed. While this does happen from time to time, it is far from the norm. The vast majority of people can have their wisdom teeth safely and painlessly removed in the dentist’s office. Hospital based treatments are only required when multiple wisdom teeth are being removed at the same time and if the patient is likely to experience complications during the procedure.
If you are being administered general anesthesia, your dentist will recommend that you do not eat or drink anything the day of the extraction.
If you are being administered local anesthetic, there is no such requirement. In fact, many people like to eat their favorite food just before the procedure. This is because during the healing process eating will be difficult. Dietary choices will be limited to soft foods that may not be a patient’s ideal choice of meal.
The vast majority of issues that occur with wisdom teeth happen between the ages of 15 and 25. Many people do not have their wisdom teeth removed during this time of their lives, and wonder if they need to have them removed now that they are older.
Not everyone will have issues that arise from their wisdom teeth, some people are genetically lucky. If you are over 30 and have not had any issues, then the chances of future complications that require removal are slim. It can happen, but it’s very rare, and in the majority of cases removal extraction is not required.
It’s very hard to answer this question without a full dental examination. There are cases where there appears to be no need for removal, wisdom teeth can erupt without any problems. It’s always best to get a full dental examination when your child’s wisdom teeth start to come through. There is no substitute for getting expert professional advice on their specific situation from your dentist.
Extraction of a wisdom tooth is much more difficult (and recovery times are greater) after the age of 30. If extraction is required at a later date, it can become a much larger ordeal for your child. Even the slightest signs of complication in younger people are often met with extraction recommendations from most dental surgeons.
Most dental insurance plans will partially cover a wisdom tooth removal that is medically necessary. This means that in most cases your insurer will only cover treatment that has been recommended to you by your dentist. If you decide you wish to take preventative action and have your wisdom teeth removed, you may find yourself uncovered.
This is obviously only a general overview, some comprehensive policies actually cover the entire cost of wisdom teeth removal. As always, we highly recommend that you check with your insurance company before starting any dental treatment to avoid unwelcome surprises.
For genetic reasons that are still not fully understood, there is a significant difference in the amount of wisdom teeth people have. It is usual to have between 2 and 4 wisdom teeth, but some people can have as little as 1 wisdom tooth (or even none).
Wisdom teeth are usually more complicated and difficult to remove than other teeth for several reasons. The main reason is that the jawbone in the rear of the mouth where wisdom teeth are located is much thicker and denser than it is in the rest of the mouth. Additional complications come from the often, unusual angles of the roots of wisdom teeth (and the fact that they can often have multiple roots).
To make things even more difficult wisdom teeth are often covered by gum and bone which needs to be removed before extraction (unlike other teeth). When dental surgeons do this, they need to be careful about damaging nerves and blood vessels that can be covering the eruption site.
This is a very personal decision that ultimately needs to be decided on an individual basis. Pain and discomfort can be slightly more intense if you have multiple wisdom teeth removed at the same time. However, in most cases, the difference is reasonably negligible. Healing times remain the same regardless of how many teeth you are having removed as they all heal simultaneously.
One of the main reasons people have all their wisdom teeth removed at the same time is due to simple economics.
The cost of the actual extractions does not usually come down with some kind of “bulk discount”. However, the anesthetic only needs to be applied once. This allows for (not insignificant) savings for patients that deal with all of their wisdom teeth in a single appointment. Additionally, when multiple wisdom teeth are being removed at the same time, the patient becomes a much more viable candidate for general anesthesia. As previously mentioned, this can remove much of the discomfort of the procedure.
The decision parents have to make about the removal of their child’s wisdom teeth can often be difficult and without a clear answer. If a dental examination is showing no signs of immediate issues, then subjecting a child to an invasive surgical procedure (that they may not need) is not an easy choice to make.
In the long run, it’s usually better to have wisdom teeth removed. However, the decision ultimately rests with the individual (or the parent). Dr. Choi prides himself on his impartial advice that puts the patient’s interests first. He will help you by giving his professional medical opinion, and answer any questions you may have.
If anything in this guide was unclear, or you are concerned about wisdom teeth, why not book an appointment today with Dr. Choi. He is available at 214-592-0692 and looks forward to helping you make the right decision for you and your family to enjoy happy, healthy teeth.