When wisdom teeth are a problem
Wisdom teeth are the third set of molars at the back of the mouth. They usually appear between ages 17 and 21, and even healthy ones can be uncomfortable as they come in. They do not always need to come out. Properly aligned wisdom teeth can even help with chewing.
If there is no room for them, or they come in at the wrong angle, they can become impacted, trapped in the jaw or under the gum. This can lead to pain, infection, cysts, gum disease, decay and damage to the neighboring teeth. Your dentist should monitor their development. Catching problems early can shorten healing time. We like to examine patients from age 17 on for this reason.
Preparing for the procedure
Many people feel nervous before surgery, but wisdom teeth removal is common and dentists perform it often. At your consultation, tell us about your symptoms and health history so we can decide whether extraction is safe and plan for it.
- Avoid smoking, alcohol and acidic drinks for at least eight hours beforehand.
- Brush and clean your mouth well, and drink only water in the hour or two before.
- A local anesthetic keeps the area numb. If general or IV anesthesia is planned, you will need someone to drive you home. With local anesthesia only, you can usually drive yourself. We will confirm which applies to you.
What happens during the extraction
After the anesthetic takes effect, the dentist opens the gum to expose the tooth and removes any bone blocking its root. If the tooth is badly impacted, it may be divided into pieces and removed bit by bit. The site is then cleaned, stitches are placed if needed and gauze is packed over the area to control bleeding and help a clot form.
If you need all four wisdom teeth out, they can be removed in one visit. We may also suggest taking out two on the same side at a time, which can lower cost, recovery time and discomfort.
Recovery
- Rest on the first day, and skip strenuous activity, straws, smoking and spitting for the first few days.
- Use an ice pack to reduce swelling and change the gauze every few hours.
- Most people feel recovered in several days, up to a week. The empty socket can take a month or two to close completely.
If you have pain or swelling lasting more than a week, call us for a follow-up. We may take X-rays to find out why. Healthy gums, with no swelling or redness, are a good sign that the site is healing.
Risks
Extraction is common and safe, and complications mostly affect people at higher risk because of other conditions. Possible problems include dry socket, infection from bacteria or trapped food, and damage to nearby teeth, nerves, jawbone or sinuses. We review your history to decide if you are a good candidate.
Dry socket usually brings pain, sometimes a bad smell or visible bone. If you think the clot has come out, call us.
Common questions
At what age are wisdom teeth usually removed?
They typically erupt between 17 and 21, though some come in later.
How do I know the site is healing properly?
The socket should begin closing within a few days, and the gums should look and feel normal, without swelling or redness. We schedule follow-ups to confirm.
How can I tell if I have dry socket without pain?
Most people feel pain, and some notice a bad smell or exposed bone. If you cannot see a blood clot in the socket, a dry socket is likely.
Can I drive myself home?
After a simple extraction with local anesthesia, usually yes. After surgical extraction with general or IV anesthesia, someone else needs to drive.
Can all four come out at once?
Yes, in one visit. We may also recommend two at a time on the same side.