Wisdom Teeth Removal

Wisdom Teeth Evaluation:

What are wisdom teeth and why should I be aware of them? 

Wisdom teeth are the 3rd molars in the very back of each corners of your dental arches. You typically have 4 of them but it is possible to have fewer (and rarely it’s possible to have more). They are the most common tooth that fail to erupt, and that failure can result in some significant problems.

 

How do I know I have wisdom teeth?

If they do they erupt they do so between the ages of 17-25. Since they often don’t have a chance to fully erupt looking or “feeling” for them with your tongue is not the most accurate way to determine if you have them. The best way to see them is with a 2-dimensional Panoramic x-ray or with a 3-dimensional cone beam CT scan.   

 

How do I know if my wisdom teeth are impacted? 

Impacted teeth wisdom teeth will often grow at an angle or be trapped under a layer of bone in the jaw. Once again, only a 2D or 3D radiographic image can show us if your wisdom is impacted.  

 

Do I need my wisdom teeth removed? 

Not every patient needs their wisdom teeth removed. We will start with a thorough evaluation considering factors like your age, your tooth position and development, the proximity to vital structures, other health concerns and your ability to keep the wisdom teeth clean. With that information, we will provide you with a personalized “risk-benefit” assessment and help you determine whether keeping or removing your wisdom teeth is best for you. A good time for this evaluation is the mid-teenage years. 

 

Why should I have my wisdom teeth removed if they’re not giving me any pain? 

Unfortunately, the absence of pain does not always indicate the absence of disease. 30-60% of patients with asymptomatic or “pain free” teeth eventually proceed with an extraction within 4-12 years. The decision of retaining asymptomatic wisdom teeth must be weighed against the relatively high risk of complications in the future

How much time does the procedure take? 

The whole procedure will usually take between 30 and 60 minutes and you will be in the office for about 90 minutes. 

 

Will I feel any pain? 

Your dentist will make sure that you are comfortable and pain free throughout the procedure. Most patient chose to have the removal of the wisdom teeth performed under IV sedation, in which case even the numbing portion of the procedure will be pain free. We will prescribe you a customized pre-operative medication regiment that will reduce the post-operative discomfort and risks of complications 

 

What’s my recovery going to be like and when can I return to normal activity? 

To minimize the risks of complications and optimize your recovery we recommend following these instructions: 

• Try to rest and avoid any strenuous activity for 48 to 72 hours after your surgery.  
• We will provide you with a headwrap and ice packs to try icing the area 20 minutes every hour for the first 2 days. 
• Try to take your anti-inflammatory medication religiously for 3-7 days.
• We recommend keeping a soft diet for about 1-2 weeks.
• To avoid a dry socket you cannot smoke, spit or drink with straws for about 1-2 weeks. 
• Protein supplements are recommended.
• Vitamin supplements are recommended.

If your daily activity does not involve heavy lifting or a lot talking, most patients are ready to return to school or work on the 3rd day following the surgery. 

If an athletic activity is part of your daily schedule we recommend taking it easy and avoid training for 5 days following the surgery.

After 2 weeks, except for a slightly different oral hygiene routine, you should feel like everything is back to normal. 

 

Do I need to stop my medication before the procedure? 

We recommend bringing a medication list at your consultation appointment and discuss any modification to your regular medication schedule with your Periodontist. 

 

Can I eat prior to my appointment? 

Since most wisdom teeth extractions are done under IV sedation, it is necessary NOT to eat for 6 hours prior to your surgery appointment. We recommend hydrating very well with water the day before your surgery and to not limit your water intake on your surgery day. 

 

What are the main risks associated with the removal of my wisdom teeth? 

The vast majority of wisdom tooth extractions do NOT result in long-term complications. Some minor complications are inevitable and part of your recovery and these include: 

• Some bleeding that should stop in about 24 hours after the surgery  
• Some discomfort will be present for about 72 hours 
• Some extra-oral swelling (the chipmunk look) can be present for 1-2 weeks after the procedure. 

Some more rare complications include: 

1. Residual tooth or bone fragments that can require a second procedure to go retrieve. 
2. Damage to nearby teeth, to the jawbone or the sinuses that could require a second procedure to repair.
3. Post-operative infections can occur in 2-3% of cases (even with pre-operative antibiotic coverage). 
4. Limited ability to open your mouth, also known as trismus
5. Bruising
6. Nerve damage is a rare (<1%) but significant complication that varies with each patient’s anatomy. We recommend discussing this risk at your consultation appointment.
7. The infamous “Dry Socket” in which the bone clot that is necessary to proper healing gets dislodged from the socket and where there is significant discomfort lasting more than the usual 3 days post-operatively. 

 

Should I call you after my surgery?

Following your dental surgery you will have access to your Periodontist 24 hours/day 7 days/week. We recommend calling if you’re experiencing: 

1. Heavy bleeding 
2. Pain that is not alleviated by your medications
3. Fever
4. A bad taste in your mouth 
5. Pus or oozing from the back of your mouth 
6. Persistent loss of sensation 
7. Difficulty swallowing or breathing 

   

We hope that we have managed to answer your questions but please feel free to call us for any additional information or to setup a consultation.