A Comprehensive Guide to Wisdom Tooth Removal: Indications, Procedure, Benefits, and Aftercare

What Are Wisdom Teeth?

The four adult teeth located in the rear, top, and bottom corners of the mouth (the third set of molars) are known as wisdom teeth. For most people, wisdom teeth tend to erupt between the ages of 17 and 26, being the last adult teeth to come in. When they emerge in a straight direction behind the second molars and align with the other teeth, they typically do not cause any problems and, therefore, do not need to be removed.

In many other cases, wisdom teeth do not have enough room in the jawbone to develop and erupt in a normal, healthy way. Consequently, due to the crowded jaw, they begin to grow at an irregular angle or stay entrapped (impacted) in the jawbone or gum tissue.

When the third molars are impacted or misaligned, they are harder to clean and thus accumulate plaque and food debris, inviting infection. This can often lead to painful and debilitating symptoms that require immediate attention. Treating impacted or malaligned third molar teeth may involve surgical extraction of the wisdom teeth, a common oral surgery procedure that can reduce the risk of dental complications associated with these teeth. 

However, sometimes your dentist may suggest that you get your wisdom teeth removed even if you don’t have any symptoms to prevent future complications. Blanc Dentaire, with its latest dental technology and team of highly experienced oral surgeons, offers long-term management and surgical removal of impacted and diseased wisdom teeth. For more information regarding this procedure, please do not hesitate to get in touch. 

What Are Misaligned Wisdom Teeth?

As the name implies, misaligned wisdom teeth may be positioned horizontally or angled toward or away from the other teeth. This misalignment may damage the neighboring teeth, cause jaw or nerve pain, and cause other symptoms. In addition, poor positioning may make these teeth harder to clean, allowing plaque and other debris to accumulate, which, in turn, can lead to decay or infection of the teeth and surrounding tissues.

What Are Partially Impacted Wisdom Teeth?

Sometimes, a wisdom tooth may erupt partially, with some of the crown becoming visible in the mouth while the rest remains entrapped in the jawbone or surrounding soft tissue. This tooth orientation allows bacteria to gain direct access to penetrate the area around the tooth and cause an infection. This can lead to painful swelling and difficulty opening the mouth and may even cause the infection to spread into deeper tissues of the face and neck. Typically, partially erupted teeth are more prone to tooth decay and gum disease.

What are the Symptoms of Misaligned or Impacted Wisdom Teeth?

Impacted wisdom teeth don’t always cause symptoms, especially if their position does not disturb the neighboring teeth or structures. This is why some patients with misaligned or impacted wisdom teeth do not experience any symptoms. However, when an impacted tooth becomes infected or starts damaging other teeth, you may experience the following symptoms:

• Painful swelling of the face
• Swollen or inflamed gums
• Stiffness or pain in the jaw that makes it difficult to open the mouth
• Bad breath (halitosis)
• Unpleasant taste in the mouth
• Food getting trapped behind the wisdom teeth
• Periodontal disease
• Tooth decay in the adjacent teeth

What Problems Can Impacted Teeth Cause if Left Untreated?

Impacted wisdom teeth can cause a range of serious oral health problems if left untreated. Here’s a breakdown of the potential complications:

• Infection (Pericoronitis)
  Impacted wisdom teeth, particularly partially erupted impacted teeth, create an opening in the gum that can become a breeding ground for bacteria. Food particles and plaque can accumulate around the partially erupted tooth, leading to a painful infection of the gums known as pericoronitis. This infection can cause swelling, tenderness, and difficulty chewing or opening the mouth.
• Damage to other teeth
  Impacted wisdom teeth can press against the adjacent molars, exerting pressure and causing damage. This pressure can erode the enamel of the neighboring tooth, leading to cavities or even compromising the tooth’s structure. In some cases, this pressure can also cause the neighboring teeth to shift or become misaligned. 
• Cysts
  Wisdom teeth develop in sacs within the jawbone. These sacs can fill with fluid, forming cysts that can damage the jawbone, teeth, and nerves and, although rare, may give rise to a tumor. This type of tumor is usually noncancerous (benign). However, due to this problem, tissue and bone may need to be removed.
• Decay
  Partially impacted wisdom teeth appear to be at higher risk of cavities, as their position allows food to get stuck between the partially erupted tooth and the gum. This makes them harder to clean and more susceptible to decay and cavities.
• Sinus Problems
  Impacted wisdom teeth in the upper jaw can sometimes exert pressure on the sinuses, causing sinus pain and congestion. This is because the roots of the upper wisdom teeth can be located close to the sinus floor and may lead to sinus-related symptoms if they become impacted or infected.

Leaving impacted wisdom teeth unaddressed can lead to a myriad of complications that affect not only your oral health but also your overall well-being. Early detection and prompt treatment of impacted teeth can prevent these issues, further underscoring the importance of routine dental visits. If you suspect you have an impacted tooth, do talk to your dentist about it so they can investigate further and provide appropriate treatment.

How to Care for Wisdom Teeth?

Wisdom Teeth Evaluation and Management

Due to the complex and uncertain nature of wisdom teeth-related disease, the oral surgeons at Blanc Dentaire recommend that everyone between the ages of 18 and 21 get a comprehensive evaluation of their wisdom teeth with a dentist. This will allow the oral specialist to:

• Assess and document the current state of the wisdom teeth (position, development, and any symptoms of wisdom tooth-related diseases)
• Discuss possible treatment options with you, which may include surgical removal of the wisdom teeth or long-term management.

If you choose wisdom tooth management over surgical removal, our oral surgeon will discuss appropriate hygienic measures for you to follow, as well as information on recognizing signs and symptoms of disease and potential risk factors. We suggest you visit your dentist every two to five years to monitor the state of the wisdom teeth and allow them to intervene when necessary. 

You may also choose to move forward with the surgical removal of your wisdom teeth if you prefer.

Surgical Wisdom Teeth Removal

The best option to treat misaligned or impacted wisdom teeth is to remove them surgically. Extraction of wisdom teeth is performed safely on an outpatient basis under local, intravenous (IV), or general anesthesia.

Indications for Wisdom Tooth Removal

Wisdom teeth often do not erupt properly, leading to various oral health issues. Common reasons for removing them include:

• Impaction: When a wisdom tooth is trapped beneath the gum and doesn’t fully emerge, it is called impacted. Impacted teeth can cause pain, swelling, and infection.
• Crowding: Wisdom teeth can push against other teeth, causing misalignment or crowding.
• Infection and Decay: Partially erupted wisdom teeth can be hard to clean, leading to plaque buildup, decay, and gum infections.
• Cysts or Tumors: In rare cases, impacted wisdom teeth can develop cysts, which may damage the surrounding jawbone and teeth.
• Orthodontic Reasons: Sometimes, wisdom teeth are removed to prevent complications during or after orthodontic treatment, such as braces.

Removing wisdom teeth at an early stage is usually recommended before they cause these problems.

What is the Procedure for Wisdom Tooth Removal?

The procedure of wisdom tooth extraction varies depending on the position and condition of the tooth.

• 1

  Consultation and Imaging

• Your dentist will start by taking a detailed medical and dental history, inquiring about your general health, any medications you might be taking currently, and your past dental procedures. If you are taking any medicines, vitamins, or supplements, please tell your dentist at this stage. 
• During the consultation, your dentist or oral surgeon will examine your wisdom teeth and take an X-ray to determine their exact location and angulation in the jaw. This also helps assess the positioning of the wisdom teeth and determine the complexity of the surgery.

• 2

  Anaesthesia Options

• Depending on the complexity of the procedure and your personal preference, local anesthesia (to numb the area), sedation, or general anesthesia (to make you unconscious) may be used. Local anesthesia is common for simple extractions, while sedation or general anesthesia may be used for impacted teeth or in patients with severe dental anxiety. 
• If you opt for IV sedation or general anesthesia, your surgeon will give you detailed instructions on how to prepare for your appointment. This generally includes fasting after midnight the night before your surgery and stopping certain medications a few days earlier.

• 3

  The Extraction Process

• Simple Extraction: If the wisdom tooth is fully erupted, the dentist will loosen it using an elevator and remove it with forceps.
  

  

• Surgical Extraction: For impacted teeth, the surgeon makes an incision in the gum tissue to expose the tooth and bone and gain access to the tooth trapped in your jawbone. The tooth may be divided into smaller pieces for easier removal.
  

  

• The area is then cleaned and debrided to prevent infection, and stitches may be used for better and faster healing.

Your surgeon may place pieces of gauze over the extraction site to reduce the chances of bleeding after the procedure.

The entire procedure can take 15 minutes to an hour, depending on the complexity of the case. It may take longer if the case is complex.

Benefits of Getting Your Wisdom Tooth Removed Timely When Necessary

Timely removal of impacted wisdom teeth is important to prevent serious complications such as infections, tooth decay, gum disease, and damage to surrounding teeth. When left untreated, impacted wisdom teeth can lead to more complex dental issues like cysts, jawbone damage, and tooth misalignment, which may require extensive, invasive, and more expensive treatment.

Early extraction reduces the risk of infection and prevents long-term damage to oral health. It also ensures a smoother recovery and preserves the integrity of surrounding teeth and tissues.

Risks Associated With Wisdom Tooth Removal

Though wisdom tooth removal is generally safe, it comes with potential side effects and risks:

1. Pain and Swelling: These are common after the procedure, particularly with surgical extractions. Swelling in the jaw and cheeks may last a few days, but pain management is usually effective with medication.
2. Bleeding: Some bleeding is normal after surgery. It should subside within 24 hours, but any excessive or prolonged bleeding should be reported to your dentist.
3. Infection: Though uncommon, infections can occur. Signs include fever, severe pain, or pus from the surgical site.
4. Dry Socket: This occurs when the blood clot at the extraction site becomes dislodged or dissolves before healing. It can cause intense pain and delay recovery.
5. Nerve Damage: In rare cases, the procedure can result in temporary or permanent numbness in the tongue, lips, or chin if the nerves are affected.
6. Jaw Stiffness: Temporary difficulty in opening the mouth may occur, particularly after surgical extraction.

Despite these risks, which are generally mild and temporary, complications are rare, and most patients recover fully within a week or two. The side effects can include pain, swelling, and bruising around the extraction site, which typically subside within a few days. Some patients may experience minor bleeding or oozing from the extraction site, jaw stiffness, and difficulty opening the mouth. In rare cases, complications like infection, dry socket (when the newly formed blood clot dislodges), or temporary nerve damage causing numbness in the lips, tongue, or chin may occur. Following post-operative care instructions from your doctor helps minimize these side effects and promotes faster healing.

Post-Procedure Care

Proper aftercare is crucial to ensure a smooth recovery and prevent complications.

• Immediate Care After Surgery

  • Leave gauze in place. Leave gauze in place for about 30-40 minutes after your surgery to stop bleeding. Replace with clean gauze if necessary. It’s normal to have some oozing from the socket, but you shouldn’t have excessive bleeding.
  • Rest well. Take it easy for the first 24 hours after surgery. Rest as much as possible and avoid strenuous activity as it may raise blood pressure and increase the chances of bleeding.
    We advise that you stay at home and recover for at least three to five days after the procedure. If you have a physically challenging job, it is better to wait longer before returning to work to give your body a chance to heal properly. 
  • Manage swelling. Apply ice packs to the outside of your cheeks at 20-minute intervals to reduce swelling.
  • Keep the extraction site clean. Gently soak the surgical areas with alcohol-free antibacterial mouthwash. Do not swish or rinse, as doing so can dislodge the newly formed blood clots and cause dry sockets, a painful condition that exposes the bone at the extraction site. Instead, we recommend that you gently lean your head to each side to let the mouthwash soak the areas.
    Do not spit forcefully or drink through a straw, as this can create suction and dislodge the clot, causing the site to bleed and impede healing. 

• Diet

  • For the first few days, stick to soft foods like yogurt, mashed potatoes, applesauce, and smoothies. Avoid hot, spicy, crunchy, or chewy foods that could irritate and damage the gums at the extraction site and delay healing.

• Avoid smoking and alcohol

  • Smoking can dislodge the new blood clots formed in the extraction socket by creating negative pressure in the mouth when you take a drag. Smoking delays wound healing, slowing down the recovery and increasing the chances for complications, such as a dry socket.
    Do not drink carbonated beverages or beverages containing alcohol. These drinks can dislodge blood clots and cause dry sockets. We recommend you steer clear of these drinks for at least five days to allow your gums to heal. 

• Oral Hygiene

  • On the day after surgery, rinse your mouth gently with a saltwater solution to keep the area clean. Brush your teeth carefully, and take care not to over-brush the extraction site. Keeping the rest of your teeth clean during recovery reduces your risk of infection. 

• Medication

  • Your surgeon will prescribe medication to prevent infection and keep you comfortable after the procedure. These may include over-the-counter pain medications like ibuprofen and antibiotics. Take them as and when advised by your dentist, and don’t stop taking them until they ask you to.

• Follow-Up

  • Attend your follow-up appointment to monitor healing and remove any non-dissolvable stitches.

What is the Recovery Timeline Following a Wisdom Tooth Removal?

The recovery timeline following wisdom tooth removal typically spans about one to two weeks, but most people can safely return to work or school three to five days later. In the first 24-48 hours, you may experience swelling, pain, and minor bleeding from the tooth socket, with swelling and pain peaking around day three or four for most people. By the third to fifth day, most people notice a significant reduction in discomfort, and everyday activities can often be resumed. Soft foods and careful oral hygiene are recommended during this time.

By the end of the first week, stitches (if present) are removed, and most of the swelling and pain should subside. Full healing of the extraction site, including bone and gum tissue, can take several weeks to months.

• First 24 Hours: Some bleeding, pain, and swelling are expected. Rest and adhere to aftercare instructions.
• 1-3 Days: Swelling may peak on the second day, but pain should gradually decrease.
• 4-7 Days: By this time, most patients are comfortable resuming normal activities but continue to avoid strenuous activity.
• 1-2 Weeks: Full recovery occurs within two weeks. If stitches have been used, they are often removed during this time or dissolve on their own.

Risks Associated With Wisdom Tooth Surgery

While rare, wisdom teeth removal may cause some long-term complications. In these instances, people may develop:

• Infection at the extraction site (pus coming out from your socket or incisions).
• Dry sockets (dislocation and loss of blood clot from the extraction site, exposing the bare bone underneath).
• Damage to other oral structures, including the jawbone, nerves, sinuses, or neighboring teeth.

Why Choose Blanc Dentaire for Wisdom Tooth Removal?

Selecting the right dentist or oral surgeon for wisdom tooth removal is crucial to ensure a smooth, successful procedure with minimal complications. Wisdom tooth extraction can vary in complexity, and a skilled professional can make all the difference in your dental care and overall experience. Here are some key factors to consider when choosing an oral surgeon:

The Bottom Line

Wisdom tooth removal is a common procedure that can prevent future dental complications, alleviate pain, and improve oral health. While the procedure and recovery involve some discomfort, following the proper aftercare ensures a smooth and speedy recovery. 

While we know that wisdom tooth extraction probably isn’t number one on your bucket list, we want you to understand that it can save you a lot of time, worry, and money in the future, especially if your wisdom teeth can have detrimental effects for your oral health. If you are experiencing symptoms related to your wisdom teeth, consult with a dentist to discuss the best course of action.