Incisors, canines, premolars, 2 sets of molars, you have all the teeth you need! Then some unwelcome latecomers show up, a third set of molars–wisdom teeth. Whether your wisdom teeth are coming in right now, you’re getting them removed soon, or you just want to learn more about these mysterious extra teeth, we’ve got you covered! In this article we will discuss the history and purpose of wisdom teeth, the varying human experiences, problems caused by wisdom teeth, everything you need to know about wisdom tooth extraction including how to take care of yourself after wisdom tooth removal.
What is the purpose of wisdom teeth?
Why do we have wisdom teeth? Early humans had tougher diets that included things like coarse plants, raw meats, and hard nuts that required more chewing power and extra surface area to break down. Wisdom teeth were a necessity for our ancestors, but as time went on our diets became softer, our jaws grew smaller, and wisdom teeth became an annoyance rather than a necessity.
Does everyone get wisdom teeth?
No! Some people never grow wisdom teeth. In a Harvard University review 23% of subjects were missing one or more wisdom teeth. The rate of missing wisdom teeth varies drastically geographically and across ethnic groups. For example, nearly 100% of indigenous Mexicans do not develop wisdom teeth while only 11% of African Americans don’t.
When do wisdom teeth come in?
The name “wisdom teeth” stems from the fact that they show up later in life when we are supposedly wiser. This is a little laughable considering that wisdom teeth usually come in during our late teens or early twenties. However, it is possible for wisdom teeth to erupt outside this window or not at all depending on genetics, jaw size, and dental development.
Do I have to get my wisdom teeth out?
No, you don’t automatically have to get your wisdom teeth out. For some people, wisdom teeth cause no issues. The decision to remove wisdom teeth depends on several factors and should be made in consultation with your dentist. Below are some of the reasons that wisdom teeth removal may be recommended.
Why are wisdom teeth removed?
We’ve already discussed that we don’t need wisdom teeth, but why go through the trouble and pain of getting them removed? It’s true that some people do not need to get their wisdom teeth removed, but for 85% that do, why? Let’s discuss some of the problems caused by wisdom teeth and common reasons why wisdom tooth extraction is recommended.
- Impaction: If wisdom teeth don’t have space to grow normally, they can become impacted–trapped beneath the gumline and/or under existing molars. Impacted wisdom teeth can grow at an angle, push against adjacent teeth, and cause pain and discomfort. Impaction is the #1 cause of wisdom tooth extraction.
- Damage to Other Teeth: Misaligned or impacted wisdom teeth can harm adjacent teeth.
- Resorption: The gradual breakdown of the tooth structure and root systems of existing molars.
- Increased Risk of Cavities: Due to their location, awkward angles, and crowding, wisdom teeth can be difficult to properly clean which can lead to decay and cavities in wisdom teeth themselves and surrounding molars.
- Gum Disease: Also due to cleaning difficulty, inflammation and infection can occur around wisdom teeth, spread to other teeth and surrounding gums.
- Orthodontic Concerns: Wisdom teeth can cause crowding or interference with the alignment of other teeth. If wisdom teeth are not removed in a timely manner, they can undo previous orthodontic work or create orthodontic issues.
- Cysts: While somewhat rare, cysts can develop around impacted wisdom teeth, causing damage to surrounding bone, teeth, and nerves. This situation requires removal of the cyst and wisdom teeth.
Wisdom Tooth Removal
Your dentist sits down for that dreaded conversation– “it’s time to get your wisdom teeth out”. It’s natural to feel nervous, but understanding the process can help ease your anxiety and let you know what to expect. Let’s break down wisdom tooth removal from preparation to recovery so you can feel confident and take good care of yourself.
Preparation: Getting Ready for Extraction
Before the big day you will meet with your oral surgeon or dentist for a consultation. This is what you can expect during the appointment:
- Explanation of the procedure: They will talk you through the general process and your specific procedure.
- Additional X-rays may be taken to help them plan the best approach for extraction
- Discussion of medical history: prescriptions, medications, allergies, health conditions
- Sedation options: Learn more about your options below
Wisdom Tooth Removal Sedation Options:
- Local Anesthesia is a numbing medication injected into gums to block pain, but you’ll be awake and aware throughout the procedure. This may be recommended for simple extractions.
- Nitrous oxide (“laughing gas”) or oral sedatives can be paired with local anesthesia to help you relax during the procedure.
- IV Sedation (conscious sedation): You’ll receive medicine through an IV that will make you very relaxed and sleepy. You’ll likely have no memory of the event.
- General Anesthesia: IV medication that will make you completely unconscious during the surgery. Typically, General anesthesia for wisdom teeth removal is only necessary in cases of severe anxiety or complex extractions.
Wisdom Tooth Removal Patient Checklist
Now that the oral surgeon’s portion is out of the way, what do you need to do to prepare for wisdom tooth extraction?
- Plan Transportation: Depending on sedation type, you likely will not be able to drive following your wisdom tooth extraction. Make sure to arrange a ride home.
- Shopping: stock up on the necessities
- Soft foods to eat while you recover.
- Over the counter pain medicine (ask your doctor which medications are safe/recommended).
- Ice packs
- Fast before your appointment if the sedation type requires it.
Procedure: Wisdom Tooth Removal
It’s time to get those useless teeth out of there! Every wisdom tooth extraction is different depending on the unique structure of your mouth, impaction, position, roots etc., so we will keep our discussion of the procedure itself brief. The oral surgeon will make a small incision in your gums, extract the teeth whole or in smaller pieces, if necessary, clean the socket, and stitch the gum tissue closed. The whole procedure usually takes an hour or less. The extraction zone will be packed with gauze to slow the bleeding and pad the area and then it’s time to go home and heal.
Recovery: After Wisdom Tooth Removal
The recovery period after wisdom tooth removal is crucial for proper healing. It’s not going to be fun but knowing what to expect and how to take care of yourself will keep your healing on track so you can get it over with as soon as possible.
What to expect after wisdom tooth extraction:
- Bleeding: Oozing and blood is normal during the first 24-48 hours after surgery. Gently bite down on gauze pads to absorb the blood during the first day or two following surgery. DO NOT RINSE during the first 24 hours to allow blood clots to form.
- Pain: You will experience pain as the anesthesia wears off and it may continue in the days following wisdom tooth removal. Take prescribed medication and/or OTC pain relievers as directed.
- Swelling: This can begin day 1 and those chipmunk cheeks will usually peak around day 3. Apply ice packs to your cheeks to reduce swelling.
- Bruising: If your face starts turning colors do not be alarmed. It’s all part of the healing process.
- Jaw Stiffness: Swelling and sore muscles from the procedure can cause jaw stiffness. This will subside over time.
Hygiene and Nourishment
- Soft Foods: Stick to foods that require minimal chewing such as yogurt, apple sauce, mashed potatoes, and soup. Try not to starve yourself, remember that your body needs nutrients to heal itself.
- Rest: Give your body time to heal (and pass the time) by getting plenty of rest. Avoid strenuous activity for at least a week following extraction.
- Stay hydrated: Hydration promotes healing, reduces swelling, and can reduce the odds of dry sockets.
- Maintain good oral hygiene
- Brush your teeth gently while avoiding surgical site
- Saltwater Rinses: After 24 hours you should rinse your mouth with warm saltwater several times per day and after each meal. This helps keep the area clean and promotes healing.
- Attend follow-up appointments
Things to avoid after wisdom tooth removal:
- Straws: Sucking on a straw can dislodge blood clots in extraction sites that are crucial to healing and stopping bleeding. Using straws can cause dry sockets to develop.
- Smoking reduces blood flow to surgical site which hinders healing. Smoking also increases the likelihood of dry sockets.
- Rigorous Rinsing can dislodge blood clots.
- Touching surgical area increases risk of infection.
- Hot liquids can irritate surgical sites.
When to Seek Medical Attention
You will have routine checkups following your wisdom tooth extraction, but there are some situations in which you should contact your doctor immediately or head to the emergency room. Some blood, pain, and discomfort are normal, but if they become unbearable or excessive, that’s a problem. How do you know if you need to seek medical attention after wisdom tooth surgery? These are some of the red flags you should look for.
Infection
The surgical sites are vulnerable to infection during the recovery process. Bacteria in the mouth and food particles trapped in the extraction socket can lead to infection if oral hygiene isn’t well maintained.
Signs of infection:
- Increased pain or swelling that worsens after the first 2-3 days instead of improving
- Pus/Discharge
- Foul taste or odor
- Fever
- Warmth or redness around extraction site
- Flu-Like Symptoms: fatigue, chills, swollen lymph nodes
Dry Sockets
Dry sockets are a painful condition that occur when the blood clot doesn’t develop properly, is lost, or dissolves before the gum tissue has healed. The blood clot protects the underlying bone, nerves, and tissue until the socket is healed. Without it these sensitive areas are open to air, food, fluids, and bacteria which can lead to major discomfort.
Signs of dry sockets:
- Severe, throbbing pain beginning days after extraction
- Empty socket where blood clot should be (bone may even be visible)
- Persistent bad breath/taste
Excessive or Prolonged bleeding
Some bleeding is normal, but you should contact your doctor if you experience the following.
- New or increased bleeding: Bleeding restarts or increases significantly after 1st day
- Bleeding doesn’t stop: Can’t be controlled by applying pressure with gauze for 30-60 minutes
Additional reasons to seek medical attention
- Nerve Injury: Persistent numbness or tingling in lip, chin, tongue, or cheek that lasts more than a few days.
- Difficulty breathing or swallowing
- Loose stitches or opening in the incision
- Allergic reaction
Achieve a Healthy, Pain-Free Smile at UGD
University General Dentists is a private dental practice and proud participant in the University of Tennessee Graduate School of Medicine’s dentistry residency program. We are a top provider of dental care in Knoxville, TN offering a wide range of services including family dentistry, veneers, TMJ therapy, dentures, and of course, wisdom tooth extractions.
At UGD we know that wisdom tooth removal isn’t fun, but we will do everything in our power to make your experience as pleasant as possible. Our experienced doctors will develop a thoughtful personalized surgical plan to minimize pain and set you up for a speedy recovery. Our team will provide excellent patient care every step of the way, making sure you feel confident, comfortable and supported.
Whether your wisdom teeth were recently detected beneath the surface or they are fully erupted, having them removed can help you avoid the wide range of problems wisdom teeth can cause. We encourage you to act now. Contact us today to schedule a consultation!