If you're unlucky enough to need a molar extracted, you may be wondering what you can expect from the procedure. The type of procedure and the reasons for removal depend on where the tooth is located. The third molars, also known as the wisdom teeth, are more difficult (in most cases) to extract because they sit at the very back of the jaw. Here's all you need to know about the differences between a third molar extraction and a first or second molar removal.
First/Second Molar Extractions
Dentists usually extract first and second molars when the teeth are damaged by decay or cracked to be saved with a filling or crown, or if they're very loose and can't be repaired with bone graft surgery. If the tooth is whole and visible, the dentist will begin the procedure by injecting a local anesthetic in the area where the tooth is located. Then, a tool called an elevator will loosen the tooth. Next, the tooth is pulled out by forceps. Rarely, the tooth breaks during the procedure, and then a simple extraction turns into a surgical extraction and stitches are needed to close the site.
When a first or second molar hasn't erupted or has broken off at the gumline, the following surgical procedure is similar to a third molar extraction. Dentists and oral surgeons are qualified to perform surgical tooth extractions. A local anesthetic and sedation anesthesia may be administered to relax the patient. General anesthesia may be needed to calm children for a tooth extraction.
Wisdom Teeth Extractions
The reason for a third molar extraction is different than a regular tooth extraction in that the wisdom teeth are usually healthy. The problem is that the mouth is usually not large enough to accommodate the extra molars that erupt when a patient is around 17 to 21 years old, according to the Cleveland Clinic. Third molars may erupt sideways, which could lead to pain, infections, cysts or damage to the second molars.
The preparation and procedure for a wisdom tooth extraction are different from a first or second molar extraction. The dentist may require a panoramic X-ray to show the position of all the teeth. He or she can then see the third molars' placement in relation to the sinuses, jawbone nerve and rest of the teeth. The X-ray also detects any infection or disease that may be present.
While a regular tooth extraction may involve only a local anesthetic and the dentist pulls the tooth, a wisdom tooth extraction is more complicated. General anesthesia is sometimes best for the patient and, according to the Mayo Clinic, the surgery can be extensive. The dentist opens the gum and determines how to extract the tooth. If it makes the extraction easier, the surgeon may divide the tooth into sections before removal and the surgical area is stitched together.
Due to the more extensive surgery required to extract a third molar compared to a first or second molar extraction, recovery time can last longer. Depending on how the wisdom teeth are positioned, the patient may take as long as a week or longer to recover from the surgery, though most patients recover in three to four days.
For the first few days after a third molar extraction, patients shouldn't drink alcohol, soda, coffee or other hot beverages, or eat solid food. To avoid dislodging the blood clot that forms in the wound or damaging the gums, patients shouldn't brush their teeth for the first day. After 24 hours, brushing can resume, using a soft-bristled toothbrush like Colgate 360° Enamel Health Soft Toothbrush for Sensitive Teeth.
Follow Your Dentist's Advice
The line between first or second molar extractions and third molar extractions isn't clear cut, but removing a first or second molar is often a more straightforward procedure. Dentists may recommend a third molar extraction as a preventative measure. The removal of other teeth is often reactive. In all cases, it's best to follow your dentist and oral surgeon's advice about extractions to maintain a healthy and pain-free mouth.