Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt; they usually come in when a person is in their late teens or early twenties.
Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. As teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.
As wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted (below the gum line and not erupted). If teeth are impacted, swelling and tenderness may occur in the area of the third molar.
A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral maxillofacial surgeon, will recommend either local anesthesia, if the teeth are erupted, or IV sedation or general anesthesia, if the teeth are impacted. The oral surgeon will recommend the best anesthetic option to the person who is having their wisdom teeth extracted.
If the wisdom teeth are erupted, the tooth (or teeth) will be removed. After surgery, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur.
If the wisdom teeth are impacted and embedded in the bone, the oral surgeon will put an incision into the gums and remove the tooth or teeth in sections in order to minimize the amount of bone being removed. Some pain and swelling may occur, but it will normally go away after a few days; however, you should call your dentist or oral surgeon if you have prolonged or severe pain, swelling, bleeding or fever.
Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.
If surgery is completed, swelling and tenderness in the face and neck are common, as is bruising. Ice packs and pain medications prescribed by the dentist or oral surgeon will help, but if you have any questions or are concerned about what you are experiencing, contact your oral surgeon.
After a tooth is extracted a blood clot forms in the tooth socket and seals the area so that it can heal. A dry socket occurs during the first five days after extraction, when the blood clot breaks down or is dislodged, and exposes the bone and nerves of the tooth. Only 2 to 5% of people will develop a dry socket.
A dry socket is very painful! To ease the pain, a dentist will rinse out the empty socket, remove any debris and apply medicated dressings to protect the area and decrease the pain. They will prescribe an antibiotic to prevent infection and a painkiller to decrease discomfort. With proper care and rest a dry socket should heal in 7 to 10 days.
Pericornitis is a dental infection that occurs when there is not enough room in the mouth for a wisdom tooth to erupt. The wisdom tooth is partially erupted and the gum tissue covers a part of the top of the tooth. This allows food or plaque to become lodged under the gum tissue flap. If the area becomes infected, it is called pericoronitis and the gum tissue will become swollen and red.
Symptoms include a bad smell or taste in the mouth, discharge of pus from the gum near the tooth, swollen lymph lodes under the chin, muscle spasm in the jaw and swelling on the affected side of the face. You can treat it by rinsing with warm salt water and make sure that food is removed. An antibiotic may need to be given and oral surgery may be necessary to treat this oral care issue.