Patient Information

General Information for the Patient Having Their Wisdom Teeth Removed


What is an impacted tooth?

An impacted tooth is one which has been prevented from erupting into the mouth. The tooth may be blocked by another tooth, dense bone or a pathological condition. Any tooth can be impacted, but more often than not, impacted teeth are third molars or “wisdom teeth”. 

Some people have enough room in the back of their mouths for their wisdom teeth to function well for a lifetime. However, many people do not have enough room and their wisdom teeth are crowded and fail to come through the gum tissue properly.


What harm can impacted teeth do?

  1. Impacted teeth may grow in any direction; however they often grow forward and push against the adjacent second molar and possibly damage its roots or crown. The second molar may also be pushed out of position.
  2. All teeth develop in a sac, deep in the bone. If the tooth erupts normally, the sac generally disappears. If the tooth is impacted, the sac fills with fluid and enlarges to form a cyst. The cyst can cause destruction of surrounding bone and damage to other teeth in the area.
  3. Whenever saliva reaches the tooth, decay may occur, and since such cavities cannot be filled severe pain may result. This may be followed by the formation of an abscess.
  4. Bacteria in the saliva may cause an infection around the crown of the wisdom tooth and under the flap of the gum tissue which may be covering part of the tooth. This infection may spread to the cheek, throat, or neck and result in severe pain, stiffness of the jaws, fever and severe generalized illness.


When is the best time to have wisdom teeth removed?

The oral and maxillofacial surgeon can study an x-ray of the teeth and jaw, and can frequently tell by the teen years if the wisdom teeth are going to be impacted. At this stage, the roots are usually not fully formed and in most people the bone is less dense.

As a result, the wisdom teeth are less complicated to remove when they are removed during this time period. 


What is it to have an impacted tooth removed?

Because the impacted tooth is usually completely beneath the surface of the gum and often encased in bone, we consider its removal an operation in every sense of the word. This is said not to frighten the prospective patient, but rather to give a better understanding about certain features regarding cost, careful preparations and the need for good aftercare. Both local sedation or general anesthesia may be used. The surgeon chooses the method of treatment based on each individual situation. Having a comfortable patient helps to control bleeding, allows the surgeon to work without haste and causes less physiological disturbance to the patient. The actual removal of the tooth is done in keeping with recognized surgical principles, with meticulously sterile instruments, good light, a dry operative field, gentle handling of the soft tissue and bone and the advantages of a well trained team. Depending on the degree of difficulty of the individual case, the procedure may last from fifteen to sixty minutes. If sedation or general anaesthesia is used there will be a recovery period from thirty to ninety minutes. The surgical wound will be sutured with a material of the surgeon’s choice. Most often dissolving sutures are used.


What should I expect after surgery?

After any surgical procedure a certain amount of discomfort is anticipated. For this reason you will be provided with a prescription for pain relieving medication before you leave the office. You are to take one tablet as soon as you arrive home before the local anaesthesia wears off, one in two hours and then one or two tablets every three to four hours as necessary for pain control.

Your surgeon will decide if antibiotic medication is necessary and if this medication has been prescribed, it should be taken until all tablets are gone.

Swelling 

Swelling after surgery is normal.  You should expect to be most swollen 2 to 3 days after surgery. The swelling then begins to resolve.

Bleeding 

Bleeding the day of surgery is not unusual. The major bleeding will be stopped by the time you leave the office. It is not unusual however to have a little oozing from the surgical site the entire day of surgery. This usually ceases by the following morning and after that the only bleeding which might occur is associated with brushing your teeth. This is nothing to be alarmed about.

Stiffness

Stiffness of the jaws is normal sequel of wisdom teeth surgery and it is usually worst two to three days after surgery. One should start to exercise the jaws on the second or third postoperative day to allow the jaws to return to their normal movement.

Numbness

It is not unusual for many patients to experience a temporary numbness of their lower lip and chin and / or the tongue on one or both sides. This occurs from the pressure being placed on the nerve either from swelling or the manipulation of the tooth, and it is most often temporary, lasting a few days / weeks / months.

Difficulty Eating

Although it will probably be difficult to eat after surgery one must remember that the body heals itself by drawing upon its reserve of protein, vitamins, minerals, calcium and iron. Failure to replenish the body’s supplies of the above mentioned nutrients can result in fatigue, infections, and even delayed healing. For the first twenty-four hours following surgery eat soft food.  Beverages should be warm or cold – NOT HOT . Fluid intake should be approximately six to eight glasses of water per day for the average adult. Detailed postoperative instructions will be provided before you leave the office.



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