Wisdom Teeth: Wise to Keep?

Wisdom teeth are the third and final set of molars that most people acquire in their late teens or early twenties. Misaligned wisdom teeth  can crowd or damage adjacent teeth, jawbone, or nerves. They can also become impacted, meaning they only partially erupt through the gum. This makes brushing and flossing difficult and allows bacteria to permeate the tooth’s surrounding area, causing infection. Swelling, pain, jaw stiffness, and general malaise results. Oral bacteria may also travel from your mouth through the bloodstream, leading to possible systemic infections and illnesses effecting your organs.

Diagnosis
If you’re a young adult between ages 17-25, your dentist can determine if you have wisdom teeth. He or she may require an X-ray to detect their position in your mouth, or refer you to an oral surgeon for further evaluation.

Wisdom teeth that are completely erupted and functional, painless, disease and cavity-free, and surrounded by healthy gums may not require extraction.

Procedure
Teeth should be removed when the following is present:

    • Infections and/or periodontal disease
    • Cavities that cannot be restored
    • Pathologies such as cysts and tumors
    • Damage to neighboring teeth

Even if you are not in pain, wisdom teeth may require extraction as a preventative measure prior to infection. Extraction is less painful and complicated if conducted before problems arise. It is also easier in younger patients, since the teeth roots aren’t fully developed and the bone is less dense. Healing time is typically extended in older patients.

Fully erupted wisdom teeth are extracted like any other tooth. However, if it is embedded under the gums, an incision is required to remove the portion of bone lying over the tooth. Often the tooth it is removed in small sections to reduce the required bone removal.

Just like when a cavity is filled, local anesthetic is used to numb the surrounding tissue before teeth are pulled. Sedatives may be administered to reduce anxiety and may require someone else drive you home after the procedure.

Recovery
First 24 Hours

      • Bleeding may occur for several hours
      • Facial swelling typically occurs – treat with ice compressions
      • Pain medications can be taken
      • Antibiotics may be prescribed to treat active infection
      • Liquid diet is required until numbness has worn off
      • No alcohol if taking prescription pain meds
      • Brush teeth, but avoid teeth neighboring extracted tooth

After 24 Hours

      • Treat facial swelling with heat
      • Rinse mouth with warm salt water (1/2 tsp salt in 1 cup water)
      • Stitches will be removed in one week (if used and not self-dissolving)
      • Monitor signs of dry socket, which requires treatment from a dentist

Complications
Dry Socket: This is a common complication that occurs approximately 3-4 days post-extraction, when a blood clot fails to form in the extracted tooth socket, or else becomes dislodged. Healing is delayed without the clot. Patients begin sensing pain and a foul mouth odor. Medication will be placed in the socket to treat the condition.

Parasthesia: On rare occasion, nerves adjacent to embedded widow teeth become bruised or damaged during extraction, resulting in a numb tongue, lip, or chin. This can last for days, weeks, or months and is sometimes permanent.

Complete healing takes a few weeks to a few months, but within the first week or so, your mouth will be reasonably comfortable again.

Contact Dr. Arhiri to schedule an appointment for determining the position and condition of your wisdom teeth, especially if you’re a young adult and/or experiencing pain. Once disease is established around your last molars, it is persistent and progressive, so don’t delay! Call 610.647.7611 or email drarhiri@premiersmilespa.com today!

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