Wisdom teeth removal

Wisdom teeth removal means having one or more of the third molars (your wisdom teeth) at the back of your mouth taken out. This can sometimes involve a surgical procedure.

Your wisdom teeth are the last four of the large grinding teeth (molars) at the back of your mouth to come through. You’re likely to have them by the time you reach your mid-twenties, though some people find they come through earlier or later than this. Sometimes, your wisdom teeth don’t come through properly (they’re impacted). This can cause problems such as pain, swelling and infection. Having wisdom teeth taken out can ease these symptoms.

Impacted wisdom teeth can cause complications as the condition worsens, such as damage and realignment of the surrounding teeth, gum disease, and cysts. You should make an appointment to see your dentist if you’re experiencing severe discomfort from your wisdom teeth.

Common symptoms of impacted wisdom teeth are throbbing pain in the back of the mouth, swollen or bleeding gums, swelling around the jaw, swollen glands in the shoulder or neck, and headaches. These symptoms can often be mistaken for Gum Disease. If you think you might have gum disease take a look at our main gum disease treatment page here.

A simple home remedy for the pain is gargling with salt. This naturally antiseptic compound helps reduce inflammation in the gums, and even has the potential to fight infection. However, if pain and oral distress persists, you may need to consider an extraction or removal of the teeth. An experienced dentist will be able to remove your wisdom teeth with no problems thereby preventing inflammation and infection, overcrowding, damage to nearby teeth and cysts. Extracting impacted teeth can improve your dental hygiene significantly and lower the chance of wisdom tooth infection.

Helpful tips

Simply put, there isn’t enough room for wisdom teeth because our jaws don’t grow to be big enough to have enough space for them to come in. Since there isn’t enough room for them to erupt properly, wisdom teeth tend to come in at an angle or they don’t fully emerge, which causes problems for the rest of the mouth.

Third molars (the wisdom teeth) routinely damage the teeth right next door, called second molars. Dentists recommend removing wisdom teeth before they become a problem and to avoid a more complicated surgery.

In our practice, we see very few people who don’t need their wisdom teeth removed.

Our jaws are smaller than they used to be. That’s not because of evolution — it’s because our modern diet lacks certain key nutrients that allow the jaw to develop properly.

One vitamin in particular, Vitamin K2, is responsible for letting the jaw develop by taking calcium in the body and putting it into the bones. Most people don’t grow up eating the kinds of food where you’d get Vitamin K2 — liver and organ meat as well as animal products from animals that eat grass (not grain or corn). The low-fat food craze of the 90s, as well as factory farming, have virtually obliterated Vitamin K2 from our diets.

That’s why, these days, an underdeveloped lower third of the face is so common that it has become the norm. Our ancestors and small tribes not eating the modern diet had great jaw development with room for all 32 teeth to come in straight.

So, how do you know if your jaw developed fully? It depends on your childhood. Eating raw, crunchy foods rich in the nutrients found in organ meats and grass-fed animal fats are what stimulate proper jaw development. Nowadays, childhood diets are heavy in soft, nutrient-poor foods like applesauce and Goldfish crackers. Bottlefeeding and sippy cups can also hinder proper jaw development. Our diets have gotten too soft and our jaws aren’t developing fully due to lack of use

Try this right now: get a mirror and look at your bottom teeth. First, count how many of the big teeth you have at the back of your mouth—these are called molars. By age 12, you should see two molars in place. Wisdom teeth are your “third molars.”

To see if you have room for your wisdom teeth, put your finger behind either second molar. If you feel a flat pad of tissue, then you may have enough room! If you feel the tissue curving upwards, chances are you don’t have room for your wisdom teeth. Of course, this is a rough estimation and you’re going to need your oral surgeon to measure this space. This quick-and-dirty test is just to give you some idea of what your dentist is going to do to measure the space back there.

  • Do all of my wisdom teeth need to be removed?
  • What are my options for anesthesia?
  • What complications do you expect to see during the procedure? What is the worst case scenario?
  • Compared to all of the other cases you have done, how does my case rank in terms of difficulty?
  • What are the risks of doing this surgery?
  • Will my face get puffy? How long will it be until my appearance is normal and I can return to school or work?
  • What will happen if I leave my wisdom teeth in?

The reason we remove wisdom teeth is to prevent them from damaging other healthy teeth. Often, wisdom teeth erupt perpendicularly to the teeth next door (your second molars). When wisdom teeth come in sideways like this, it throws off your bite, creates an area where food gets caught, decays both of the teeth, and can even cause a painful infection. So, if you skip the surgery today, it’s likely to cause complications and issues down the road.

But what if the wisdom teeth never come in? If your wisdom teeth don’t erupt and you leave them in, there is a 25% chance that the epithelial lining around the wisdom tooth will become cancerous. I found this in my mom while I was in dental school and it was successfully removed, but it was a complicated procedure. This is one of the many reasons that you get your wisdom teeth out earlier, rather than later, in life.

Of course, if you were born without wisdom teeth, then you can skip the rest of the article because you’re all good! This is not to be confused with people who still have wisdom teeth in the bone that haven’t erupted yet. A limited percentage of the population is born without wisdom teeth and those people never have to get surgery.

before the root is fully formed
If the roots develop fully, it becomes way more difficult to do an extraction than when only the crowns (molars) have developed. Teeth grow from the crown down to the root, so if you get it done before the root develops, then the surgery is easier with less recovery time.

To imagine what this is like, think of a skateboard or a tennis ball buried in the sand - which is easiest to remove? The skateboard has to be dug out, but the tennis ball can be rolled out - this should give you some sense of why it’s better to do the surgery before the roots come in.

at the start of summer break
We always recommend getting it done when life is simple, your health is good, stress is low, you have someone to take care of you, and have time to find a great surgeon (and not settle for a last minute choice). For most people, this time is during one of the summer breaks in high school. If you’re not lucky enough to have already had it done in high school, that’s okay - try to stick to the same guidelines when finding the ideal time. We will say that in our 30 years of dentistry, we’ve noticed wisdom teeth complications always happen right before a major life event, like a big exam, date, or wedding -so don’t delay!

Typically about one week. Occasionally, it’ll take as short as four days to recover, but that’s usually just for straightforward surgery cases with no impaction or other complications.

Your recovery time will depend on:

  • What type of anesthesia you choose. You’ll be able to bounce back a lot faster if you have just local anesthesia or nitrous than if you have to go under.
  • Your nutrition during recovery. In just about every case, we see people who have a straight diet of Jell-O and ice cream recover more slowly.
  • Preventing a dry socket. A lot of people delay recovery several weeks by not following proper protocol after the surgery - including using a straw, not keeping the head elevated, or brushing their teeth too soon after surgery.

Wisdom teeth removal is an outpatient procedure, meaning that you get to go home on the same day as the surgery. Ask your dentist or oral surgeon these questions beforehand:

Are you willing to do a bone graft?
If you’re over 25 years old, I usually recommend getting a bone graft. When you take out an adult wisdom tooth, the tooth next to it has a level of bone that it’s accustomed to, but when you take out the tooth next door, you get some shrinkage. When the bone shrinks, that makes the tooth next door sensitive to sugar and cold drinks months after the surgery. Bone grafts prevent this. Usually, people under age 25 don’t need this, but it doesn’t hurt to ask!

Should someone drive me home?
This will depend on the type of anesthesia used. In the majority of cases, plan on having someone there to drive you home.

Should I fast before the surgery? If so, when do I begin the fast?
For local anesthesia, it’s good to have a light meal in your stomach a few hours before the procedure to keep blood sugar levels up. For any other kind of anesthesia, including nitrous, it’s best not to have a full stomach.

Can I take my prescription medications before the procedure?

Are there any nonprescription drugs that I should avoid before the procedure?

What kind of anesthesia will I get?

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