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WISDOM TEETH

Expertise with even the most complicated
impacted wisdom teeth cases!

Because wisdom teeth are the final set of teeth to appear after all other adult teeth have been settled into place for years, they are the most likely to cause a variety of issues. Without adequate space to erupt, impacted wisdom teeth are a common problem for many people. Even when they are able to break the surface, chances are that your wisdom tooth may grow in sideways or cause overcrowding in the jaw, resulting in jaw pain, tooth decay, gum disease and infection, and even cause damage and alignment issues to neighboring teeth. Usually, the most common course of treatment for all of the above diagnoses will involve wisdom tooth extraction to eliminate the cause of the issue. For an erupted wisdom tooth, a standard tooth extraction will be performed. However, surgical extraction will be necessary in the case of an impacted wisdom tooth.

Diagram of impacted wisdom tooth
Diagram of wisdom tooth damaging other teeth
Diagram shows wisdom teeth can grow sideways

Not all wisdom teeth need to be removed. As long as the tooth erupts cleanly without causing damage or crowding to other teeth and is accessible for daily hygiene practices such as brushing and flossing, you will not require an extraction.

Circumstances surrounding the need for wisdom tooth extraction usually involve shortage of space within the jaw that either prevents proper eruption of the tooth, causes other teeth to become damaged or misaligned, or causes the tooth to erupt in a way that prevents access to the tooth or surrounding teeth for proper hygienic care.

An example may include an angular wisdom tooth eruption where the tooth grows in sideways. This places pressure on the remaining teeth causing damage and misalignment, headaches, jaw pain, and also makes it difficult to keep teeth clean. The wisdom tooth may also develop in a sac within the jawbone producing cysts or even benign tumors that cause damage and partially erupted or impacted wisdom teeth are notoriously difficult to keep clean and can often result in gum disease.

In some cases, a wisdom tooth may require emergency extraction due to a severe infection. If you are experiencing red, swollen gum tissue near your very back teeth along with a bad taste and smell, pain when biting down, and possibly even draining pus, contact your dentist immediately for an emergency procedure. Left unattended, wisdom tooth infection can radiate to the ear causing ear and sinus infections, so it is important to seek care immediately if you suspect an infection.

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Wisdom teeth extraction is a process that can take up to 45 minutes depending on complexity and can take two forms; the conventional tooth extraction method for erupted teeth, or surgical extraction for an impacted wisdom tooth.

For a surgical tooth extraction, the procedure should be performed by a qualified oral surgeon who is also skilled in anesthesia such as our in-house oral surgery specialist.

The process will usually begin with the application of a local anesthetic. Depending on the degree of invasiveness of the surgery, this may be supplemented with nitrous oxide to help you relax and maybe even doze, or IV sedation to help you sleep throughout the entire procedure. Alternately, you may choose to go under general anesthesia which will put you to sleep through the whole procedure and take about an hour post-surgery to wake up. This may also be administered intravenously or by breathing in gas via a mask.

Extraction of an erupted wisdom tooth is a fairly straight forward process where specialized tools are employed to securely hold the tooth and rock it back and forth within its socket until it detaches.  Surgical tooth extraction for an impacted tooth will involve the removal of tissue and cutting of the bone that covers the tooth to create a small opening. The tooth will usually be cut into pieces through this opening to minimize cutting of bone tissue, then thoroughly removed before suturing back up with several stitches to close the surgical site and promote healing of the surrounding gum tissue.

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Depending on the type of anesthesia you had for your wisdom tooth removal and your personal response to the anesthetic, you may feel alert directly after your procedure, or you may be very drowsy and require somebody to drive you home.

Likewise, the level and duration of pain will vary from person to person and also depend on the invasiveness of the procedure. Some people may experience little to no pain and be able to drive themselves straight to work, while others may need to take some pain medication such as Tylenol or a mild narcotic and rest at home for the remainder of the day.

Typically, complete recovery after wisdom tooth removal can take from three to five days. During the first day, you may experience light bleeding from the surgical site which should subside within the first 24 hours. As the anesthesia wears off, you may experience some pain, stiffness of the jaw, and possibly some difficulties in opening your mouth. This should reduce over the next couple of days, downgrading to some swelling and mild discomfort. Severe and persistent pain is not normal, and you should contact your dentist or oral surgeon immediately if you experience such symptoms.

For effective tooth extraction aftercare, we recommend that patients eat soft foods and avoid spicy foods, drinking through a straw, harsh rinsing, excessive exercise, and alcohol and tobacco use for the first 3-5 days. To help with swelling, you can apply an ice pack, and to relieve stiffness, try opening and closing your mouth gently to exercise and loosen the jaw.  

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What Causes Wisdom Tooth Pain?

There can be a number of circumstances surrounding wisdom tooth pain, but the underlying factor that is prevalent in virtually all patients is lack of space. Human jaws have become smaller over time, leaving less and less room for the mouth to accommodate for wisdom teeth when they do come in. This can lead to impaction, pressure upon other teeth causing damage and misalignment, infections, jaw pain, and even headaches, resulting in wisdom teeth surgery being one of the most common oral surgery procedures performed.

When Do Wisdom Teeth Come In?

Our set of third molars are more commonly known as wisdom teeth, and are the final set of teeth to erupt, as well as the most posterior teeth in the dental arch. Typically developing between the ages of 17 and 21, it is possible for some adults to never see their wisdom teeth coming in, and also for some to develop more than the usual set of four.

Life After Wisdom Teeth Removal

According to Healthline Magazine, wisdom teeth are no longer totally necessary due to human advancements in cutting and crushing utensils as well as cooking. Healthline states that anthropologists believe humans to have evolved beyond the need for wisdom teeth, and indeed, many people today don’t ever see their wisdom teeth coming in (as many as around 47% of adults 25 years and older according to a 2013 study). If you have had wisdom teeth surgery, you can continue to expect normal function in chewing and speaking, and no visual changes or facial distortions to occur after wisdom teeth removal.

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