Wisdom Teeth Removal

What Is A Wisdom Tooth Extraction?

A wisdom tooth extraction is a type of procedure designed to safely remove wisdom teeth that are no longer necessary. Wisdom teeth are the final molars on each side of the jaw. These are the very last teeth to emerge from the gums. This typically occurs between the ages of 15 and 20.

Because most people do not have extra room in their mouth for these teeth, a wide range of issues can begin to occur if they are left in the mouth. They could become trapped under the gums or impacted with other teeth, which can lead to swelling and bleeding. Only in rare cases will these teeth be able to emerge from the gums and have sufficient room to stay in the mouth and remain healthy. In all other cases, a wisdom tooth extraction procedure is advised. It’s a very common procedure that doesn’t come with many adverse effects. The length of the procedure largely depends on the position of your wisdom teeth and how many teeth you’re having removed.

How Do You Prepare For Wisdom Teeth Removal?

During your first visit with an oral surgeon or another dentist, you can expect him or her to lay out a plan for treatment. You will most likely have X-rays performed at the time of your visit, too, so make sure you tell the dentist if you’re pregnant or have any condition that can be affected by the X-rays.

Dr. Jamali and his team at Oral & Maxillofacial Surgery of New York hope your first visit is a great one. If you have any questions about what to expect or what to bring along to your first appointment, call (212) 480-2777 and a member of our team will help you out.

Why Should I Remove My Wisdom Teeth?

Wisdom teeth can erupt in various positions. No individual’s teeth will be exactly the same, and the way that the wisdom teeth develop is different for each individual. It is possible for the teeth to develop healthily and correctly for some. Most wisdom teeth are positioned at a horizontal angle, or towards the second molars. These unhealthy angles can impact the nerves in the gums, the jawbone, or other teeth located nearby. Some wisdom teeth become partially trapped in the bone as they attempt to emerge. When this occurs the wisdom teeth are said to be impacted. Being impacted allows them to become enclosed in the tissue and only become partially visible. This can create many issues and the opening will let bacteria from around the tooth enter the gums and jawbone. An infection can occur which creates pain, jaw stiffness, swelling, and many other possible illnesses from the infection. Tumors and cysts can also occur around the impacted wisdom teeth. This can cause the jawbone to be destroyed and infected which can cause further issues for the jaw and other surrounding teeth.

The wisdom teeth that are visible through the gums are also more prone to become decayed and develop gum disease because of their location. Since wisdom teeth are located on the third molar they can be difficult to reach in the back of the mouth. This can create challenges when brushing and flossing.

It is often highly recommended that wisdom teeth are removed in their very early stages to avoid the many problems that can occur. The risks of the surgery are decreased when they are removed at an early stage and it can prevent other teeth from being negatively affected. This is very important when other orthodontic measures such as braces have already been put in place on the other teeth.

Why Are Wisdom Teeth Removed?

There are plenty of reasons as to why you might choose to undergo a wisdom tooth extraction procedure. This procedure is highly beneficial for any individual who is experiencing issues because of the presence of these teeth. Impacted wisdom teeth can result in a myriad of problems, including everything from general pain and damage of a nearby tooth, periodontal disease, tooth decay or in some cases, severe face and neck infection.

Having these teeth removed early will alleviate these symptoms and prevent related dental problems from occurring in the future. Even wisdom teeth that are symptom-free could still hold some form of the disease. When a tooth doesn’t erupt as it should, it can be very difficult to clean properly, which may result in the development of a cavity or tooth decay. It’s also recommended that you seek this procedure as young as possible.

As you get into middle age, the risks from the surgery increase somewhat. If a wisdom tooth becomes impacted, the chance for the development of tiny cysts and tumors increases. The removal of these would require the assistance of an oral and Maxillofacial specialist. These are just some of the reasons as to why you should consider a wisdom tooth extraction. The oral and maxillofacial procedure is very successful, especially for those in their late teens and early 20’s. There are hardly any possible long-term complications, so the downside to having this procedure done is minimal.

What Can You Expect During The Extraction?

In the hands of an oral & Maxillofacial surgeon, the wisdom tooth extraction procedure is pretty straightforward. It begins with the application of a local anesthetic by the oral surgeon. The area directly surrounding the teeth that are set to be pulled will be numbed so that you don’t feel any pain during the procedure. If more than one tooth is being pulled, a general anesthetic may be administered instead so as to keep you unconscious throughout the extractions. If you choose to have IV sedation, you should not eat or drink 8 hours before the procedure. Once the extraction begins, the gum tissue that’s over or around the tooth will be opened up. If any bone is covering the tooth, it will be removed.

Once this is completed, the tooth may be cut into separate pieces so as to make the removal process a simpler one. Following the surgical procedure, stitches may be placed in the area where the tooth was extracted. In most cases, these stitches will dissolve. In general, the entire recovery process is just a few days long.

How Long Will The Procedure Last?

The time it takes for your wisdom teeth to be removed all depends on:

  1. The qualification and expertise of your surgeon. An oral and Maxillofacial (OMS) surgeon has 4-6 years of additional training past dental school. Dr. Jamali, an OMS is an expert in removing wisdom teeth.
  2. Location of the teeth and how many are being removed. If only one wisdom tooth is being extracted, expect the procedure to last a total of 20-30 minutes. In the event that you are having all four wisdom teeth removed, it’s possible that the procedure can last up to 30-45min.
  3. If IV sedation is chosen, plan to be in our office for about 90 minutes.

What Is The Followup And Recovery Like For Wisdom Teeth Removal?

Once the procedure has been successfully completed, you should expect the recovery process to take anywhere from a single day to a few days. Initially, you will experience small amounts of bleeding, swelling, and pain. Bleeding typically dissipates after a day, while swelling and pain can last 2-3 days. Bruising of the area may occur, lasting upwards of four days. Make sure to drink lots of water and eat only liquids like soup for the first 2-3 days and soft foods for the next 10 days following the procedure. Stitches may be placed in the treatment area. These dissolve in a couple of weeks. Only resume brushing your teeth and rinsing with warm salt water after 24 hours have passed. Do not use mouth wash for the first 7 days.

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately following surgery:

  1. The gauze pad placed over the surgical area should be kept in place for a 45 min. After this time, the gauze pad should be removed and discarded.
  2. Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  3. When arriving at home, take the gauze out and eat something cold like ice cream or yogurt. Then take the pain medication and antibiotics (if given) immediately after. This must be done before you feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  4. Restrict your activities the day of surgery and resume normal activity when you feel comfortable. If you increase your heart rate for the first 10 days after surgery, you will experience throbbing pain. Long walks or talking a lot may cause pain as well.
  5. Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding can be controlled by placing a gauze pad over the area and biting firmly for thirty minutes. No talking during this period! Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

For mild pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every four hours or Ibuprofen, (Motrin or Advil) three to four 200 mg tablets may be taken every 6-8 hours.

For severe pain, take the tablets prescribed as DIRECTED. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. DO NOT USE STRAWS FOR THE FIRST 10 DAYS. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Hygiene

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the DAY AFTER of surgery but rinse gently. The day after surgery you should begin rinsing at least 1-2 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Jamali if you have any questions.

What Are The Potential Costs For Extracting Wisdom Teeth?

Cost is based on the level of impaction of the teeth. There are codes that are sent to your insurance company and based on those codes, you or your surgeon is reimbursed. This is done nationally.

What Are The Potential Risks For Removing Wisdom Teeth?

There are several risks that you should be aware of when considering this procedure. Swelling and pain are common around the socket where the tooth was removed. You may experience bleeding that continues almost constantly for 24 hours. Difficulty with opening your jaw and slow-healing gums are also possible. If the blood clot that protects the treated area is removed too quickly, a substantial amount of pain will occur, which is referred to as a dry socket. Rarer risks include a fractured jaw and an opening in the sinus cavity.

Meet Dr. Majid Jamali

Dr. Jamali, a board-certified oral and maxillofacial surgeon, practices a full scope of oral and maxillofacial surgery with expertise ranging from dental implant surgery and wisdom tooth removal to corrective jaw surgery. This also includes techniques designed to rebuild bone structure with minimal surgical intervention and optimal patient comfort. We can also diagnose and treat facial pain, facial injuries, and fractures. Learn More »

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