Wisdom teeth cause long-term problems for a great many people. Often they simply cause pain, but at other times they lead to complications and have a negative effect on the entire set of teeth. In such cases, there is no choice: having the wisdom tooth extracted is the only solution.
Most people are aware that the removal of a wisdom tooth is considered a more serious procedure than an ordinary tooth extraction. This is why people tend to be more apprehensive about it, even though it is now regarded as a routine procedure in a well-equipped dental practice.
It is, however, a fact that the extraction of wisdom teeth carries more risks and requires greater care; for this very reason, it is not uncommon for dentists not to wait until problems arise, but to recommend the procedure as a preventative measure.
In this specialist article, we have compiled all the information about wisdom tooth extraction that patients need to know before or after the procedure!
What are wisdom teeth?
Wisdom teeth, also known as third molars, are normally located at the very back of the mouth and the dental arch. They usually erupt between the ages of 17 and 25 and cause problems, but this is not always the case: they can appear much earlier or much later.
According to scientists, wisdom teeth can be regarded as a kind of vestigial structure which modern humans no longer need, but which was essential for our ancestors’ survival.
The third molar actually helped us to chew raw foods, roots, nuts and meat thoroughly. Nowadays, we eat with a knife and fork, which means we take small mouthfuls of food, so there is no longer any need for these teeth.
There are some people whose four wisdom teeth all come through without any problems (two at the back of the upper jaw and two at the back of the lower jaw), but there are others whose wisdom teeth do not come through at all, or only partially.
If they are completely absent, this is not considered an abnormality, but merely a sign of evolutionary change. In fact, anyone who has had or is having problems with their wisdom teeth often wishes they had never come through at all.
When is it necessary to have a wisdom tooth extracted?
Unlike other teeth, wisdom teeth do not only need to be extracted if there is a problem with them.
Its removal is often recommended as a preventative measure, a sort of precaution, to prevent the development of problems later on – whether these be unwanted tooth decay and toothache, or crowding of the teeth.
Wisdom teeth usually need to be removed in the following situations:
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In the case of an impacted wisdom tooth – meaning that the tooth has not been able to erupt properly and is partially or completely trapped within the gum or jawbone, or perhaps has no room to come through –.
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Wisdom teeth that have grown at an angle or sideways, causing problems with maintaining proper oral hygiene.
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The teeth in question cause pain, which may be classic toothache, a sensation of pressure resulting from force exerted on the other teeth, or pain associated with the jaw.
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Frequent or persistent gingivitis, or other gum diseases, develop around the molars.
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Severe tooth decay.
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A cyst has developed around one or more wisdom teeth.
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The surrounding teeth or bones may have been, or may be, damaged by the wisdom tooth.
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The eruption of a wisdom tooth causes crowding, but removing it can prevent the need for orthodontic treatment.
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The teeth in question cannot be cleaned properly, and food debris often builds up behind them.
The benefits of having wisdom teeth removed
There are numerous benefits to having wisdom teeth removed. They can help prevent
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gum diseases that recur regularly or become chronic;
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tooth decay, which can later lead to pain and infection;
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damage to adjacent teeth;
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bone loss;
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as well as injury to the jaw.
If the wisdom tooth is not removed, even in the face of the discomfort experienced, the following complications may arise:
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An infection causing a continuous discharge of pus from the area around the wisdom tooth.
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Damage to certain structures in the oral cavity, which may affect the jaw, nerves, maxillary sinus and surrounding teeth.
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The formation of cysts, which can also damage the bones, teeth and nerves.
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Pain, swelling and difficulty chewing.
Preparing for the removal of a wisdom tooth
Wisdom tooth extraction is always carried out as part of outpatient treatment, meaning that patients who have undergone the procedure can return home the same day and recover at home – provided they strictly follow the instructions given by their dentist or oral surgeon.
Tooth extraction usually begins with a thorough consultation, during which the treating dentist carries out a physical examination, assesses the area surrounding the tooth, its location and position, and takes an X-ray.
The latter is particularly important because it is only through imaging techniques that the dentist can gain an insight into the region beneath the gums. This is essential for planning the procedure.
Before having a blood test, we must always inform our doctor about any medicines we take regularly, as well as any vitamins and dietary supplements, and any chronic conditions we have.
If you have opted for local anaesthetic for the extraction, no preparation is required before the procedure. However, in the case of tooth extraction under general anaesthetic, your dentist will always provide you with detailed information on what to do.
The procedure for extracting a wisdom tooth
The procedure for removing a wisdom tooth varies slightly from patient to patient, but the main steps are generally the same. Below, we have outlined what anyone facing a wisdom tooth extraction can expect:
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Anaesthesia/sedation:Nowadays, even the most complex dental procedures are carried out with a view to ensuring that the patient feels no pain. Accordingly, the first step in the process is always to administer an anaesthetic or, in some cases, to put the patient under general anaesthesia.
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Exposure of the gingiva:If, based on the X-ray, the dentist considers that extracting the tooth will be more complicated – for example, because it is impacted in the jaw – it will be necessary to make small incisions to open up the gum.
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Extraction of a wisdom tooth:The next step is to use a special forceps to loosen the wisdom tooth, dislodge it and then carefully remove it from its socket. In more complicated cases, it may be necessary to section the tooth to do this.
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Cleaning/checking the site of the tooth extraction:If the wisdom tooth is no longer in place, it is possible to examine it more thoroughly to check for any infections and to ensure it is properly disinfected.
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Stabilising the site of the tooth extraction:If incisions were necessary or if there is a large wound left after the wisdom tooth has been removed, the dentist may secure it with stitches. Afterwards, sterile gauze is placed over the wound to stop the bleeding and aid healing.
Methods of wisdom tooth extraction
Modern dentistry employs several different methods for removing wisdom teeth. Let’s take a look at what these are:
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Simple wisdom tooth extraction:If the tooth is easily accessible, there are no anatomical obstacles and it has already erupted fully or almost fully, it can be removed in the same way as any other tooth.
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Laser wisdom tooth extraction:The laser wisdom tooth extraction It is an excellent choice for both simple and more complex cases. Its advantage is that it allows for more precise work with less bleeding; moreover, the laser has a sterilising effect and the sites of extracted teeth heal more quickly.
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Surgical wisdom tooth extraction:Where a tooth has a complex root structure, has grown at an angle or has not fully erupted, surgical removal is indicated; this may involve making an incision in the gum, and in some cases, removing bone or sectioning the tooth.
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Coronectomy:A specialised technique used when the roots of a tooth are too close to the nerves and removal would result in severe nerve damage. In this procedure, part of the tooth root remains in place; only the crown is removed.
What to do after having a wisdom tooth removed
Following the procedure, the attending doctor always discharges the patient with specific instructions. Mild discomfort, some bleeding and swelling are generally to be expected.
It is important to follow your dentist’s advice carefully after having a wisdom tooth extracted, but we have compiled below some general advice and a list of things to avoid which we believe may be useful for patients:
Useful advice following the removal of a wisdom tooth
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Do not remove the gauze for at least 30 minutes:After a wisdom tooth has been extracted, a sterile gauze pad is placed over the socket. It is recommended that this be kept in place for at least 30 minutes, as natural clotting begins during this time.
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Let’s get as much rest as possible:Having a wisdom tooth extracted can be quite taxing for many people, so make sure you rest as much as possible afterwards. If necessary, ask for time off work – this is particularly important if you do physical work. You must strictly avoid any physical activity for a few days.
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Let’s apply an ice pack to the swelling:As we mentioned, it is perfectly normal for swelling to occur at the site of removal. To reduce this, use ice – such as an ice pack or ice gel wrapped in a towel – and press it against the sensitive area.
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Let’s keep the area around the tooth clean:Great care must be taken to maintain proper oral hygiene and keep the wound clean for several days. However, we must be sufficiently careful, as vigorous brushing or rinsing can easily dislodge the scab and cause the wound to reopen. You must not suck or blow on the wound.
Things to avoid after having a wisdom tooth removed
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Using a straw or a water bottle:After having a wisdom tooth extracted, you must not under any circumstances use a straw or a water bottle that requires you to suck on it to drink. This creates a vacuum effect in the mouth, which causes the blood clot in the socket to dislodge.
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Physical work, exercise, lifting: Physical work or exercise is strictly prohibited for 48–72 hours following the procedure; you must also avoid lifting heavy objects or, in the case of parents, small children.
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Eating hard, crunchy, chewy or seedy foods: Foods of this kind can damage gums that are in the process of healing and may even cause pain; the seeds can become lodged in the site of the extraction, so for a few days it is recommended that you eat only soft, mushy foods, without any strong or hot spices.
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Fizzy, alcoholic drinks: Due to their caustic nature, these drinks can not only cause irritation around a fresh wound, but may also lead to it coming away prematurely. It is advisable to avoid consuming such liquids for at least 4–5 days.
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Smoking:It is recommended that you completely avoid smoking and the use of tobacco products for 4–5 days, as they can introduce a large number of harmful substances into the fresh wound.
When should we return to our dentist straight away after having a wisdom tooth extracted?
In most cases, the extraction of a wisdom tooth does not require a follow-up check-up. However, in more complex cases or where stitches have been applied, your dentist will provide you with detailed information on this.
However, we should see our dentist straight away if we experience any of the following after having a wisdom tooth extracted:
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The bleeding at the site of the tooth extraction is not subsiding; even the following day, a visible and noticeable amount of blood is still oozing out.
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Shortness of breath or difficulty swallowing has developed.
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A feverish state.
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Intense pain that is not relieved by either over-the-counter or prescription medicines.
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Swelling that worsens two or three days after the procedure.
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A persistent bad taste in the mouth that neither rinsing with salt water nor the prescribed mouthwash can alleviate.
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The appearance of pus-filled discharge at the site of the extracted tooth.
Frequently asked questions
How long does it take to have a wisdom tooth removed?
The duration of the treatment is always significantly influenced by factors such as the complexity of the tooth’s root. In most cases, the procedure rarely takes longer than an hour.
How long does it take for the socket of an extracted wisdom tooth to heal?
In most cases, recovery takes one or two weeks, but this also depends on a whole host of factors, such as age and even lifestyle. Most people are able to return to work and their everyday activities as early as the following day.
How much does it hurt to have a wisdom tooth extracted?
Wisdom tooth extraction is always carried out under local anaesthetic or general anaesthesia, so the procedure itself is completely pain-free, causing no more than minor discomfort.
How much does the site of an extracted wisdom tooth hurt?
This depends on the nature of the procedure, as well as the patient’s pain tolerance. It is perfectly normal to still experience some minor discomfort the day after a tooth extraction.
However, if the pain following the extraction of a wisdom tooth is so severe that you still need to take medication continuously even after two days, it is advisable to return to your dentist.
When can I eat after having my wisdom tooth removed?
It is recommended that you wait a few hours after the procedure and ensure that, for the first 3–5 days, you eat only soft, easily chewed, mushy foods.
What is an impacted wisdom tooth?
We refer to a wisdom tooth as ‘impacted’ when, for whatever reason, the tooth in question is unable to break through the gum or is trapped in the bone. This often causes discomfort and requires treatment.
Do all wisdom teeth need to be extracted?
Not necessarily. If the tooth is healthy, can be cleaned properly and isn’t causing any problems, it can stay where it is.
Is a dental prosthesis necessary after a wisdom tooth has been extracted?
No, because wisdom teeth are non-functional teeth; therefore, their absence has no negative impact on the oral cavity.
Can wisdom teeth be removed during childhood?
In most cases, wisdom teeth begin to emerge in adulthood. However, there are exceptions, so if they appear in children and cause problems, they can, of course, be removed in such cases as well.
