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Wisdom teeth removal surgery is an outpatient procedure that is typically performed by a dentist or oral surgeon.
A dentist will recommend this surgery if an exam and X-rays reveal that your wisdom teeth are impacted or may cause dental problems for you in the future. (Not everyone has wisdom teeth, but most people have one to four.)
The surgeon will cut into the gums and remove the tooth, either as a whole tooth or in pieces. You’ll be under anaesthesia, which could include nitrous oxide (laughing gas) or intravenous (IV) sedation.
You’ll likely need your impacted wisdom tooth pulled if it results in problems such as:
Arrive on time for your appointment at the oral surgeon’s office. Your healthcare provider may perform dental X-rays again on the day of surgery if necessary.
During the Surgery
The surgery should take about 45 minutes. With anaesthesia, you shouldn’t feel any pain or discomfort. Depending on what type of sedation is used, you may be asleep or conscious during the surgery.
These are the steps for a typical procedure:
Sedation
If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask to fit over your nose to inhale the sedative, allowing you to be awake but remain relaxed.4 If intravenous (IV) sedation is chosen, the assistant will place a needle in the vein in your arm to administer a sedative throughout the surgery. This is generally considered the most comfortable option since you drift in and out of consciousness and are unlikely to remember the procedure afterwards.
Numbing
After sedation, your surgeon starts by numbing the wisdom teeth and their surrounding tissues with a local anaesthetic.
Tissue removal
The surgeon removes any gum tissue covering the area where the wisdom tooth is located to access the tooth.
Bone removal
An impacted wisdom tooth could be fully or partially covered with bone. If this is the case, a high-speed handpiece is used to drill through and remove the bone covering the tooth.
Loosening and sectioning of the tooth
When the impacted wisdom teeth are visible to the dentist, various surgical instruments are used to gently loosen them from any connective tissue in the tooth’s socket. The surgeon may also cut the tooth into sections to allow for easier removal.
Tooth removal
Once the wisdom tooth is loose or has been completely sectioned, it is ready to be removed. The surgeon will use surgical instruments specially designed to fully remove the tooth.
Stitches
Now that the wisdom teeth are gone, the surgeon may add stitches to close up the area. This is sometimes necessary when impacted wisdom teeth are removed or when the healthcare provider feels the patient will better heal with stitches in place.
Myth 1
Only Teenagers need wisdom teeth removed
Myth 2
Pain with a Wisdom Tooth Is Normal and Can Be Ignored
Myth 3
Everyone Will Need All Four Wisdom Teeth Removed
Myth 4
All Four wisdom teeth must come in before they can be removed
Myth 5
The surgery is painful and you’re awake the whole time
As you heal from your surgery, follow your dentist’s instructions on:
Some oozing of blood may occur the first day after wisdom tooth removal.
Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
Pain management
You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist or oral surgeon. Prescription pain medication may be especially helpful if the bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.
Swelling and bruising
Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
After your surgery, plan to rest for the remainder of the day
Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.
Drink lots of water after the surgery
Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
Eat only soft foods, such as yoghurt or applesauce, for the first 24 hours
Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
Cleaning your mouth
Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you’ll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
Tobacco use
If you smoke, don’t do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
You may have stitches that dissolve within a few weeks or no stitches at all.
If your stitches need to be removed, schedule an appointment to have them taken out.
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