Even one misaligned wisdom tooth can cause serious problems. Minimally, the misalignment can lead to the crowding of other teeth. People may also suffer from nerve trouble, pain, and/or damage. Most commonly, wisdom teeth become impacted. This means they do not completely break through the gums. Impacted wisdom teeth can lead to infection and decay. The risk of gum disease also increases because the teeth cannot be properly cared for.

The Presence of Wisdom Teeth

To determine if wisdom teeth are present and/or properly aligned, the dentist can take an x-ray. On an x-ray, teeth are visible even if they have not yet cut through the gums. The dentist can determine if wisdom teeth are growing as they should. In many cases, however, it is likely that removal will be recommended before problems begin. Removal can be easier, and healing can occur faster, in younger patients. The tooth roots are not completely established and bone density is lower.

Non-surgical Removal

The removal of wisdom teeth, also called an extraction, can either be surgical or non-surgical. Non-surgical removals can be used when the tooth has cut through the gum, either completely or at least halfway. If the tooth has not erupted completely or has only cut through partially, surgical removal is likely.

Surgical Removal

Surgical extraction of wisdom teeth is often required because there is not enough erupted tooth, or when the tooth is embedded in the jaw bone. For many patients, removals are completed by removing each wisdom tooth in sections to reduce the amount of bone that needs to be taken out. During the exam, the dentist will determine the best way to extract the wisdom teeth.

What to Expect

Before extraction begins, the dentist will numb the surrounding gum area of the tooth, similar to many other procedures such as cavity filings. The dentist may also recommend a sedative. Sedatives can include nitrous oxide gas, an orally administered sedative, or an injected sedative. If nitrous oxide gas is administered, most patients can safely drive home following the extraction. For other sedatives, patients will need someone else to drive them home because of the grogginess usually experienced.

After Care

It is important to thoroughly discuss, and understand, the instructions for after care with the dentist. Bleeding will generally last for a few hours following the extraction; use clean gauze to help with aiding clotting. For 24 hours following the extraction, avoid rinsing or sucking, such as drinking through a straw and smoking, because these actions can break away clots and lead to dry socket. Patients should also avoid drinking hot liquids or eating any foods that require chewing during this period of time. Swelling can be managed by using cold packs. Pain medications should be taken as directed to help manage pain experienced.

After the first 24 hours, facial swelling should be managed with heat packs instead of cold packs (but should not be too hot). A warm salt water gargle should be used after eating and before going to sleep. If non-dissolving stitches were used, they will need to be removed by the dentist in about a week.

It is important to discuss all areas of an extraction with the dentist. Patients should fully understand the extraction method that will be used, the recommendations for sedative and anesthetic use, along with the side effects and potential complications, including dry socket. After care instructions should be followed completely to reduce healing time. Full healing can take several weeks, but most patients can resume normal eating and drinking habits comfortably within two weeks.