Wisdom tooth extraction is largely viewed as a rite of passage in adolescence. But why do we have third molars in the first place, and do we really need them?
Wisdom teeth are a remnant of our ancestors, who needed them to properly chew and grind plants a primary food source. Wisdom teeth were necessary to ensure the proper breaking up of plant matter, which was crucial for digestion and nourishment.
Scientists say our forebears had larger jaws to accommodate these third molars, but modern man no longer needs wisdom teeth to grind plants, and we no longer have enlarged jaws to fit them into our mouths easily. For most people today, wisdom teeth are a hindrance rather than a benefit.
What are the signs of wisdom teeth coming in?
Wisdom teeth typically erupt between the ages of 17 and 21, but can come in as early as 13 or as late as 25 years old.
When third molars begin to grow, your teenager or young adult may complain of soreness, swollen gums, or discomfort when eating. Some patients experience no symptoms at all and only learn that their wisdom teeth have grown in during a dentist visit.
When should wisdom teeth be removed?
Wisdom teeth can create problems in your teen’s mouth and jaw even when the they erupt without any pain whatsoever. That’s because third molars are notoriously difficult to brush and floss, leading to an accumulation of bacteria that can result in cavities over time. Cavities in wisdom teeth often occur in the space where they align with adjacent molars, spreading decay to surrounding teeth.
Other reasons for wisdom tooth extraction include:
- Impacted wisdom teeth: This happens when the third molars don’t have enough room to grow in straight. In many cases, wisdom teeth are unable to fully erupt or even grow in sideways.
- Even when they do erupt in a seemingly straight manner, wisdom teeth can force other teeth out of alignment over time, pushing against adjacent molars to create room.
- Gum disease: Wisdom teeth lead to gum disease in about a quarter of the population, which in turn can lead to cysts and abscesses. If left unchecked, infection can spread to other parts of the body, potentially resulting in life-threatening situations.
The best time to get wisdom teeth removed is during the teenage years, before the roots are completely formed. As we age, the roots continue to grow, and wisdom tooth extraction becomes more risky because the chances of injuring a nerve increase, and recovery time is typically longer in adults than adolescents.
What happens during wisdom tooth extraction?
The dentist begins by making a small incision in the gums to better access the tooth, its root, and jaw bone. The wisdom tooth is then split into sections for easier removal. Once the tooth is removed piece by piece, the dentist cleans the surgical site and removes all traces of tooth or bone debris. The wound is subsequently stitched closed to promote healing. Finally, the dentist places gauze on the surgical site to help control bleeding.
Does wisdom tooth extraction hurt?
Some intrepid patients undergo wisdom tooth extraction with only a local injection, although most opt for stronger methods of sedation. Summit Dental Center offers a full range of sedation options to ensure you experience no pain or discomfort during the procedure.
- Laughing gas: Nitrous oxide helps you relax, and combined with a local anesthesia injection, you shouldn’t feel any pain. You’ll be awake for the procedure, however, and you’ll be aware of the smells and sounds in the room. You’ll likely feel some pressure on the tooth and jaw as the dentist removes the wisdom tooth.
- Oral sedation: A lot of patients choose to ingest a combination of pills prescribed by the dentist ahead of time. The pills are taken just prior to the surgery appointment and will block out practically all sensations of discomfort, as well as smells and sounds in the operating room. While you’re technically “awake” and able to communicate with the dentist and others, you’ll have no recollection of the procedure itself. Patients who choose this option cannot get in the driver’s seat and must have a friend or family member to take them home after surgery. It is helpful to have someone stay with you until all effects of the procedure have worn off (usually within 4 hours).
- General anesthesia: This is the type of anesthesia usually used in hospitals for surgeries of all kinds. The patient typically receives an IV and is “asleep” throughout the procedure. You won’t remember the procedure when you wake up. Like with oral sedation, you’ll need someone to drive you home afterward and, ideally, stay with you for a few hours.
How do I take care of myself after wisdom teeth removal?
If you chose oral sedation or general anesthesia for your surgery, you’ll likely feel sleepy and groggy for a few hours afterward. It helps to have someone stay with you until all effects of the anesthetic have dissipated. Your dentist may prescribe pain medication to keep you comfortable in the days following surgery, and it is preferable that a friend or loved one administer the first dose or two while you may still be a bit confused from the anesthesia.
- Pain relief after surgery: Your dentist may call in a prescription like hydrocodone or oxycodone to keep discomfort at bay. For many patients, over-the-counter ibuprofen (Advil) or acetaminophen (Tylenol) work just fine, and others may not need any pain relievers at all. Be sure to follow your dentist’s after-care instructions and don’t skip (or increase!) your prescription medication dose.
- Bleeding: The gauze in your mouth following surgery should help stop the bleeding. Bite down on the gauze for about 15-30 minutes to help blood clotting. You can also bite down on a moist tea bag to help stop the bleeding. Call your dentist if bleeding shows no sign of letting up a couple of hours after surgery.
- Swelling: Your cheeks may be a bit puffy and your gums may be swollen following wisdom tooth extraction. Applying an ice pack to the affected cheek and keeping your head elevated should help. Swelling typically peaks 2-3 days after surgery before gradually declining within a week.
- Eating and drinking: Implement a liquid diet for the first 24 hours (soup, smoothies, etc.), then stick with soft foods over the next few days after surgery. Calcium-rich foods like yogurt, cottage cheese, ice cream (yes!) are ideal. Other options include mashed potatoes, oatmeal, scrambled eggs, and soft noodles. Avoid chewing tough foods like meat!
- No-nos! Avoid any actions that may create suction in your mouth as it can dislodge the newly-formed blood clots on your surgical site(s). This means no sucking on a straw or smoking for the first 24 hours after surgery! Also, no alcohol or chewing gum. Playing the trumpet or other wind instrument? That, too, is out and will have to wait until a week after surgery.
- Oral hygiene: Be careful when brushing and flossing. Use a soft toothbrush and avoid the surgical site. No rinsing for the first 24 hours, then gently rinse with salt water for the next few days.
- Returning to work: Let your body guide you on this one. Most patients feel back to normal after 2-3 days following surgery. If you still need prescription medication after that time, however, it’s best to rest some more at home because driving on pain killers is also a no-no.
Want to know more?
Your Summit Dental Center dentist is your best resource for information and personalized advice. Every patient is different, and while some guidelines apply to everyone, be sure to call your dentist if things don’t feel right, pain or bleeding won’t stop, or you’re worried about a symptom you experience.