By the age of eighteen, the average adult has 32 teeth: 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth or molar teeth are used to grind food into a consistency suitable for swallowing.
The average mouth will hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as "wisdom teeth."
Why should I remove my wisdom teeth?
Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.
These poorly positioned, impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
Oral Examination
With an oral examination and x-rays of the mouth, Dr. Griffin can evaluate the position of the wisdom teeth and predict if there may be present or future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral and maxillofacial surgeon.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Griffin has the training, license, and experience to provide various types of anesthesia for patients to select the best alternative.
Removal
In most cases, the removal of wisdom teeth is performed under IV sedation or general anesthesia. These options as well as the surgical risks (i.e., sensory nerve damage, sinus complications) will be discussed with you before the procedure is performed. Once the teeth are removed, gauze is placed in your mouth to bite on to control bleeding. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your post-operative kit will include postoperative instructions, prescriptions for pain medication, and a follow-up appointment in one week for evaluation. If you have any questions, please do not hesitate to call us.
Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff that are experienced in anesthesia techniques.
Pre-Op Instructions
You will need to arrange to have someone at home with you the afternoon and night of surgery.
Do not attempt to drive yourself to the office. It is absolutely essential that you have a responsible adult bring you to the office, stay in the waiting room during your surgery, drive you home, and care for you the day of surgery. The person driving the automobile must stay as well, even if this person will not be caring for you that day. We cannot do the procedure if the car you arrived in leaves for any reason.
Do not eat or drink anything after midnight the night prior to the surgery. If medication is taken prior to surgery, swallow it with only a small amount of water.
If you are a minor, at least one parent or guardian must be with you.
Get a good night’s sleep before your surgery.
You should wear loose fitting, comfortable clothing with short sleeves. Do not wear a tight collar or necktie. False eyelashes or contact lenses should not be worn. Wear low heel shoes. Also, you should try to empty your bladder immediately prior to your surgery.
The profound effects of the sedation will subside prior to your discharge from the office. However, you should plan to go home and stay in bed for the remainder of the day or ambulate only with help. ABSOLUTELY NO DRIVING THE DAY OF YOUR SURGERY OR WHILE TAKING PAIN MEDICATION!
If you develop a cold, sore throat, upset stomach, diarrhea, fever blister or anything abnormal prior to surgery, please notify us as soon as possible.
Post-Op Instructions
The removal of wisdom 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.
Your case is individual - no two mouths are alike. Do not take well-intended advice from friends seriously. Discuss your questions or concerns with the persons best able to effectively help you: the OFSC surgical staff.
Immediately following surgery:
The gauze pad should be placed over the surgical area until the bleeding subsides. It should be held in place with moderate pressure for 30-60 minutes. After this time, the gauze pad should be removed or replaced if bleeding has not subsided..
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.
Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.
Brushing your teeth is okay - just be gentle at the surgical sites.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced and exercise may weaken you. If you get light headed, stop exercising.
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 may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. 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. It is important to wrap the ice packs in a towel. The ice packs should be left on continuously while you are awake. After 36 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 moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3 to 4 hours or Ibuprofen, (Motrin or Advil) 2-4 200 mg tablets may be taken every 3-4 hours. Please follow the dose instructions on the bottle.
For severe discomfort take the tablets prescribed for pain 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 anesthesia or IV sedation, liquids should be taken at first. Do not use straws. 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. 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 will heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position, you may become dizzy. Therefore, immediately following surgery, when you are lying down, make sure you sit for one minute before standing.
Keep the mouth clean
No rinsing of any kind should be done until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 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. 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.
Risk & Complications
Possible 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 it, so be careful.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing. As you were not able to eat or drink prior to surgery, and it is difficult to take fluids, and taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute, and then get up.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are pieces of the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, the doctor can remove them.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
Sore throat and pain when swallowing are not uncommon. The muscles are swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
Stiffness (trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that should resolve in time.
Frequently Asked Questions
What is a dry socket?
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.
How long will it take to heal?
There will be a cavity where the tooth was removed. The cavity will gradually fill in with the new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.
Wisdom Teeth MultiMedia
To provide you with a better under-standing of dental implants, we have integrated the module you see below with our website. Many of the frequently asked questions pertaining to wisdom teeth are discussed.
For a brief narrated overview of Wisdom teeth, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about Wisdom Teeth.
