Wisdom Teeth Removal: What to Expect Before, During, and After
Wisdom teeth removal isn’t likely to be high on your to-do list if they’re not bothering you. After all, your wisdom teeth are kind of like the appendix of your mouth: They’re there, but there’s really no reason for them—you can live a totally healthy life without them. Sometimes your wisdom teeth will just, you know, exist in your body without bothering you much. Other times, though, they can unleash utter chaos upon your body. That’s why so many dentists recommend people undergo a wisdom teeth removal procedure, even if their wisdom teeth aren’t causing any problems—depending on how your wisdom teeth are situated, they can cause trouble for you and your mouth down the road if you leave them in there. Here’s what to know if you’re considering a wisdom teeth removal.
Why is wisdom teeth removal necessary sometimes?
FWIW, you might not even have the molars (flat teeth in the back of your mouth) known as wisdom teeth. They aren’t necessary for your overall chewing ability, so not everyone develops them. But if you do, these four teeth—two on top, two on bottom—are the third and final set of molars you’ll get. They usually erupt (which is a very vivid way of saying they’ll push through your gums) when you’re in your late teens or early 20s, the American Dental Association (ADA) says.
Sometimes wisdom teeth can be impacted, which happens when they try to squeeze into a spot where there’s no room, crowding the rest of your teeth, the Mayo Clinic says. This might happen when they grow in at an angle or flat on their sides, or they might stay in their lane but get trapped within the jawbone instead of fully erupting. All of this can lead to complications like pain, fluid-filled cysts, or damage to the nearby teeth or bones, the Mayo Clinic says.
This can also make it harder to clean your teeth properly, which can lead to periodontitis (gum disease) symptoms like swollen and bleeding gums and bad breath. It can even cause difficulty opening your mouth, according to the Mayo Clinic.
The truth is that wisdom teeth can cause discomfort when they come in, even if they do so properly. And if they become infected on top of that, well, you may unfortunately be in for some serious aches and soreness. “When that occurs, there’s no question those teeth have to come out,” Mark S. Wolff, D.D.S., Ph.D., dean at the University of Pennsylvania School of Dental Medicine, tells SELF. To avoid this painful rigmarole, your dentist may recommend having your wisdom teeth removed before they can make trouble, even if you feel totally fine.
If you need your wisdom teeth removed, it really is…wise…to have the procedure done when you’re younger if possible rather than put it off. As you get older, the roots of your teeth form more fully and can make extractions tougher, Dr. Wolff says. You’ll also have less vascularity in your jaw, so healing tends to take a little longer, Susan Maples, D.D.S., author of Blabber Mouth! 77 Secrets Only Your Mouth Can Tell You to Live a Healthier, Happier, Sexier Life, tells SELF. Plus, the longer you leave wisdom teeth in, the greater your chances of developing cysts and abscesses. “Even if one of four [wisdom teeth] acts up in your lifetime, you would be happier to have them out earlier,” Dr. Maples says.
How does wisdom teeth removal work?
Wisdom teeth removal is a surgical procedure to remove one or more of those wisdom teeth, the Mayo Clinic says. The whole process starts with an exam. Whether you’re having pain or not, your dentist will typically want to do an X-ray to see what’s going on with your wisdom teeth, the ADA says—namely, how your wisdom teeth are positioned and how much room you have for them to grow. If you’re experiencing symptoms or your dentist foresees problems with your wisdom teeth, you’ll schedule an appointment to actually have them removed. This will be done by either your dentist or an oral surgeon, depending on how your teeth are positioned and how often your dentist actually does this procedure. Make sure you go to someone who knows what they’re doing. While your go-to dentist may be amazing, they also might not do this very often. If they say they typically do a few wisdom teeth removals a month, you should ask for a referral to an oral surgeon, Dr. Maples.
How do I prepare for wisdom teeth removal?
Wisdom tooth removal is almost always done as an outpatient procedure, meaning you’ll go home the same day, the Mayo Clinic says. Given that this is still technically surgery, you’ll probably want to take the day off from work ahead of time, Dr. Wolff says.
Once you’ve decided on a care provider and booked your appointment, you should receive instructions from the hospital or dental clinic staff on what to do before the surgery and on the day of your scheduled surgery. If the instructions don’t cover it, the Mayo Clinic recommends asking about whether you’ll need someone to drive you home afterward, and whether you’ll need to avoid eating or drinking before the procedure. It’s also a good idea to check in with the medical staff on any prescription medication you’re taking and whether it’s okay to take any nonprescription medication before your surgery.
What is it like to have your wisdom teeth removed?
Luckily, wisdom teeth removal isn’t something out of Saw: The Dentist Will See You Now.
First, you’ll get some sort of numbing mechanism. It may be local anesthesia (you’re awake and may feel pressure but shouldn’t feel pain), sedation (you’re awake but with lessened consciousness and won’t remember much), or general anesthesia (you’re completely knocked out and won’t remember jack), the Mayo Clinic says. The type you get depends on how difficult the dentist or surgeon thinks the procedure will be, plus how nervous you are, Dr. Wolff says. You’ll typically be asked to avoid eating or drinking for a certain amount of hours beforehand, depending on what kind of anesthesia you’ll be receiving, which is why it’s good to clarify that beforehand with your care team.
Once your ability to feel pain has been dulled, your dentist or oral surgeon will use a special instrument to loosen and disconnect the tissue around your wisdom teeth, then essentially pop them out, Dr. Wolff says. (Sometimes they may divide the teeth into sections before removal if that’s easier.) The whole thing requires more “finesse” than force, Dr. Maples says. And remember, you really shouldn’t feel pain during this process.
After the procedure, your dentist or surgeon will likely stitch up the surgical sites then put gauze over the holes, the Mayo Clinic says. This promotes clotting that will help your wounds heal.
What is wisdom teeth removal recovery like?
After wisdom teeth removal, it’s best to take things as easy as possible and let yourself heal. Here are a few things you should expect after your procedure, according to the Mayo Clinic:
Depending on your level of sedation, you may feel a little groggy afterward, so you’ll probably need someone to drive you home, which is one of those things we mentioned discussing with your care team beforehand.
Sorry, but you’ll have some pain. Your specific experience can range from “Cool, I have a slightly uncomfortable day off work” to “I wonder if there’s any way to just entirely remove my mouth from my head.” Your level of postprocedure pain will depend on factors like whether you just got one tooth out or all four and how impacted the teeth were. No matter what, your gums where your wisdom teeth were will typically be sore to the touch for about a week, the experts say. But barring any complications, the pain tends to get a lot better after a day or two, Dr. Wolff says. Some medical professionals will prescribe narcotics for the pain, but they are increasingly being encouraged to try something else due to the opioid crisis. (Dr. Maples says she typically suggests ibuprofen and acetaminophen.)
You’ll probably bleed. This will usually happen the first day after your wisdom tooth removal. Try to avoid spitting a lot so that you don’t dislodge the blood clot from the socket (that spot where your tooth used to be). You’ll also want to replace the gauze over the socket, based on directions from your dentist or oral surgeon.
You may have some swelling and bruising. Don’t be surprised if your face looks like a chipmunk for a few days. It’s completely normal to experience swelling after wisdom teeth removal. Use an ice pack may help. Swelling usually gets better in two to three days, while bruising may take a few more days to go away.
You’ll want to rest afterward. In fact, plan on doing it for the remainder of the day. You can usually go back to work and other normal activities the next day, but you’ll want to avoid doing a hard workout or anything else that might dislodge your tooth socket’s blood clot.
You’ll need to hydrate. Drinking plenty of water is important, but it’s recommended that you take a pass on alcohol, as well as caffeinated, carbonated, or hot drinks in the first 24 hours post-op.
You should stick with soft foods. Eat only soft foods, like yogurt or applesauce, for the first 24 hours after your procedure. You can ramp up to semisoft foods when you can tolerate them. But avoid hard, chewy, hot, or spicy foods that might get stuck in the socket or irritate the wound for a bit.
You should avoid brushing your teeth for 24 hours. Don’t brush your teeth, rinse your mouth, spit, or use mouthwash during that period. When you do start brushing again, be especially gentle near the surgical wound.
A saltwater rinse can help. Once the 24 hours have passed, you can gently rinse your mouth with warm salt water every two hours and after meals for a week.
Don’t use tobacco. If you smoke, it’s recommended that you wait at least 72 hours after your surgery to do it again. And, if you chew tobacco, you shouldn’t use it for at least a week. Otherwise, you can delay healing and increase your risk of complications. (And we know you’ve heard this before, but quitting tobacco overall is great for your health—here are some tips to help you get started.)
If you have stitches, they may dissolve within a few weeks or may need to be removed at a later time.
One thing to be wary of in the aftermath of your wisdom teeth removal is something known as dry socket, a frankly agonizing condition whereby the clot over an extraction site gets dislodged, exposing bare bone and nerves, the Mayo Clinic says. Using a straw within a week after your procedure can cause this, as can cleaning your mouth too soon or too forcefully postsurgery, so be sure to ask for guidance as to how soon you can get back to your usual oral hygiene based on your specific situation.
If you do develop dry socket, your dentist can put a medicated paste in the socket to promote healing, although in rare occasions they need to go back and try to get closure of the socket by pulling the tissue over it, Dr. Wolff says. Dry socket is the most common complication after tooth extraction, according to the Mayo Clinic, and it really sounds like a world of pain, so it’s really important that you follow all post-op instructions.
If you still have your wisdom teeth and you’re not sure whether they need to come out, talk to your dentist about it. They should be able to help you come up with a solid game plan. And, on the flip side, if your dentist is insisting you need them out but you’re not sure, get a second opinion if you’re able.
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