Extractions are a fairly common procedure in dentistry.  Sometimes teeth require extraction (removal) when they become damaged with problems such as deep decay, cracks, and periodontal disease, etc... Wisdom teeth can also cause problems when they begin to protrude through the gum tissues.  When a wisdom tooth is impacted, it typically means the tooth is prevented from coming in straight through the gum line.  This can cause pain, the gum tissues can become inflamed and infected, and the tooth may only emerge partially causing bacteria to trap beneath the gum.

When a wisdom tooth only emerges partially, a flap of skin called an operculum may form over the tooth.  This can make the tooth hard to clean, and pieces of food may be caught under the skin.  This makes it easy for an infection, called pericoronitis, to develop.  It may resolve on its own, however, often it does not resolve and causes swelling and pain in the area.

Most people do not have sufficient space in their mouth to accommodate wisdom teeth, and this is the most common reason wisdom teeth are removed.  Extractions can range from a single tooth, to removing all four (4) wisdom teeth at once.  Referral to an oral surgeon may be advised by your dentist. Based on the preference of the doctor and/or the patient, a local anesthetic could be used to numb the areas where the teeth will be extracted.   Most patients prefer to have sedation or general anesthetic during the procedure, to ensure comfort and ease of the procedure.

Wisdom teeth are typically performed in the following manner:   The gum tissue around the wisdom tooth is opened slightly to reveal the tooth.  The tooth is loosened until it can be lifted out of the gums and surrounding bone.  Sometimes a tooth may be impacted so tightly that it cannot be simply lifted out.  In cases such as this, the dentist will separate the tooth into several pieces to facilitate easier removal.  Depending on the incision and extraction site, sutures may be needed to close the area ideally.  Soluble sutures are the best option, which will dissolve on their own over a period of days to weeks.

After the surgery, we advise that you have some rest.  In circumstances where sedation or general anesthesia was used, it is absolutely necessary that you be driven home by a friend or family member because of the anesthesia.  You can expect for the extraction site to bleed for a little while after the surgery.  Gauze and pressure will be applied at the completion of the surgery, and you will need to change the gauze periodically when it becomes soiled.  If bleeding continues for longer than 24 hours, you should call your dentist.  It is advised that you rest when you return home, but do not lie flat.  Lying flat could prolong the bleeding.  Prop your head up on a pillow when lying down.  Do not perform exercise or workouts until the area has healed and your dentist has permitted you to do so.  

Your dentist or dental surgeon will prescribe you pain medication, so if you become sore or some pain develops, please take as directed.  You can also use an ice pack for the soreness.  Your dental surgeon or dentist might also provide you with a cleaning solution to clean the extraction site.

You will be limited to soft foods for a few days after your surgery.  Some recommended foods are:

  • Gelatin
  • Pudding
  • Yogurt
  • Mashed Potatoes
  • Ice Cream
  • Soups
  • Other food you can eat without chewing.

When drinking, make sure you do not use a straw. The sucking motion (when using a straw) can loosen your sutures and slow the clotting and healing process of the extraction area. The same goes for smoking! DO NOT SMOKE!

If you have prolonged pain, bleeding, irritation, or if you do not feel that the extraction site is healing properly --- call your dentist or dental surgeon immediately for a follow up appointment to evaluate the area.