Wisdom teeth, also called third molars, are the last of the teeth to erupt. And usually, they're the most troublesome. By the time they grow in - typically between the ages of 15-25 - the teeth are already crowded in the mouth, leaving little room for four additional molars.

When a wisdom tooth doesn't have room to grow in properly, it becomes impacted; this means that it's wedged against the adjacent teeth, surrounding bone or soft tissue. Left untreated, an impacted wisdom tooth can be trouble-free. However, it's more likely that it will develop any of a wide range of problems, which could include:

     Infection

     Jaw pain and stiffness

     Periodontal disease and tooth decay

     Tumors and cysts

     Damage to the adjacent second molars

Early removal of wisdom teeth is often recommended to avoid these problems altogether. It's just not a good idea to wait until the areas surrounding the impacted teeth become swollen or painful.

Typically, we track wisdom tooth development with the help of X-rays. Then, if we determine that the troublesome third molars won't grow in to an acceptable position, we'll recommend their removal.

Why isn't there enough room for my wisdom teeth?

Thousands of years ago, early humans had large, powerful jaws. As they evolved, and learned to use crude blades and fire to prepare and cook their food, the workload of their jaws was lightened. Consequently, through the course of evolution, the human jaw has decreased in size, but the number of teeth remains the same. So when it's time for the wisdom teeth to make their appearance, there's usually just not enough room to accommodate them properly.

Post Surgery Instructions

      Post-Operative Instructions:

• Bite on the gauze for 1 hour. Change gauze as needed.
  
  
• Have a cold nutrient drink after 1 hour (fresh fruit juice or milkshake). No carbonated beverages.
  
  
• No smoking for 48 hours.
  
  
• No alcohol for 24 hours or the length of the time you are taking medication especially if you are taking metronidazole or tinidazole.
  

• No spitting, rinsing or drinking through a straw for the first 24 hours.
  
  
• After 24 hours start rinsing GENTLY with warm salt -water rinses 5 times a day for 7 days. (1 teaspoon of table salt in 8 ounces of water) Especially after meals.
  
  
• Maintain a soft diet until you feel comfortable to eat harder foods. ( curd/yogurt, ice cream, scrambled eggs, soup, mashed potatoes are some good examples.)
  
  
• Take medication as prescribed
  
  
• Prop head up when in the lying position.
  
  
• Keep activity to a minimum.
  
  
• A little oozing of blood is normal, if bleeding is excessive, place a damp tea bag on the site and bite on it until the bleeding subsides.

I have a swelling after tooth removal?

Swelling may occur after a tooth extraction. The trauma created by the tooth extraction process can cause swelling. This swelling might present itself as a slight fullness that you can feel but is not readily apparent to others, or at the other extreme a clear enlargement of facial tissue. In general, the more difficult the extraction has been the more likely swelling will occur. Any swelling that does occur can be kept to a minimum by placing ice on your face in the area where the extraction has taken place. Position the ice on your face for 10 minutes, and then leave it off for the next 20 minutes. Repeat this cycle as you feel is necessary for up to 24 hours after the extraction.

If you have any concerns, don't hesitate to call.

Post-Op Instructions: After a Tooth Extraction

After an extraction, it's important for a blood clot to form to stop the bleeding and begin the healing process. That's why your dentist will ask you to bite on a gauze pad for 30 to 45 minutes after an extraction. If bleeding or oozing continues after you remove the gauze pad, place another gauze pad on the area and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it's important to protect it, especially for the next 24 hours. It's important to not:

     Smoke

     Suck through a straw

     Rinse your mouth vigorously

     Clean the teeth next to the extraction site

These activities could dislodge the clot and slow down healing.

Limit yourself to calm activities for the first 24 hours. This keeps your blood pressure lower, reduces bleeding, and helps the healing process.

After the tooth is extracted, you may feel some pain and have some swelling. You can use an ice bag (20 minutes on, 20 minutes off) to keep this to a minimum. The swelling usually starts to go down after 48 hours.

To control discomfort, take pain medication as recommended. Don't take medication on an empty stomach or nausea may result. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. Also:

     Drink lots of fluids.

     Eat only soft, nutritious foods on the day of the extraction.

     Don't use alcoholic beverages.

     Avoid hot and spicy foods.

You can begin eating normally the next day, or if not by then, as soon as it's comfortable. Gently rinse your mouth with warm salt water three times a day (put a teaspoon of salt in a cup of warm water, and then gently rinse, swish, and spit). Also, rinse gently after meals. This helps keep food out of the extraction site.

It's very important to resume your normal dental routine after 24 hours. This should include brushing your teeth and tongue and flossing at least once a day. This will speed healing and help keep your breath and mouth fresh. Call your dental office right away if you have heavy bleeding, severe pain, continued swelling after two or three days, or a reaction to the medication. After a few days, you'll be feeling fine and can resume your normal activities.