The majority of people have four third molars—or wisdom teeth — which usually appear between the ages of 17 and 24. Extractions of wisdom teeth are recommended when the jaw becomes crowded and other teeth are affected, the wisdom tooth becomes impacted or misaligned, or other serious issues develop such as infection or a cyst.
Children 18 years and younger are eligible for a screening Panorex (x-ray) and wisdom teeth that should be removed can be with or without IV sedation as a covered expense under Medicaid.
Wisdom teeth are easier to remove when the patient is younger, since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed (may involve the nerve), and the jawbone is denser.
A local anesthetic is used to numb the area surrounding the wisdom tooth. In addition, intravenous sedation may be used. It is recommended that patients do not eat or drink six hours before surgery.
After surgery, cotton gauze is placed over the wound to stop bleeding. Dissolvable stitches may be used if necessary.
Recovery from wisdom teeth removal lasts approximately three days, although full healing may take several weeks or months. Acetaminophen or ibuprofen is recommended for pain. In some circumstances, more potent painkillers may be prescribed by your oral surgeon.
To speed up the healing process from wisdom teeth removal, bite gently on the cotton gauze and change the pads as necessary. If you still have bleeding after 24 hours, contact your oral surgeon. Keep your head propped on a pillow to decrease bleeding. Your mouth will be numb from the anesthesia, so be careful not to bite your lip, tongue, or cheek. Use an ice pack on the side of your face for periods of 15 minutes on and 15 minutes off for the first 24 hours after extraction. During the next two days use a warm washcloth on the side of your face in case of swelling. Rinse your mouth with warm saltwater. Do not use mouthwash.
During recovery your diet should consist of liquids and soft foods such as pudding or gelatin. Gradually add solid foods as healing progresses. Avoid hot liquids and alcohol for the first 24 hours after wisdom teeth removal surgery.
Do not use a straw or smoke. Sucking can loosen clots and increase bleeding. Smoking increases the risk of infection by germs and other cigarette contaminants. Avoid touching the area with your tongue or fingers, and be gentle when brushing your teeth and tongue. If necessary, stitches will be removed within a week.
Contact your oral surgeon if you experience:
• prolonged bleeding (more than 24 hours)
• dry socket (throbbing pain 3-5 days after surgery)
• difficulty opening your jaw (trismus)
• numbness (paresthesia) in the mouth or face
People with the following health issues may need to take antibiotics before and after surgery:
• heart defects
• liver disease
• weakened immune system
• artificial joints
• history of endocarditis