Wisdom teeth can often cause problems as they are trying to break through the gums. An impacted wisdom tooth is coming in at an angle and not straight up and down through the gum line and often the tooth may only emerge partially.
When a wisdom tooth only emerges partially, a flap of gum tissue, called an operculum, may form over the tooth. This can make the tooth even harder to clean, and pieces of food may be caught under the skin. This can result in an infection, called pericoronitis, which causes swelling and pain in the area. An antibiotic is usually needed and this usually indicates the need to have the tooth removed.
Impacted wisdom teeth that can potentially cause problems, including gum weakness in the adjacent tooth, and movement of other teeth as the wisdom tooth tries to force its way into a place where there is not enough room. Most patients should have their wisdom teeth removed at or before the age of 23 since statistics show far fewer complications after the procedure.
In our practice, on occasion, we remove simple upper wisdom teeth under local anesthesia (novocaine). While an oral surgeon usually removes more complicated wisdom teeth, we can provide a referral following a simple evaluation. We recommend most patients seeing a surgeon have all wisdom teeth removed and the oral surgeon can provide a twilight sedation to help make the treatment easier for the patient.
After any surgery, you will need to rest. It is advisable that a friend or family member drives you home. Some bleeding is common after any extraction and gauze is applied at the site of tooth removal to help promote clotting and stabilization of the area. While some residual bleeding and oozing is common in the first few hours after surgery, you should contact the dentist immediately if there is heavy bleeding following an extraction.
Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. Your dentist will prescribe you pain medication, which should be taken as directed. You can also use ice, which minimizes swelling and bruising, also helping to control pain. The usual regimen is 20 minutes of ice and 20 minutes without ice, followed by another 20 on and 20 off. Your dentist may also provide you with a cleaning solution to clean the extraction site.
You will be limited to softer foods for a few days after your surgery. Proper nutrition is critical to ensure good healing. Some recommended foods are:
- Mashed potatoes
- Ice cream
- Thin soups
- Scrambled eggs
- Nutrition shakes
Drinking through a straw and aggressive spitting and or rinsing can cause prolonged bleeding and may result in loss of the blood clot at the tooth removal site. This problem is called a “dry socket” and can be rather painful. Smoking is the most common cause of dry socket.
If you have prolonged pain, bleeding, irritation, or don’t feel that the extraction site is healing properly call us for a follow up at (609) 409-3992.