Wisdom Tooth Removal

When a tooth is prevented from erupting into the mouth normally, it is said to be impacted. The presence of impacted teeth in the mouth is a risk factor for problems such as tooth infection, tooth abscess, cyst formation, or damage to adjacent teeth.

The removal of impacted teeth is an operation, much like any other operation. A flap of tissue has to be opened to gain access to the tooth, and often bone has to be removed and the tooth has to be sectioned. Don't approach this operation casually, and plan for a couple of days' rest afterward to promote good healing. Your jaws will swell considerably and will be very sore. The swelling will make it hard to open your mouth for a few days. You will need to take pain medications for about two to five days afterward, depending on the extent of the surgery and your body's response to it. Plan on a diet of soft foods for up to a week. You will also have general body weakness for a few days.

We will provide you with written instructions on how to cleanse the area of the surgery, how to control abnormal bleeding, and other aspects of post-operative care. Follow these instructions carefully for best healing results.

Possible complications

In the lower jaw, particularly, there may be a healing complication known as a dry socket. This ordinarily occurs in about 10 to 15% of patients, although we see it rarely in our office. With dry socket, healing progresses normally for about three days, and then there is a dramatic increase in pain in the socket and radiating to the ear. If this happens to you, call the office for treatment.

Sometimes sharp edges of bone may surface during the healing process. This does not necessarily need to be treated. They occur because of the body's work of reshaping the tissues in the area formerly occupied by the tooth. Unless the edges cause great discomfort, it would be best to let them alone, and the healing processes will smooth them out.

The roots of lower wisdom teeth may lie near the main nerve to the lower jaw, and the crowns may be near the nerve to the tongue. In about 1 to 2% of the cases, these nerves could be damaged during removal of the tooth. The result would be numbness in the lips, chin, and teeth on the side affected, or in the side of the tongue. Movement would not be affected--only sensation. If this happens, call the office immediately for a prescription of anti-inflammatory medication to ease the damage to the nerve. Expect some difficulty in using your mouth for several weeks, until it accommodates to the change. The nerve may take a month or several months to repair itself. It is not very common for this numbness, if present, to be permanent, but that is also possible.

It is also possible that the roots of upper wisdom teeth or other upper posterior teeth may lie so close to the wall of one of your nasal sinuses that the sinus wall would be perforated during the operation. This would result in some bleeding through the nose. If this should happen, Dr. Hall will advise you on how to care for it until it heals. Sometimes, in rare cases, the wall between the tooth and the sinus can be so delicate that attempts at extraction cause the tooth or a piece of the tooth to be displaced into the sinus. If this happens, an opening would have to be made into the sinus to remove the tooth.

If you do experience any of these healing complications, be sure to inform Dr. Hall so that you can get proper care until the healing is complete.

The degree of risk of complications varies from patient to patient. If you are over age 25 or 30 when the impacted teeth are removed, you have a greater chance of complications, because of the increased density of the bone. The risks increase with increasing age. If you have the tooth extraction before their roots are completely formed, the risk of complications is usually minimal. The position of the teeth in the jaw and the difficulty of the surgery also affect the degree of risk.