When Your Wisdom Teeth Should be Extracted

Wisdom teeth are the third and final set of molars in both the upper and lower jaws. They usually erupt in the late teens (16 to 18) or early twenties, although some rare cases erupt later, or not at all. If you do not have enough room in your jaw due to overcrowding or if the wisdom teeth do not erupt in the correct position, you may experience pain and discomfort. This can be felt as toothaches in the adjacent teeth, swelling in the jaws, or headaches as the pressure on the nerves in the jaws increases. In addition, it may be difficult to keep these molars and their immediate neighbors clean, so decay and gum disease are a very real problems with wisdom teeth remaining in place.

Making the decision.  Because of the problems just mentioned, many patients decide to have these teeth extracted. You and Dr. Gotun can decide when it is the right time to take out the wisdom teeth, but as a rule, recovery is more rapid and less likely to be painful if you decide to have the teeth out sooner rather than later. Also, the chances of complications are reduced when special x-rays are taken prior to the extractions so there is no doubt about how the wisdom teeth or their roots are located in the jaw. Dr. Gotun generally does not recommend leaving the wisdom teeth in place except when other medical conditions might complicate the removal of the teeth.

The extraction appointment.  In most cases we start with prescribing antibiotics to make certain we prevent any possible post-extraction infection problems. While many patients worry about pain, in modern dentistry, extractions done the proper way will most of the time not be followed by any major pain or discomfort. There are many techniques available to ensure the most comfortable, pain-free approach to surgical procedures. We use local anesthetics to numb you before Dr. Gotun begins the surgery. Also, as with some other extensive procedures, we use conscious sedation by prescribed oral medication that can be taken a short while prior to the appointment. This form of sedation simply relaxes you and puts you at ease so the procedure is not uncomfortable.  You are still able to communicate with us throughout the procedure. This gives us a chance to have constant feedback from you during and after the procedure and helps us to monitor how you feel. If a sedative is prescribed, someone will need to bring you to the appointment and pick you up afterwards. Once the teeth are extracted, Dr. Gotun often gives anti-inflammatory injections of steroids to reduce swelling and therefore pain caused by the swelling. This speeds up healing and drastically limits discomfort in most cases. Depending on the difficulty of the extractions, Dr. Gotun may also prescribe a pain medication afterwards. However, in many cases we recommend nonsteroidal anti-inflammatories to control minor pains, such as Ibuprofen, Tylenol, Advil, etc.

Initial aftercare.  Plan to relax at home for 48 hours after the surgery, and remain quiet – no long conversations, exercising or working on household projects. Rest is the key to proper non-traumatic healing. No smoking, and do not drink sweetened beverages: sugar slows the healing process. Minor postsurgical bleeding may continue for more than 24 hours. More specific instructions will be given to you before you leave the office. Also plan on eating soft foods once the bleeding stops, and for 48 hours afterwards. If you have stitches, you will need to come in after 7-10 days for their removal.

Recovery.  Everyone heals at their own rate, and it is not unusual to feel discomfort for the first week or two. We continuously monitor our patients progress and we encourage our patients to contact us with any questions while the healing takes place. Initial healing of the soft tissue takes about three weeks, and the sockets should fill in with soft tissue in four to six weeks. Expect complete recovery and bone formation to take from six to twelve months.

As always, we want you to understand your dental health and help you make informed decisions about it. We welcome the chance to answer your questions about either treatment or fees at any time!

For our patients after undergoing a surgery:

Here you can download Post Operative Instructions: . PDF