Wisdom teeth, also known as third molars, are the last set of permanent teeth to emerge. They appear between the ages of 17 and 25. Their removal is a common dental procedure often recommended to preserve oral health and prevent future issues.
Reasons for Wisdom Teeth Removal
Wisdom teeth often cause problems as the human jaw lacks sufficient space for their proper emergence. This can lead to them becoming “impacted,” meaning they are partially or completely trapped within the gums or jawbone. An impacted wisdom tooth may grow at an angle towards other teeth, towards the back of the mouth, or even horizontally within the jawbone.
These misaligned or partially erupted teeth can result in various issues. They can cause pain, trap food and debris, and make the area difficult to clean, leading to tooth decay or gum disease. Impacted wisdom teeth can also damage adjacent teeth or surrounding bone, or even lead to the formation of fluid-filled sacs called cysts. Dentists recommend removal as a preventive measure.
Deciding on Simultaneous Removal
The decision to remove all four wisdom teeth at once or separately is a personalized one, made in consultation with a dental professional. This choice depends on individual oral health, the status of each wisdom tooth’s impaction, and overall health considerations. While it might seem more extensive, removing all four wisdom teeth simultaneously offers several advantages.
A primary benefit is undergoing a single recovery period, which means only one session of anesthesia and one stretch of post-operative discomfort. This can be more convenient for scheduling and minimize time away from work or school compared to multiple separate procedures. Combining the extractions into one appointment may offer cost efficiencies, as some fees, such as those for anesthesia or facility use, are not duplicated.
However, there are also considerations for simultaneous removal. The immediate recovery might be more extensive due to the larger surgical area, leading to greater initial swelling and discomfort. Patients might experience more widespread soreness across their jaw and a longer period of dietary restrictions. Despite these points, dental professionals often recommend removing all four at once if they all present issues or are likely to cause problems, especially for younger adults between 15 and 22 years old. Their roots are less formed and bone density is lower, leading to easier procedures and faster recovery.
What to Expect During the Procedure
When all four wisdom teeth are extracted, the procedure involves various types of anesthesia to ensure patient comfort. Local anesthesia is administered to numb the teeth and gums, often combined with sedation. Sedation can range from nitrous oxide (laughing gas) to intravenous (IV) sedation that induces a twilight sleep. In some cases, general anesthesia may be used, rendering the patient completely unconscious throughout the surgery.
The duration of the procedure can vary depending on the complexity of the extractions, but it takes about an hour. During the surgery, the oral surgeon may need to make incisions in the gums to expose teeth trapped in the bone. Bone around the tooth may also be removed, and sometimes the tooth might be divided into smaller sections for easier removal from its socket. After extraction, the area is cleaned, and stitches may be placed to close the surgical sites, with gauze applied to help control bleeding.
Managing Post-Procedure Recovery
Following the simultaneous removal of wisdom teeth, managing pain and swelling is a primary focus during recovery. Patients are prescribed pain medication, and over-the-counter pain relievers like ibuprofen can help manage discomfort. Applying ice packs to the outside of the cheeks for the first 24-48 hours, in cycles of 20 minutes on and 20 minutes off, can reduce swelling.
A soft diet is recommended for several days post-surgery to avoid irritating the surgical sites. Foods like yogurt, mashed potatoes, applesauce, and soups are good choices. It is important to avoid using straws, as the suction can dislodge the blood clot that forms in the extraction site, leading to a painful condition known as “dry socket”. Oral hygiene should be gentle; patients are advised to avoid brushing the surgical areas directly for the first 24 hours and then to rinse gently with warm salt water several times a day to keep the area clean and promote healing.
Activity restrictions are also important; strenuous exercise and heavy lifting should be avoided for at least 24 to 48 hours to prevent increased bleeding or swelling. Patients should monitor for signs of complications, such as excessive bleeding, severe pain not relieved by medication, persistent swelling beyond a few days, fever, or pus, and contact their oral surgeon if any of these symptoms occur. Full recovery takes about two weeks, though improvement is seen within the first week.