Wisdom teeth, or third molars, are the last set of molars to erupt, typically appearing in the late teens or early twenties. These teeth often cause problems due to insufficient space in the jaw, leading to impaction, misalignment, pain, and potential damage to adjacent teeth. Removal of wisdom teeth is a common procedure to prevent or resolve these issues. Medications are important for a comfortable and safe experience before, during, and after extraction.
Medications Administered During the Procedure
During wisdom teeth extraction, medications manage pain and anxiety. The choice of medication depends on the complexity of the extraction, the patient’s anxiety level, and the oral surgeon’s recommendation. These options span from localized numbing to complete unconsciousness.
Local anesthesia, such as lidocaine or articaine, is frequently injected directly into the gum tissue around the wisdom tooth. This numbs the area, blocking pain signals to the brain while the patient remains awake and aware. The numbing effect typically lasts for a few hours, providing initial pain relief.
Nitrous oxide, or laughing gas, is another option for mild to moderate anxiety. It is inhaled through a mask placed over the nose, inducing a relaxed and euphoric state. The effects are rapid and wear off quickly once the gas supply is stopped, allowing patients to drive themselves home after a short recovery period.
For greater anxiety or more complex extractions, intravenous (IV) sedation may be administered. Medications like midazolam or propofol are delivered directly into a vein, inducing a deeper state of relaxation. Patients typically remain conscious but are in a twilight state, often having little to no memory of the procedure itself.
General anesthesia is reserved for highly complex cases, patients with severe anxiety, or those undergoing multiple extractions. This renders the patient completely unconscious. A specialized anesthesiologist monitors the patient’s vital signs throughout the procedure to ensure safety.
Managing Pain After Wisdom Teeth Extraction
After wisdom teeth extraction, managing pain is a primary concern. Over-the-counter pain relievers are often the first line of defense for mild to moderate discomfort. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (e.g., Advil, Motrin) and naproxen (e.g., Aleve) are recommended because they reduce both pain and inflammation.
Acetaminophen (e.g., Tylenol) is another common over-the-counter option for mild to moderate pain relief. It can be taken every four to six hours, but exceeding the recommended dose should be avoided to prevent liver damage. Some protocols suggest alternating ibuprofen and acetaminophen for improved pain control.
For more severe pain, a prescription opioid like hydrocodone (e.g., Vicodin) or oxycodone (e.g., Percocet) may be prescribed. These stronger medications are typically used for a short duration (usually less than three days) due to side effects like drowsiness, nausea, constipation, dizziness, and the risk of dependence. It is important to take these medications as directed by the dentist or surgeon, ideally with food to minimize stomach upset, and to avoid combining them with alcohol or other sedatives.
Reducing Swelling and Preventing Infection
Beyond pain management, other medications reduce post-operative swelling and prevent infection. Swelling is a common response to oral surgery. Anti-inflammatory drugs, particularly corticosteroids like dexamethasone, may be administered as a single dose during or immediately after the procedure to minimize swelling. Ibuprofen, an NSAID, also reduces inflammation.
Antibiotics, such as amoxicillin or clindamycin, are not universally prescribed after wisdom teeth extraction but are used in specific situations. They are typically given if there is a pre-existing infection, for patients with weakened immune systems, or following complex surgical extractions where the risk of infection is higher. If prescribed, it is important to complete the entire course of antibiotics to ensure effectiveness and prevent the development of antibiotic resistance.