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Wisdom teeth are another name for any one of four third molars found in the permanent dentition. These teeth are the last or most posterior teeth in the dental arch. Although most people have wisdom teeth, it is possible for some or all of the third molars to never develop. It is also possible for a person to have more than four wisdom teeth. In many individuals, the wisdom teeth aren't visible because they have become impacted (not normally erupted through the gums) under the gingival tissue.
Not all wisdom teeth need to be extracted. When a wisdom tooth erupts cleanly through the tissue without compromising the adjacent tooth, the wisdom tooth can be retained in the mouth with little concern as long as the person is able to brush, floss, and clean it thoroughly. However, removal of the wisdom tooth is indicated if the tooth has partially erupted through the gingival tissue, causing inflammation and/or infection. A soft-tissue growth over a partially erupted wisdom tooth is referred to as an operculum. If bacteria become trapped under the operculum, an infection called pericoronitis can develop.
A wisdom tooth is extracted to correct an actual problem or to prevent problems that may come up in the future. Some of the problems that can occur when wisdom teeth come in are:
Once it has been determined that a wisdom tooth is problematic, extraction by an oral surgeon or qualified general dentist is usually indicated. Local anesthesia is administered to ensure the tooth can be pulled out without any discomfort. Many people will choose conscious sedation (being put into a sleepy state where pain signals are blocked) so they have little or no memory of having the wisdom teeth extracted. A minor surgery is then performed where the tissue and bone around the wisdom tooth are removed so that the tooth can be cleanly extracted from the socket. Several stitches may be needed to close athe surgical site and promote healing of the overlying tissue.
The initial recovery and healing from wisdom tooth extraction usually occurs over about three to five days. It is normal to have slight bleeding (oozing) from the site considering the surgical procedure performed. The minor bleeding (oozing) after extraction should start to ease after the first 24 hours. Pain medication is often prescribed to help with any postoperative symptoms and discomfort. Usually, Tylenol, an ice pack and a mild narcotic is enough to provide pain relief. Some patients may be prescribed antibiotics. The patient will be asked to eat soft foods for a few days and avoid spicy foods, tobacco and alcohol use, and excessive exercise. The best remedies for pain following extraction are rest and giving the area time to heal. Adhering to the postoperative instructions of the surgeon is important to minimize any complications. Complete healing of the gums may take three to four weeks.
The most common reasons for tooth loss include advanced periodontal disease, extensive tooth decay, and facial trauma. According to statistics, gum disease is responsible for close to 70% of tooth loss in adults. Although less frequent than the preceding three reasons, it should also be noted that specific diseases, drugs, smoking, and poor nutrition contribute to the risk of tooth loss.
The Centers for Disease Control and Prevention report that in the United States, an average of 12 teeth (including the wisdom teeth) are lost by the age of 50. Also, 26% of adults between 65 and 74 years of age have lost all their teeth.
Every patient and every situation is different. However, when a tooth and the surrounding tissues are numbed with a local anesthetic, you should only expect to feel a bit of pressure, but no pain as the tooth is being loosened from the surrounding tissues and extracted. For patients who are apprehensive and for some surgical extractions, our office will discuss our options in dental sedation to provide further relaxation and reduce any sense of discomfort.
While it's normal to feel some tenderness and swelling following an extraction, the degree of these sensations can vary. It mostly depends on the complexity of the extraction and the body's response to the procedure. We'll recommend or prescribe the appropriate pain medication to help ensure your comfort and give you specific instructions for maximum effectiveness and safety.
Typically, the recovery period following a simple extraction is shorter than a surgical extraction. However, a patient's overall health, habits, and the size and location of the tooth, and other variables can influence recovery and healing. To speed up the recovery and avoid any complications, patients must follow the given at-home instructions diligently. We'll carefully review what to expect following your procedure and go over your post-op instructions.
Smoking interferes with blood clot formation, which is an essential first step in the healing process. Blot clot formation not only provides a protective layer to cover the underlying exposed bone and nerve endings, but it also supports the growth of new tissue. Cigarette smoke also contains chemical toxins that can disrupt the healing process and lead to problems such as continued inflammation, infection, or dry socket.
In a very small percentage of cases, a condition known as dry socket can develop in the aftermath of a dental extraction. This painful condition can arise when the blood clot in the extraction site doesn't form properly or gets dislodged. With dry socket, you may experience throbbing pain and symptoms such as bad breath and an unpleasant taste in your mouth. As skilled providers of care, our office will provide immediate treatment to alleviate your discomfort and promote healing.
The last teeth in your mouth to develop, wisdom teeth often do not have enough room to fully erupt or may be positioned in the wrong direction. These issues can affect your dental health as well as overall wellbeing. While some individuals never develop all their wisdom teeth, and a few have sufficient space for them, there are many people with partially or fully impacted third molars. Our office will monitor the development, position, and health of your wisdom teeth and will advise you if and when extractions are indicated.
After a tooth is removed, bone-grafting material is sometimes placed in the socket to promote healing and encourage new bone development. This procedure is often performed to support the eventual and successful placement of a dental implant.
At the office of Urban Smiles Dental, we strive to make dental care affordable and accessible. Depending on the type or complexity of the extraction and other variables, the cost of the procedure can vary. Based on our diagnostic findings, our office will inform you of the healthiest choices in care, explain the fees, discuss insurance coverage, and explain your payment options.
Many dental plans offer some level of coverage for tooth extractions. We'll advise you if your plan covers the full cost of the procedure and if there is any out-of-pocket expense. Our business office will work with you to maximize your insurance benefits as much as possible while helping you minimize any out-of-pocket expenses.
Our goal is to help every patient experience the benefits of good oral health and a beautiful smile. We value the trust you have placed in our office and strive to provide solutions that meet your dental needs and expectations of care.