Wisdom Tooth Removal

Wisdom teeth are the last molars to appear, usually in the late teens or early twenties. There are four, one at each back corner of the mouth. They often have little room to come through, so a wisdom tooth may erupt only partly, come in at an angle, or stay buried under the gum and bone. Wisdom tooth removal takes such a tooth out.

When wisdom teeth are removed

A tooth that comes through only partly is difficult to clean, and plaque collects where the gum still covers it. That leads to inflammation around the tooth and, often, to decay on the molar in front of it, which is the tooth worth protecting. Because a wisdom tooth adds little to chewing, removal is frequently advised once it causes trouble or is likely to, even when there is no pain.

How the treatment works

The dentist examines the mouth and takes imaging that shows the position of the tooth and the shape of its roots. The procedure is carried out under local anesthesia. A tooth that has erupted may be taken out much as any other extraction; one that is impacted is reached through the gum and is sometimes divided so that it can be removed in sections, and the site is closed with sutures where needed.

After the procedure

Swelling and discomfort are expected in the first days and are managed with what the clinic prescribes. The instructions below protect the blood clot that forms in the socket, which is what allows the site to heal.

• Bite firmly on the gauze pad, and swallow normally rather than spitting, since spitting can restart the bleeding.
• Hold a cold pack against the outside of the cheek over the treated area to limit swelling.
• Eat soft, cool food at first, and drink plenty of fluids.
• Do not drink through a straw, and do not pick at or suck on the socket; either can dislodge the clot.
• Rinse gently with warm salt water, or with the mouthwash you were given, rather than forcefully.
• Brush as usual but stay clear of the surgical site, and take any antibiotic through to the end of the course.
• Avoid smoking and alcohol, leave very hot or spicy food aside, and postpone strenuous exercise.
• Return to have sutures removed if any were placed, and contact the clinic if the swelling worsens or a fever develops.