The last and third molars present on each side of the lower and upper jaws are referred to as the wisdom teeth. They are the last set of teeth to grow and typically appear in the late teens or the early 20s.

Problems posed by Wisdom Teeth

Wisdom teeth may pose many problems. They may emerge partially, they may grow towards the back of mouth at an angle, they may erupt in a crooked manner, they may grow towards the second molar at an angle, they may trigger painful teeth crowding and oral diseases, they may grow normally but remain trapped inside the jawbone, or they may grow at right angles as compared to other teeth.

All of these above issues can result in pain, trapping of debris and food at the back of the wisdom teeth, formation of a cyst (abscess/fluid-filled sac) around affected wisdom teeth, decay of partially grown wisdom teeth, gum diseases, oral infections, and/or damage to nearby bones or teeth.

In order to avoid the above problems, dentists generally recommend evaluation of the wisdom teeth at the earliest and their removal if need be. It may be noted that removal of teeth before the age of 20 years results in fewer oral complications as they have roots that are less developed.

Dentists may recommend preventive removal of wisdom teeth if they find any problems with it during evaluation. Wisdom tooth extraction should not be a cause of worry; in fact, it would be a smarter decision to go for it in case the dentist determines that it is going to adversely affect your oral health in the long term.

It may also be noted that wisdom teeth without any visible symptoms can also promote disease as they may be harder to reach and clean properly. Additionally, younger adults are less likely to experience serious complications of wisdom tooth extraction as compared to older adults. Playing it safe and going for wisdom tooth removal if recommended by the dentist is the right choice.

Wisdom tooth removal surgery

Wisdom tooth removal is a simple surgical procedure that involves creating an incision in the tissues of the gum and extracting bone. There may be mild discomfort, stiff jaw, short-term bleeding, sore jaw, disagreeable taste in mouth, minor bruising of the cheeks, pain, and swelling of the cheeks and mouth. Uncommonly, there may be numbness or tingling of the lips, face, or tongue.

Complications of wisdom tooth extraction are rare. One of the most common complications is dry socket, but that is easily preventable. A dry socket forms after dissolving or dislodgement of the newly developed blood clot inside the socket, thereby leading to exposure of the nerve endings and bone. The complication is marked by bad breath, extreme pain, minor fever, swollen neck lymph nodes, and bad taste in mouth.

Other complications include damage to adjacent nerves, teeth, sinuses, or the jawbone and infection of the new socket by debris, trapped food, bacteria, or other germs.

All of the above problems can be averted by unfailingly following the wisdom tooth removal aftercare instructions given by the dentist. Healing of the area may take around two weeks.

Immediately seek medical attention if you experience any signs of infection, fever, chills, severe pain, or other adverse symptoms after wisdom tooth extraction surgery.

Wisdom Teeth Removal Aftercare and Healing Process

Presented below are some aftercare guidelines for wisdom teeth removal surgery:

• There may be mild bleeding after the extraction procedure. The dentist will place a gauze pad over the surgery site to stop bleeding. It has to be kept there for around thirty minutes after extraction.
• In case the bleeding is heavy, then you need to firmly bite down on the gauze pad to keep it in place. You have to keep at it for around 30 minutes. You may remove the pad after 3 hours or as suggested by the dentist. This will help the process of clot formation in the newly formed socket. In case the gauze pad gets excessively soaked with blood, then remove and replace it with a new pad and let it stay till clot forms.
• You may alternatively place a wet tea bag on the gauze or over the surgical site for 30 minutes or more. The blood vessels constrict after being exposed to the tannic acid present in tea, thereby promoting clotting of blood.
• Swelling, discomfort, and bruising can be alleviated via application of ice packs on the cheeks. Use the ice packs in periodic bursts of 7 to 8 minutes. Swelling of the mouth and cheeks may resolve in 2 to 3 days. Bruising will take much longer to heal.
• Do not drink or eat for at least 2 hours after the surgery. Rest and relax for a minimum of 24 hours after the procedure. Do not engage in physical activity for a day or two.
• Do not drink coffee, hot beverages, or caffeinated drinks for at least 24 hours. When there is no more bleeding, drink lots of water to keep the body hydrated; it will help the healing process. You may also drink cold or lukewarm fluids.
• Avoid rinsing the mouth for 24 hours. Do not use a straw to drink for 24 to 48 hours as the sucking action can result in removal of the blood clot.
• Do not engage in strenuous exercise for a week or more. Smokers should abstain from smoking for a few days as it can hamper the healing process and prevent clot formation. Do not use any tobacco products like chewing tobacco, etc. Excessive spitting needs to be avoided till the time the site shows bleeding.
• Sleep with your head propped up by the pillows. If you lie flat, then it may continue the bleeding.
• The dentist will give specific instructions on oral care. Follow them fully.
  • A day after wisdom teeth removal, you may rinse the mouth with diluted Listerine or other mouthwash, or you may use a saline solution with warm water. Do not rinse vigorously and be gentle.
  • You may brush the teeth on the night of the surgery day, or the next day. Use a toothbrush with soft bristles to carefully and gently brush the teeth. Take extra care to avoid the site of extraction. Make sure to brush the tongue, clean the gums, and floss the teeth. Following this rigorous practice of oral hygiene will help prevent any oral infections or diseases.
  • Rinse the mouth with warm water once every 2 to 3 hours. Do this after each meal so as to remove any debris or food particles remaining in the mouth.
• Do not drink alcohol for a week or more after surgery.
• The dentist will prescribe OTC painkillers or prescription pain medications for severe pain. Use them as directed by the doctor. Do not drive your care when under influence of strong pain meds. The doctor may also prescribe antibiotics to prevent infections.
• Eat foods that are soft or in liquid form, such as pudding, soup, eggs, gelatins, mashed bananas, mashed potatoes, yoghurt, cooked cereals, and applesauce, etc. You may also put meats, veggies, and fruits in a blender and liquefy it. Start including solid foods in the diet as and when the pain subsides and healing begins.
• Avoid foods that are chewy, hard, spicy, or hot as they can irritate the surgical wound. Do not eat popcorn, pasta, or peanuts as their particles may get trapped in the socket.
• Stitches, if any, typically dissolve in some weeks. Visit the dentist in case they have to be removed.