“Wisdom Tooth Removal” or “3rd Molar Removal”

Breaking it down in simpler words would mean removal (extraction) of the third molar/ wisdom tooth

• Why Is Third Molar Called as Wisdom Tooth?

Generally humans have 3 molar teeth; molars are teeth huge, flat teeth which are located at the back of mouth. They are used to grind food. Wisdom teeth are the ones that erupt after 17-18 years of age. Hence in earlier days there was notion that people become wiser after these erupt, thus the name.

• Do I Need to See a Dentist When Wisdom Tooth Erupts?

At times, wisdom teeth grow properly inside the jaw and don’t cause any trouble. However otherwise they get stuck inside the bone or gums and are not able to erupt.

It’s difficult to maintain hygiene when it comes to wisdom teeth as they are located at the back of the mouth, hence there is more chances for the decay of wisdom teeth.

Hence it is advisable to see a dentist annually/semi-annually and get wisdom teeth and other teeth examined.

Why Choose Us for Wisdom Tooth Removal?

• • Experienced Wisdom Tooth Extraction Specialists:

Here at Comprehensive Dental Care Clinique, we have an expert panel of oral surgeons, general dentists and other specialists. Who can guide you appropriately? Based on the complications involved during and post removal of wisdom tooth, we have a team having their expertise in the cases.

• • Advanced Technology & Pain Management:

We at CDCC try to utilise the best possible technology, from digital x-rays to studying the dental CBCT, to using motor-driven and air-driven handpieces. We incorporate prime technology to enhance patient comfort.

• • Comprehensive Pre- and Post-Op Care:

It’s very essential for the patient to follow certain pre-operative and post-operative instructions before and after undergoing, to ensure a smooth wisdom teeth treatment and healing. Here at CDCC we ensure a thorough communication, to ensure a smoother pre-operative, post-operative, as well as operative success.

When Should You Consider Wisdom Tooth Extraction?

• Impacted Wisdom Teeth:

When teeth are not able to undergo complete eruption they get stuck in gums or bone, that is called as impaction of tooth, with time the human jaw size is decreasing, hence full 32 teeth are not possibly having place to erupt.

The impaction can be of two kinds

• Impaction due to gums

It leads to condition called as pericoronitis, hereby, there is a small area where the tooth remains covered with gums, this is the area whereby the food gets entrapped and causes, redness, tenderness, discomfort in that area also difficulty in mouth opening.

• Bone impaction:

There are different kinds of ways teeth can be impacted into the human jaw bones:

1. Horizontal impaction
2. Vertical impaction
3. Mesioangular
4. Distoangular

Based on the difficulty level of operating the case, the chances of future complications, the amount of trouble the patient is experiencing due to the presence of wisdom tooth it is decided how beneficial the wisdom tooth removal surgery is for the patient.

• Pain or Swelling

Most common complaint among patients include pain or swelling in the back of your mouth. Problems arise when wisdom teeth begin to emerge but lack enough space to grow properly. As they push against existing teeth or the jawbone, the pressure can cause significant pain.

Swelling around the gums of the erupting tooth may indicate inflammation or infection, especially if the wisdom tooth is partially erupted or impacted, this condition is called as pericoronitis, it occurs when there is inadequate cleaning around the gums bacteria accumulate in the space between the tooth and the gum. Symptoms can include redness, tenderness, difficulty opening the mouth, or even fever.

At times the swelling may not be localized, especially, if the swelling is due peri apical infection, the infection can also involve, upper and lower facial spaces, leading to cellulitis at times, if not treated on time, it can lead to other life threatening complications also.

• Crowding or Shifting Teeth

Third molars can cause crowding of teeth when there is insufficient space in your jaw for them to grow. As they attempt to emerge, they may push against their front teeth, causing them to shift out towards the dental midline. This can cause reversal/relapse of orthodontic work, such as braces and aligners, done over the years

Crowded teeth can create tight spaces that are difficult to clean, increasing the risk of plaque buildup, cavities, and gum disease. With regular brushing and flossing, too, it may be difficult to maintain oral hygiene in these areas, leading to long-term dental issues.

• Broken wisdom Teeth

Wisdom teeth that are broken can create significant oral health risks. This increases the risk of food entrapment, thus cavities, infections, and gum inflammation. If any sharp edge is there it often causes injury to the cheeks, tongue, surrounding tissues.

A broken wisdom tooth, on the other hand, may expose its inner layers, including the sensitive pulp and nerves. This can cause tooth sensitivity, severe pain, and increased chances of decay.

Partially erupted or broken wisdom teeth can also lead to cyst formation around the tooth and even damage the surrounding bone and nerves. To prevent these issues, dentists often recommend removing problematic wisdom teeth as soon as possible.

Dental Care Clinique Wisdom Tooth Removal Services.

• Simple Extraction for Fully Erupted Wisdom Teeth

Wisdom teeth that have fully erupted can be removed with a simple extraction. This procedure is relatively easier performed by a dentist or oral surgeon using local anaesthesia to numb that area. During a simple extraction, the dentist uses specialized tools to loosen and remove the tooth often there is no need for a incision through the gums. The tooth is removed in a single piece and not sectioned or broken into pieces.

Simple extractions are advised for patients with wisdom teeth that are fully erupted or impacted in gums and are accessible. The process lesser discomfort and has a shorter recovery period compared to surgical extractions. Many patients resume their regular activities within a day or two or even same day, with proper care to prevent complications like dry socket, non-healing socket or infection.

• Surgical Extraction for Impacted or Broken Wisdom Teeth

When teeth are impacted, meaning they are trapped beneath the gums or jawbone, or when they are broken or severely decayed, a surgical extraction is indicated. This procedure is more complex and involves making an incision in the gum tissue to access the tooth. In some cases, the tooth may need to be sectioned into smaller pieces for complete removal.

Oral surgeons often perform surgical extractions using local anaesthesia, sedation, or general anaesthesia, depending on the complexity of the case and the patient’s comfort level. This type of extraction may take longer and often results in more swelling and discomfort post- surgery compared to simple extractions. Sutures are put on the area of surgery.

Patients undergoing surgical extractions are provided with detailed aftercare instructions, including medication for pain relief and antibiotics if needed. Recovery typically takes about a week, but patients can manage discomfort effectively with proper care and rest.

• Sedation Options for Comfort

Wisdom tooth removal can be difficult procedure due to fear of being operated, often leading to anxiety for many patients, hence depending on achievable patient co-operation, different methods are used to achieve maximum possible and required anaesthesia for the patient. The type of sedation used depends on the complexity of the procedure and the patient’s preference or level of anxiety.

1. Local Anaesthesia: most commonly used for extractions, it numbs the area while the patient remains fully conscious, used in patients not so anxious and do obey commands and co-operation is achieved by verbal instructions.
2. Nitrous Oxide (Laughing Gas): This reducing anxiety while allowing the patient to stay be conscious, commonly used for children, highly anxious patients.
3. Oral Sedation: Administered as a pill, oral sedation induces a relaxed, drowsy state during the procedure, also an option for highly anxious patient. However patient has to refrain from certain activities during the onset of this medicine.
4. IV Sedation or General Anaesthesia: Often used for surgical extractions, these options induce a deeper state of unconsciousness or complete sleep. Often used for patients with whom it is difficult to achieve co-operation using verbal commands.

The dentist or oral surgeon will discuss the best sedation options during the consultation to ensure the patient’s comfort and safety.

Post-Extraction Care & Recovery Guidance

Proper post-extraction care is necessary for a smooth recovery after wisdom tooth removal surgery. Patients are advised to rest for at least 24 hours and avoid strenuous activities, physically exhausting activities for a few days. Some key aspects of post-extraction care include:

1. Use prescribed pain relievers and cold packs to reduce discomfort and swelling.
2. Gently rinse with warm salt water after 24 hours to keep the area clean, but avoid brushing near the extraction site for a day or two.
3. Prefer soft foods like curd, dal, rice, and smoothies, juices, milkshakes, and avoid hard, crunchy, or spicy foods that could irritate the area.
4. Avoid Smoking or Using Straws and spitting too frequently as these activities can dislodge the blood clot and lead to a painful condition called dry socket.
5. If sutures are placed patient has to report for removal of sutures.

Patients are instructed to follow up with their dentist or oral surgeon if they experience severe pain, excessive bleeding, or signs of infection. With adequate care and following instructions, most patients recover fully within one to two weeks.

What to Expect During Wisdom Teeth Removal Surgery?

• Step 1: Consultation and X-rays

Step one of wisdom teeth removal surgery is a detailed consultation with your dentist or oral surgeon. During this appointment, the doctor will seek your dental history and conduct an oral examination of your mouth. IOPA x rays can be taken in the clinic or panoramic x rays are taken at radiology centre. CDCC is located close to many radiology centres. X-Rays help study the position of your wisdom teeth, including whether they are impacted or causing crowding. Also we get to check proximity of these teeth to inferior alveolar nerve, maxillary sinus and other important structures. Often we suggest patients to get a 3d scan like CBCT. This diagnostic process helps the dentist determine the best approach for removal and discuss potential risks and benefits with you.

• Step 2: Sedation and Pain Management

On the day of the surgery, we will focus on ensuring patient comfort with anaesthesia and pain management techniques. Depending on the complexity of the procedure and your anxiety level, you may receive local anaesthesia to numb the area. The dentist will discuss these options during your consultation to address any concerns and tailor the surgery according to your needs. At times there is also a need to conduct the procedure with general anaesthesia.

• Step 3: Extraction Procedure

After numbing the area of operation, and waiting for the anaesthesia to act it typically takes 30 minutes to an hour, depending on the number of wisdom teeth and their condition. If it is a fully erupted tooth, the dentist uses specialized tools to loosen and remove them in a single piece. However, if an impacted tooth, the doctor may need to make an incision in the tissues and sometimes break the tooth into smaller pieces for easier removal. We try to make the procedure as atraumatic as possible. You will not feel pain during the procedure due to the anaesthesia, though you may experience slight pressure or pulling sensations.

• Step 4: Post-Op Care and Recovery

After surgery, the dentist will provide detailed instructions post operatively. These include applying ice packs lightly and externally over the swelling, not spitting for 24 hours taking prescribed pain killer medicines, and following a soft food diet. Most patients recover within a week, however most people agreeable to restore normal routine in 1-2 days. Following care guidelines helps avoid complications like dry socket or infection. Regular follow-ups ensure proper healing.

Benefits of Wisdom Teeth Removal

Prevent Future Dental Problems

Here is answering should you remove your wisdom tooth if it is not troubling you.

Extracting wisdom teeth as a preventive measure can prevent dental issues. Impacted wisdom teeth can become breeding grounds for bacteria. That enhances the risk of infections, gum disease, and cyst formation. Additionally, partially erupted teeth can trap food particles, leading to decay and the development of painful abscesses. By removing these problematic teeth early, you can avoid complications that might otherwise require extensive treatments, such as root canals or gum surgeries.

Maintain Proper Alignment

Wisdom teeth lack the space to erupt, which can lead to overcrowding and misalignment of existing teeth. As these teeth try to emerge, they exert pressure on front teeth. Removing wisdom teeth before they cause alignment problems helps preserve the natural alignment of your teeth, making it easier to maintain good oral hygiene.

Pain Relief and Improved Oral Health

Wisdom teeth are the last teeth located at the back of your jaw, making them difficult to clean and causing excessive plaque accumulation often there is the formation of a pocket or a space between the second molar and third molar; it can also cause cavities, abscesses and periodontal problems with the second molar as well.

Thus, removing wisdom teeth helps enhance oral hygiene too, as well as save your other teeth, and you can aim for a healthy, happy smile!

Author: Dr. Krisha Kadakia