Wisdom Teeth: What You Need to Know

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Why do my wisdom teeth need to be removed? 

Wisdom teeth often erupt into odd alignment, or only partially erupt. This can cause problems such as pain in the area, infection, damage to adjacent teeth, development of a cyst around the tooth, damage to surrounding bone, and complications with orthodontic treatment requiring their removal. Other reasons to extract the wisdom teeth are to prevent future problems. Often cleaning the wisdom teeth is very difficult, if not impossible. Cavities and infection of the gum and bone in the area are very likely to develop in these cases. Another reason to take out wisdom teeth is that cysts and tumors are seen to develop more commonly around impacted wisdom teeth.

So why don’t we just take them out when they cause a problem? The procedure is much easier in a younger patient because the tooth is newly developed and held less tightly by the bone. The ideal age to remove wisdom teeth is between 17 and 25 years old. As you age, the bone fortifies around the tooth and is less pliable. This greatly increases the difficulty of the procedure and risk of complications. Healing is also slowed in older patients resulting in a long standing defect in the area and making recovery from the procedure more difficult. For patients above 35 years old, close observation and diligent oral hygiene of the wisdom teeth are preferred to their removal because of the reasons listed above.

Most wisdom tooth removal procedures are straightforward and complication-free. 
Most can be done in our clinic with Dr. Braden Giswold. However, if he feels your case is complicated, or you request it, he will refer you to an Oral Surgery Specialist for the procedure.

What can I expect?
Dr. Braden Giswold would like to have you into the office sometime before the day of the surgery so that any questions you may have can be answered. Sedation options, the procedure, and home care will be discussed. He will also give you directions to help you prepare for the day of the procedure. You will be given medications to be used before and after the teeth are removed to reduce the risk of infection, pain, and make the experience more comfortable.

Sedation options: 
Sedation during wisdom tooth removal is available. There are two main types of sedation: Oral Sedation and IV Sedation.

-Oral sedation is given in a pill form. It is taken at the office 30 minutes before the procedure. It is considered very safe and has a low risk of complications from its use. The medication used is commonly Triazolam. It makes you extremely relaxed and sleepy- a “twilight” state. Though you are conscious during the procedure, you won’t remember it. It is often used along with Nitrous Oxide/Laughing Gas.

-During IV Sedation, you are “asleep.” The sedation medication is given intravenously directly into your bloodstream. The medication used is very strong, and therefore the risk of complications is very real. It is necessary to monitor your vital signs closely to ensure your safety during the procedure. This option is not offered at our clinic. However, we would be glad to refer you to an Oral Surgery Specialist if you elect this type of sedation.

The procedure:  
The day of the surgery, after you are sedated (if elected) and numbed, the dentist will make an incision in the gums overlying the wisdom tooth and remove any bone covering it. Then, the tooth is cut into sections and removed, or removed in whole. The site is then cleaned very well and stitches are placed if needed. Gauze is packed over the site to control bleeding and help a blood clot form. After you recover briefly in the office, you are encouraged to go home to rest for the remainder of the day.

Recovery: 
For one or two days after the procedure, you will need to eat soft foods, avoid strenuous physical activity, and refrain from using tobacco products. Hard foods will need to be avoided for at least a week, as well as using a straw or creating any suction in the mouth as to avoid dislodging the delicate blood clots in the sockets. There will most likely be some swelling, bruising, and pain for a few days. Cold packs can help manage the swelling and discomfort, but you will also be given medications to control the pain and reduce inflammation.
 
If you have any questions at all regarding wisdom tooth extraction, please don’t hesitate to contact Dr. Braden Giswold by phone, email, or call to request an in office consultation. 360.221.6373 smile@saratoga-dental.com