Wisdom Tooth Extractions

Wisdom Teeth (Third Molars)

Wisdom teeth are the last teeth to erupt in the mouth and are the least important in terms of oral health. These teeth are the third molars. They are called “wisdom teeth” because they typically erupt between the ages of 17 and 23.

As we age, our eating habits change, and our jaw structure becomes smaller. Therefore, these teeth often don’t have enough space to properly erupt. This lack of space, along with the tendency of the teeth to emerge, leads to problems related to wisdom teeth.

Most people have four wisdom teeth—one in each corner of the mouth. They are usually embedded in the gums or bone, or they may erupt in abnormal directions due to space limitations. Because these situations can lead to several problems, it is often recommended to have them removed before they cause further complications.

The best time to remove wisdom teeth is around the age of 17. At this age, the teeth are just beginning to form, and since the bone is not as hard as in adults, the surgery is easier. Also, because the roots of the teeth haven’t fully developed, healing is faster.

The issues caused by wisdom teeth can vary depending on several factors. Jaw size and the direction in which the tooth is erupting are key in determining the severity of the problem. There may be no pain or complaints at all, but other teeth could still be at risk.

Problems Caused by Wisdom Teeth

Understanding the different eruption patterns and the problems they cause will help you better understand why they often need to be extracted:

Tooth Decay: Saliva, bacteria, and food particles collect in the area around a partially erupted wisdom tooth, threatening both the wisdom tooth and the neighboring molar. These types of cavities are hard to detect and treat, potentially leading to pain, infection, and even abscesses.
Gum Disease (Pericoronitis): A partially erupted wisdom tooth can create a pocket in the gum where bacteria and food debris accumulate, forming a site of infection. This can cause bad breath, pain, swelling, and trismus (inability to fully open the mouth). The infection may spread to the cheek and neck through the lymph nodes. This area around the wisdom tooth is highly prone to repeated infections. (See also: Gum Diseases)
Pressure Pain: When the wisdom tooth applies pressure to neighboring teeth during eruption, it can cause pain due to crowding. In some cases, this pressure may even lead to wear on adjacent teeth.
Orthodontic Reasons: Many young individuals undergo orthodontic treatment to correct misaligned teeth. The pressure from erupting wisdom teeth can cause other teeth to shift, potentially worsening alignment.
Prosthetic Reasons: When planning a dental prosthesis, the presence of wisdom teeth must be considered. If the teeth are removed later, the shape of the mouth may change, requiring a new prosthesis.
Cyst Formation: Impacted teeth can lead to cysts, which may result in bone destruction, jaw expansion, and displacement or damage to nearby teeth. To prevent bone loss, the tooth should be extracted and the cyst removed. In rare cases, large cysts can transform into tumors or cause spontaneous jaw fractures.

Best Time for Wisdom Tooth Extraction

The ideal time for wisdom tooth extraction is around age 17. At this stage, the tooth has just started forming, and the bone is softer than in adults, making the surgery easier. Because the roots have not fully developed, healing is quicker.

Stages of Wisdom Tooth Extraction

The procedure starts with an assessment of your dental and overall health. An X-ray is usually taken to evaluate the tooth’s position. Depending on the case, this might be a panoramic X-ray, a smaller periapical X-ray, or a digital one.

Wisdom tooth surgery is generally done in the dentist’s office, but in complex cases, a maxillofacial surgeon may perform the procedure in an operating room setting. The type and duration of the surgery depend entirely on the tooth’s condition and position. It typically lasts between 30 minutes and 1.5 hours.

If the tooth is mostly erupted, it may be removed using forceps. If the roots are spread within the bone or the tooth is deeply embedded, it may need to be sectioned or the surrounding bone removed.

If the tooth is impacted, a small incision is made in the gum to access the tooth. The gum is retracted, and if necessary, bone is removed to expose the tooth. Then the tooth is extracted, sometimes in one piece or in sections.

Post-Extraction Recommendations

After surgery, you will be monitored for a while. Once you feel better and with your doctor’s approval, you may go home. It’s usually recommended to rest for a few days following the procedure. Follow-up appointments may be required to assess healing, remove stitches if any, and evaluate overall oral health. Here are important points to consider after extraction:

Some bleeding is expected—don’t be alarmed. Oral wounds heal quickly because the area receives a lot of blood. Bleeding helps form a clot, which is necessary for healing. Avoid rinsing or spitting frequently, as it can dislodge the clot. Try to swallow the blood instead.
Your dentist will place a sterile gauze on the extraction site to control bleeding. Bite down on it for 25–30 minutes. If bleeding continues, use a second gauze for another 25–30 minutes.
Avoid biting your numb lip or tongue while the anesthesia is still active.
A blood clot will form in the socket immediately after the procedure. About two days later, the gum tissue will begin covering the area. Over 2–3 months, bone will gradually fill the space.
Do not eat or drink anything for 2 hours after the extraction. Avoid hot foods and drinks for the next 2 days. Stick to soft foods and drink plenty of water. Avoid using straws, sugary drinks, and alcohol.
The most common complication is pain in the extraction area a few days after surgery. To avoid this, follow all post-op instructions. Mild pain is normal—take a non-aspirin painkiller before the anesthesia wears off.
If antibiotics, painkillers, or mouthwash were prescribed, take them regularly as directed.
Rinsing your mouth helps speed up healing. If no mouthwash is prescribed, you can rinse with warm salt water (1 teaspoon of salt in 1 glass of water).
Do not smoke for at least 24 hours, as it delays healing. Ideally, avoid smoking for 3 days. Also, avoid heavy physical activity on the first day.
If stitches were placed, have them removed after 1 week. To reduce swelling after difficult extractions, apply cold compresses to the area for 5-minute intervals during the first 24 hours. After that, use warm compresses. Swelling typically lasts 48 hours.
Continue brushing your other teeth regularly. After 24 hours, you may gently brush the extraction area as well.
If you feel sharp edges in your mouth, they are likely bone fragments, not leftover roots—don’t worry. Your dentist will show you the entire extracted tooth after surgery. Don’t hesitate to ask questions.

Please contact us if you experience any discomfort or have concerns.