Your Dental and Medical History

Your dentist may ask whether you have tooth or jaw pain or sensitivity to cold or hot foods, about prior dental treatment and about gum or jaw problems. You may be asked about medical problems that could interfere with treatment. Be sure to tell your dentist about medications you’re taking because they could affect treatment.

Your Dental Examination

An examination helps us determine the general heath of your mouth as well as that of your wisdom teeth. We may inspect your gums and jaws for swelling, tenderness or infection. Your teeth may be examined for the presence of tooth decay. Your blood pressure, pulse and respiration may be checked to assess whether you can undergo anesthesia.

Taking Dental X-rays

To help confirm the diagnosis, we will take x-rays. X-rays are especially useful for identifying potential problems when you don’t have symptoms. Intraoral x-rays are small and provide an internal view of the individual teeth and jawbone. If intraoral x-rays don’t provide enough information, other types of x-rays may be needed such as panoramic x-rays. They provide a clear image of the area around all four wisdom teeth as well as surrounding bone. These x-rays can show hard-to-image impacted teeth clearly.

Risks and Complications

If you decide on removal, we will discuss the risks and possible complications with you and ask you to sign a consent form. Removal of wisdom teeth is a common procedure but as with any surgery, there are risks such as side effects from the anesthetic, bleeding or infection and possible complications such as numbness.

Numbness – Impacted teeth may be close to or in actual contact with the nerves that supply sensation to the teeth, gums, tongue, chin, cheeks and lips. Occasionally these nerves are injured when the tooth is removed, causing numbness and tingling. If this happens, the nerve usually repairs and regenerates itself within a short time. In some cases, numbness is permanent.

Dry Socket – Healing can be delayed if the blood clot covering the socket dissolves or is washed away. This exposes the bone and may lead to constant, deep, throbbing pain, which can easily be treated with a dressing.
Infection – Infection is a less common complication. It can usually be treated by draining the infection or with antibiotics.

Sinus Problems – Because the upper wisdom teeth are near a sinus cavity, the removal of these teeth can open the sinus cavity on rare occasions. The sinus usually heals, but if a problem persists, further treatment may be needed.

Weakening of the Jaw – In rare cases, removal of an impacted tooth can weaken the jaw, making it more susceptible to fracture.

Your Surgery Experience

You may need to take some days off work or school to give yourself enough time to recover. Schedule enough time to recover. Schedule a follow-up visit with us so we can monitor your progress after surgery and check that you’re healing properly.

Eating – If your surgery is going to include anesthesia or intravenous (IV) medication, don’t eat or drink anything after midnight the night before. Otherwise, don’t eat or drink anything for at least six hours before surgery.

Transportation – You’ll probably be tired and not alert enough to drive home safely after surgery. Arrange to have a responsible adult come with you on the day of surgery who can drive you home.

Clothing – Wear loose, comfortable clothes. Choose a shirt or blouse with short sleeves so if you receive an IV (intravenous) anesthetic, it can be administered easily.
Before Surgery – A local anesthetic is used to numb the area around each wisdom tooth being removed.

During Surgery – Expect the procedure to take about an hour. If your tooth is erupted, it may be removed (extracted) from its socket without an incision in your gum. For impacted teeth, an incision will be necessary. Stitches may be use to close the incision.

After Surgery 

You’ll rest for a while under close observation as you recover from the anesthetic. When your dentist or oral surgeon is satisfied with your progress, you’ll be able to go home. You may get a prescription for pain medication as well as instructions for your home recovery. Plan to rest at home for the remainder of the day. During the next few days, don’t plan on driving, drinking alcohol or operating any kind of machinery; you may be drowsy from the pain medication, other drugs or anesthetic.

The Healing Process

The healing process begins immediately after surgery. The body sends blood to nourish the tooth socket. To control excessive bleeding, you may be instructed to bite down on a piece of gauze, applying constant, direct pressure to the area. This helps a blood clot to form in the socket. In a day or two after surgery, soft tissue begins to fill in the opening. New bone tissue also begins to grow in the socket, becoming denser over the next two to three months.

Pain and Swelling

As the anesthetic or pain medication that you received at the facility wears off, you may experience some discomfort. Your gums and jaw may feel tender and sore. To make yourself more comfortable, take the pain medication that has been prescribed. It’s normal for your cheek to swell, but you can keep swelling to a minimum by placing ice packs on your cheeks during the first 24 hours after surgery.

Healing Tips

• DO apply pressure to stop the bleeding by placing the gauze directly over the extraction site.
• DO eat soft foods, such as soups and blenderized meals after the bleeding stops.
• DO drink lots of fluid after the bleeding stops.
• DO take antibiotics or pain-reducing medication if prescribed.
• DO keep your mouth clean.
• DON’T chew hard or crunchy foods such as carrots or popcorn for 2 weeks. These foods could become lodged in the extraction site or fracture the weakened jawbone.
• DON’T brush the teeth in the area of surgery until the day after surgery. Brush carefully.
• DON’T rinse your mouth or spit forcefully the day of surgery; it could loosen the blood clot.
• DON’T smoke after surgery. Inhaling creates suction and it could loosen the blood clot.
• DON’T over exert yourself.
• DON’T use alcohol the day of surgery or while taking pain medications.