Dos and donts after wisdom tooth extraction

The term ‘wisdom teeth’ has been used loosely in several quarters, especially among teenagers and young adults. Contrary to their name, wisdom teeth do not make one smarter or wiser. They are called that because they usually come in when a person is older, around ages 17 to 21. These teeth are in the very back of the mouth. They are the third molars and the last permanent tooth to erupt.

In general, wisdom teeth serve no specific purpose, other than being an additional pair of molars on each side of the mouth to aid in grinding food. Because of their delayed arrival, there may not be space sometimes for the wisdom tooth as it prepares to erupt which can also cause some symptoms.

What are the reasons for wisdom tooth extraction?

Because of the lack of space, wisdom teeth can sometimes emerge at an angle or get stuck and only partially emerge. Wisdom teeth that grow through like this are known as impacted. There is no proven benefit in removing an impacted wisdom tooth which is not causing any problems. Wisdom tooth can be difficult to clean and can cause some problems, especially when they are impacted. According to the British Oral and Maxillofacial Surgeons, these problems are the commonest reasons why the wisdom tooth is removed. They are:

• Infection of the gum around the wisdom tooth (pericoronitis). This is the commonest reason why wisdom teeth are removed and occurs in 50-60% of patients. The infection can be severe and cause pain with swelling.
• Tooth decay (dental caries) can occur in the wisdom tooth or the tooth in front.  This occurs in 25-30% patients. This may not cause immediate problems until the tooth decay affects the nerve of the tooth, then an abscess can form. Toothache pain will be a feature of this.
• Wisdom teeth can be affected by gum disease (periodontal disease) or contribute to gum disease on the tooth in front (5-10% of cases). Patients may get no symptoms at all from this, but it can still cause problems.
• Cyst formation around the wisdom tooth. All teeth form within a sack and occasionally this sack can expand like a balloon. This is called a cyst. Over time this can become larger and cause problems. This is not common and can occur in less than 1% patients.
• Cellulitis. A bacterial infection can occur in the cheek, tongue or throat as a result of an impacted wisdom tooth.
• Abscess. There may also be a collection of pus in the wisdom teeth or the surrounding tissue as a result of a bacterial infection

How is wisdom tooth extracted?

The wisdom tooth is usually extracted in the dentist’s office and there is no need for hospital admission. It can be done by a dentist or an oral surgeon. The procedure involves the use of anesthesia to make the area numb so pain is not felt. The tooth is then pulled out and the person is given some instructions on how to care for the tooth and sent home for further checkups. The time taken and type of anesthesia depends on the expected complexity of the wisdom tooth extraction and the individuals comfort level.

What are the complications and risks?

Most wisdom tooth extractions don’t result in long-term complications. However, removal of impacted wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:

• Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
• Infection in the socket from bacteria or trapped food particles
• Damage to nearby teeth, nerves, jawbone or sinuses

What are the dos after wisdom teeth extraction?

According to the Mayo clinic, it is important to follow the dentists instructions after wisdom tooth extraction to avoid or minimize complications or issues that can arise later. Some of the important things to do include:

• Replace gauze over the extraction site as directed by the dentist or oral surgeon.
• Use a cold pack against the jaw and prescribed analgesics to relieve pain.
• Use an ice pack against the jaw also to help to improve the swelling after the first 2 days of the procedure.
• Resume normal activities the next day after the surgery, take the rest of the surgery day off to rest.
• Drink lots of water after the surgery.
• Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods as tolerated.
• Resume brushing the teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse the mouth with warm salt water every two hours and after meals for a week.
• If the stitches need to be removed, schedule an appointment to have them taken out.
• Report to the dentist as soon as possible is symptoms like difficulty swallowing or breathing, excessive bleeding, fever, increasing pain, worsening swelling after two or three days, presence or oozing of pus from the socket, persistent numbness or loss of feeling, and blood or pus in nasal discharge.

What are donts after wisdom tooth extraction?

• Avoid excessive spitting so to prevent the dislodging of the blood clot from the socket.
• Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery.

• Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
• Avoid strenuous activity that might result in losing the blood clot from the socket for about a week.
• Don’t smoke or take tobacco products for at least 72 hours after surgery, and wait longer than that if possible.
• Don’t chew tobacco for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
• Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours.
• Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.

 So note the following helpful tips if you are preparing to remove your wisdom teeth or have just done so, and remember to work with your dentist and follow the instructions closely.