Wisdom teeth or third molars are last teeth to come and can cause problems after they erupt in mouth. Wisdom teeth can cause change in dental structure which can further cause severe discomfort and pain. People may or may not have problems with their wisdom teeth. If wisdom teeth are impacted or are poking the cheeks or they are infected, then extraction of wisdom teeth is done. Most frequently asked questions by patients are enlisted here right from symptoms of wisdom tooth to wisdom tooth extraction and healing. These FAQ’s will provide answers to all the questions. You can click on the questions enlisted below to read the answers.
1. What are wisdom teeth?
2. What is the age of wisdom teeth eruption?
3. When is extraction of wisdom teeth required?
4. What is impacted wisdom tooth?
5. What are various types of impactions of wisdom teeth?
6. What are the symptoms of impacted wisdom teeth?
7. My wisdom teeth are erupting and causing severe pain. What can I do for some pain relief?
8. What is Pericoronitis?
9. What is treatment of impacted wisdom tooth?
10. Who performs wisdom tooth extraction?
11. What type of anesthesia is used in surgical tooth extraction?
12. Is Wisdom tooth extraction painful?
13. What types of stitches are given after wisdom tooth extraction?
14. What are the various complications which can occur during wisdom tooth extraction?
15. What are the various complications which can occur after wisdom tooth extraction?
16. Do I need to follow any precautions after wisdom tooth extraction?
17. How can I control bleeding after wisdom tooth extraction?
18. After how long will swelling subside after wisdom tooth extraction?
19. What can I do to control swelling after wisdom tooth extraction?
20. How long will healing take after wisdom tooth extraction?
21. What is the cost of wisdom tooth extraction without dental insurance?
22. What is cost of wisdom tooth extraction with dental insurance?
23. Can wisdom tooth extraction be done during pregnancy?
What are wisdom teeth?
Wisdom teeth are also known as third molars and are present distal to second molars. A person gets 4 wisdom teeth. There is 1 wisdom tooth present in every quadrant. Wisdom teeth are last teeth to erupt in dental arch.
Wisdom teeth usually erupt in oral cavity in between the ages of 16-25 years with 17-21 years band being most common. In some people, wisdom teeth may erupt at 30-40 years of age.
If wisdom tooth is impacted that is there is not enough space for wisdom teeth to erupt, then wisdom tooth extraction is required. Impacted wisdom tooth can cause pain in the jaw and gums and can also cause damage to other teeth. Cyst can also form around wisdom tooth. If wisdom tooth is impacted, then extraction is required for the tooth. Wisdom teeth don’t aid in mastication so if they are infected, no treatment is required for them and tooth can be pulled out.
When there is not enough space for wisdom tooth to grow and wisdom tooth remains buried in gums or bone, due to decreased jaw size, then it is known as impacted wisdom teeth. Incidence of patients with at least 1 wisdom tooth being impacted is 16.7%.
Wisdom teeth impaction can either be bony or soft tissue impaction. If wisdom teeth have insufficient space to erupt and they are completely inside the bone, then it is known as bony wisdom tooth impactions and if wisdom tooth grows out of bone but has not erupted because of soft tissue on it, then it is known as soft tissue impaction. Impacted wisdom tooth can either be mesioangular in position, distoangular, vertical or horizontal. Mesioangular wisdom tooth impaction is most common.
Pain in gums and jaws, difficulty in mouth opening, swollen or inflamed gums, headache, bad taste in mouth, bad breath, crowding and decay of other teeth are symptoms of impacted wisdom teeth.
My wisdom teeth are erupting and causing severe pain. What can I do for some pain relief?
You can do warm saline rinses 3-4 times a day for some relief. Make sure that there are no food accumulates in back of jaw which can aggravate the pain. You can avoid eating from side of erupting wisdom tooth and visit a dentist for evaluation. Dentist will take an x-ray to see the positioning of the wisdom tooth. If wisdom tooth is impacted, then surgical tooth extraction of wisdom tooth can be done.
Pericoronitis is an acute infection which causes swelling or inflammation of gums and surrounding soft tissues of partially erupted teeth. It usually occurs in lower wisdom tooth area. For treatment of Pericoronitis, debridement of area, operculectomy or tooth extraction is required.
Surgical tooth extraction is done for impacted wisdom tooth. Cut is given on gums and if necessary bone cutting and or tooth sectioning is done to remove the tooth from socket. After surgical tooth extraction, stitches are given after tooth extraction to approximate flap margins.
To remove wisdom tooth, mostly surgical tooth extraction is done. Surgical tooth extraction is often performed by an oral surgeon as opposed to a general dentist who mainly performs the simple tooth extraction procedure.
What type of anesthesia is used in surgical tooth extraction?
Surgical tooth extraction can be done after giving shots of local anesthesia. In case of difficult surgical tooth extractions or in patients with dental anxiety, procedure can be done under IV conscious sedation or general anesthesia.
No pain occurs during wisdom tooth extraction. Before tooth extraction procedure, to numb the tooth extraction area, local anesthetic shot (Novocain), IV conscious sedation or general anesthesia is given. In case of surgical tooth extraction, cut is given on gums and bone cutting and or tooth sectioning is done to pull the tooth out of socket. After surgical tooth extraction, stitches are given to approximate the flap margins. If tooth is fully erupted in dental arch, then simple tooth extraction may also be done to pull the wisdom tooth out.
What types of stitches are given after wisdom tooth extraction?
In case of surgical tooth extractions or in extractions where much of trauma to the surrounding tissues have occurred, stitches are given. Resorbable or non-resorbable stitches can be given to the patient. Commonly used resorbable stitches are gut, polyglycolic acid and copolymer of glycolic and lactic acid. Resorbable stitches usually dissolve in 7-14 days. Non-resorbable stitches are silk, nylon, polyester or polypropylene. Non-resorbable stitches can be removed by dentist after a week of tooth extraction.
Various complications which can occur during wisdom tooth extraction are:
Injury to nerve during tooth extraction
Root displaced in fascial space
Injury to adjacent teeth during wisdom tooth extraction
Failure of anesthesia during tooth extraction
Laceration of gums and mucosa during wisdom tooth extraction
Tooth fracture or jaw fracture during tooth extraction
Fracture of tooth during wisdom tooth extraction
Jaw dislocation during tooth extraction
Prolonged pain, swelling, bleeding and bruising can occur after wisdom tooth extraction. Limited mouth opening and TMJ dysfunction can also occur after wisdom tooth extraction. Patient may also get burning or numbness sensation after wisdom tooth extraction due to nerve injury during tooth extraction. Osteomyelitis, Osteonecrosis, Ludwig’s angina are rare complications which may occur after wisdom tooth extraction.
After wisdom tooth extraction, take rest for a day. Don’t spit much after wisdom tooth extraction as it can lead to dislodgement of blood clot. Don’t drink anything with straw after 48 hours of tooth extraction and don’t smoke. Take the medicaments as prescribed by the oral surgeon and don’t chew from side of tooth extraction socket. After tooth extraction, you are advised to take soft foods such as mashed potatoes, smoothies and shakes and take more of fluids. You should not brush after 8 hours of tooth extraction and after that, you can brush your teeth gently avoiding area of surgery.
Bleeding can occur up to 3 days after wisdom tooth removal. After third day, quantum of bleeding goes down and bleeding is very less or barely noticeable. Till the bleeding is continuing, one should avoid vigorous rinsing of mouth. To control bleeding, patient can bite on a gauze pack with equal pressure without irritating the tooth extraction socket area too much. After biting on gauze pack for half an hour, gauze pack can be changed. Patient can also bite on moist ice tea bag for bleeding to stop. Tea bags have tannic acid present which will cause vaso-constriction and will stop the bleeding.
Swelling usually lasts for 4-6 days after wisdom tooth extraction. Normally, the swelling subsides completely in 7 days. Swelling usually becomes pronounced on second or third day after wisdom tooth extraction and then it will subside. If swelling doesn’t reside even after 1 week, then one should call his oral surgeon for check-up. In some cases, swelling goes away initially and then sets in again. It occurs because of secondary infection.
Intermittent ice application can be done to reduce swelling after wisdom tooth extraction. Ice application can be done during first 24 hours after wisdom tooth extraction. After 1-2 days, heat in form of moist compresses can be applied. Pressure dressing can also be given to control the swelling after wisdom tooth extraction.
After wisdom tooth extraction, socket may take 3 weeks to 3 months to heal completely depending on the procedure which is used for tooth extraction, angulation of wisdom tooth and amount of trauma to the investing tissues during tooth extraction. During healing of extraction socket, firstly hematoma and clot formation takes place, then granulation tissue formation takes place. After granulation tissue formation, replacement of granulation tissue with connective tissue and then mature bone takes place. Smoking, alcohol consumption, poor nutrition, infection in socket will delay healing process after wisdom tooth extraction.
There are different pricing for a wisdom tooth extraction. If the wisdom tooth is fully erupted, then tooth extraction will cost you in the range of $150 to $300. However, in the case of it only half erupted or impacted then the cost could be as much as $350 to $650. Extraction of a wisdom tooth requires more time and skill so the cost can be more. This fee is inclusive of all the follow up visits and the whole surgical procedure. Costs of initial consultation, X-rays and sedation will be additional. All in all, surgical wisdom tooth extraction costs about $1000 inclusive of all the costs.
Most dental plans cover for wisdom tooth extraction. Dental insurances cover 70-80% of cost of wisdom tooth extraction.
Most of the obstetricians and gynecologists believe that wisdom tooth extraction can be done during pregnancy. Wisdom tooth should be removed with minimum of trauma during pregnancy. Antibiotics and pain pills may be prescribed by the dentist to reduce the infection and pain which can stress both mother and baby. Wisdom tooth Extraction should be done in the second trimester which is the safe period of pregnancy.