February 1, 2023

The operation

Surgery is often done at your dentist’s practice rather than in a hospital. Your dentist will review the recommended procedure with you so that you will fully understand and be comfortable with the procedure before it is done. You will also be given information about eating, medication, rest, driving, and other considerations before surgery as well as after.

Many people have their wisdom teeth removed under local anesthesia by their dentist. This means that they are awake but the area around the wisdom teeth is completely numb. Sedative drugs can be given with local anesthesia to help people relax during the procedure.

The operation will not start until the anesthetic has taken effect. It is often necessary to make a small cut in the gum over the wisdom tooth, and to remove some bone so that the tooth can be lifted out. Stitches are usually put in to help the gum heal.

Post operative healing

The healing process begins immediately after surgery as your body sends blood to nourish the tooth socket. Simple pressure from a piece of gause is usually all that is needed to control the bleeding and to help a blood clot to form in the socket, which promotes healing. Within a day or two, soft tissue begins to fill in the socket, aided by the blood clot. Eventually, the bone surrounding the socket begins to grow, filling in the socket completely.

As your mouth heals, you can promote faster healing and avoid complications by simply following the care instructions that your dentist will give you. While you may experience some discomfort as your mouth heals, following simple instructions will normally be all that is needed. However, you should call your dentist if you experience excessive bleeding or swelling, persistent and severe pain, fever, or any reaction to medications. A follow-up examination may also be scheduled to make sure that the socket is healing properly and that your mouth is returning to a normal, healthy state.

Post operative care

Following the removal of your wisdom teeth it is important that you call your dentist if any unusual bleeding, swelling or pain occurs. The first 6-8 hours after the extraction are typically the worst but are manageable.

At first, it may be possible to feel small fragments of bone with your tongue. These are the edges of the tooth socket and will soon disappear as the gum heals. Depending on the type of stitches used, they may need to be removed. Arrangements will be made for this to be done. If dissolvable stitches have been used, they will disappear 7 to 10 days after the operation.

Below are some tips to assist you after the operation.

1. Do not disturb the wound.

Disturbing the wound may invite irritation, infection and bleeding. Chew on the opposite side for the first 24 hours.

2. Do not smoke for 12 hours.

Smoking will promote bleeding and interfere with healing.

3. Do not spit or suck through a straw.

This will promote bleeding and may dislodge the blood clot which could result in a dry socket.

4. Control of bleeding.

If the area is not closed with stitches, a pressure pack made of folded sterile gauze pads will be placed over the socket. It is important that this pack stay in place to control bleeding and to encourage clot formation. The gauze is usually kept in place for 30 minutes. If the bleeding has not stopped once the original pack is removed, place a new gauze pad over the extraction site.

5. Control of swelling

After surgery, some swelling is to be expected. This can be controlled through the use of cold packs which slow the circulation. A cold pack is usually placed at the site of swelling during the first 24 hours in a cycle of 20 minutes on and 20 minutes off. After the first 24 hours, it is advisable to rinse with warm saltwater every two hours to promote healing (one teaspoon of salt to a glass of warm water). Do not rinse your mouth out during the first 24 hours because this disturbs the blood clots that are part of the healing process.

6. Medication for pain control

Anti-inflammatory medication is used to control minor discomfort following oral surgery. Stronger analgesics may be prescribed by the dentist if the patient is in extreme discomfort.

7. Diet and nutrition

A soft diet may be prescribed for the patient for a few days following surgery. You can gradually return to a normal diet once any jaw stiffness has settled. Very hot drinks and spicy food can increase pain and bleeding and should be avoided until the gum has healed. Also avoid alcohol as alcohol can increase bleeding and delay healing.

Most people do not experience any complications after having their wisdom teeth removed. Nonetheless, you should plan to see your dentist approximately one week later to ensure everything is healing well.

This is the final article in a series on wisdom teeth.

If you are interested in wisdom teeth then simply consult your dentist for more information.