Wisdom Tooth Removal for Teens and Adults

What Are Wisdom Teeth?

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many develop impacted wisdom teeth that don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

How Do You Know If Your Wisdom Teeth Need to Be Removed?

When wisdom teeth are misaligned, they may position themselves horizontally, be angled toward or away from the second molars, or be angled inward or outward in the mouth. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves.

Wisdom teeth may remain enclosed within the soft tissue and/or the jawbone, or they may only partially erupt through the gum tissue. Partial eruption of the wisdom teeth creates an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning make brushing and flossing difficult.

You’ll likely need your impacted wisdom tooth pulled if you’re experiencing:

• Pain
• Trapped food and debris behind the wisdom tooth
• Infection or gum disease (periodontal disease)
• Tooth decay in a partially erupted wisdom tooth
• Damage to a nearby tooth or surrounding bone
• Development of a fluid-filled sac (cyst) around the wisdom tooth
• Complications with orthodontic treatments to straighten other teeth

Preventing Future Problems with Wisdom Teeth

It’s difficult for dentists to predict future problems with impacted wisdom teeth. However, for many, the rationale for preventive extraction includes:

• Symptom-free wisdom teeth could still harbor disease.
• If there isn’t enough space for the tooth to erupt, it’s often hard to clean properly.
• Serious complications with wisdom teeth extraction occur less often in younger adults.
• Older adults may experience difficulty with wisdom tooth surgery and complications after surgery.

What To Expect From Wisdom Teeth Extraction

During the procedure, your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:

• Local anesthesia. With a local anesthetic, you’ll experience the same numbing near the extraction site as you would during other common dental procedures. During teeth removal, although you’ll feel some pressure and movement, you shouldn’t feel any pain.
• Sedation anesthesia. Administered through an intravenous (IV) line in your arm, sedation anesthesia suppresses your consciousness during the procedure. You don’t experience pain and will have limited memory of the procedure. You’ll also receive local anesthesia to numb your gums.
• General anesthesia. In special situations, you may be offered general anesthesia. When administered, you lose consciousness. You’ll experience no pain and will have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.

During a wisdom tooth extraction, your dentist or oral surgeon:

• Makes an incision in the gum tissue covering the tooth
• Removes bone that blocks access to the tooth root
• Divides the tooth into sections if it’s easier to remove in pieces
• Removes the tooth
• Cleans the extraction site of any tooth or bone debris
• Stitches the wound closed to promote healing (if necessary)
• Places gauze over the extraction sites to control bleeding and to help blood clots form

Potential Complications of Wisdom Teeth Removal

Potential complications after having your wisdom teeth removed include:

• Dry socket. This occurs when either a blood clot has failed to form in the extracted tooth socket, or else the blood clot that did form has been dislodged. Your dentist will treat the dry socket by placing medication in the socket.
• Paresthesia. This is a rarer complication, where nerves close to the extraction site are bruised or damaged during tooth removal. The result is a numbness of the tongue, lip, or chin that can last a few days, weeks, months, or may even be permanent.

Tips for Recovery After Wisdom Teeth Removal

The speed of your healing process depends on the degree of difficulty of the extraction. In the first 24 hours, you can generally expect:

• Bleeding. Your dentist will provide gauze and instructions on how to control it.
• Swelling and bruising. Over-the-counter pain medications, as well as ice and heat, can help manage pain and discomfort.
• Rest. Take it easy for the rest of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in dislodging the blood clot from the socket.
• Drink lots of water. Avoid 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.
• Eat only soft foods. Start eating semi-soft foods when you can tolerate them.
• Mouth cleaning. Don’t brush your teeth, rinse your mouth, spit, or use mouthwash within 24 hours after surgery. When you resume brushing, be careful around the extraction sites.
• Avoid tobacco. Tobacco use after surgery can delay healing and increase the risk of complications.

Complete healing doesn’t occur for a few weeks to a few months following wisdom tooth extraction. However, usually within the first week or two, enough healing has taken place for the use of your mouth to be reasonably comfortable in the area of the extraction.