Oral Surgeries FAQs

What should I know about wisdom teeth removal?

Before surgery, your oral and maxillofacial surgeon will discuss with you what to expect. This is a good time to ask questions or express your concerns. It is especially important to let the doctor know about any illness you have and medications you are taking.

The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development. Impacted wisdom teeth may require a more involved surgical procedure.

Most wisdom tooth extractions are performed in the oral and maxillofacial surgery office under local anesthesia, intravenous sedation or general anesthesia. Your oral and maxillofacial surgeon will discuss the anesthetic option that is right for you.

When should I have my wisdom teeth removed?

It isn’t wise to wait until your wisdom teeth start to bother you. In general, earlier removal of wisdom teeth results in a less complicated healing process.The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.

Do any of my wisdom teeth have to come out if they haven’t caused any problems?

Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it.

As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age.

No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

Following surgery, what will I experience after my wisdom teeth are removed?

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your Oral and Maxillofacial Surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

What is an impacted tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.

How serious is an impacted tooth?

Impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots.

More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it.

Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.

How long is the surgery for wisdom teeth removal?

1 hour.

What is dry socket?

Dry socket is the most common complication of an extraction.It develops in about 5% of tooth extractions. It is very painful condition that is easily treated.

A dry socket is:

Any socket in which a patient is having pain due to the loss of the blood clot thus exposing the bone to air, food, and fluids along with an offensive odour. This often occurs two or more days after an extraction and can last about 5-6 days.  It is normal to have soreness and discomfort following an extraction.

However, pain should be lessening by the second day.

This condition exist when a blood clot is dislodged from the surgery site thus exposing the bone and fine nerve endings.The blood clot helps in the stopping of bleeding and lays the foundation or framework for new tissue and bone to develop over a two-month healing process.  This condition is more common in the mandibular area and in back teeth due to poorer circulation in this area, with wisdom teeth being the most common site.  Dry socket delays the healing process.

It usually takes gum tissue about 3-4 weeks to heal where as the bone can take up to six months to heal.

This condition is most often found:

  1. In individuals who smokebefore their recommended time. Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site
  2. If you do not administer the proper care for your extraction site as instructed by staff
  3. Not following your home care instructions
  4. Sucking action from smoking, sneezing, coughing, spitting or sucking,within the first 24 hours
  5. Women taking oral contraceptives are more susceptible

Prevention of dry socket:

  • Avoid drinking through a straw
  • Avoid smoking, it contaminates the extraction site
  • Avoid excessive mouth rinsing, it interferes with blood clotting
  • Keep food from impacting in this area. Chew on the other side of your mouth and gently rinse your mouth with warm salt water after the first 24 hours

    Women who use birth control pills or have their teeth removed in the first 22 days of the menstrual cycle are twice as likely to develop dry socket after an extraction.  Schedule extractions during the last week of your menstrual cycle(days 23 through 28)when estrogen levels are low or inactive.

How is dry socket treated?

Treatment could include the following:

  • Medication applied to the site
  • Clove oil technique
  • Gauze with medication
  • Additional home care instructions
  • Applying topical anesthetic
  • Alvogyl by Septodont

Patients usually notice pain relief in about 5-10 minutes after the dressing is applied.

We have experienced fewer cases of dry socket since every patient is asked to rinse with an antimicrobial mouthwash and each patient is instructed on how to care for their extraction site through our website, verbal instruction and home care instruction handouts. We highly recommend patients use Breath RX  in their daily oral hygiene routine to help control oral bacterial.

Continue these instructions for the next 3-4 days:

  • Good oral health care
  • Avoid food with any residuals i.e. popcorn, peanuts and pasta
  • Eat soft foods i.e. mashed potatoes, clear or cream soups, pudding

News Updates on Dry Socket

Oral contraceptive may increase pain after wisdom tooth extraction

That tests on 267 women showed that those on the birth control pill were more susceptible than non-users to both postoperative pain and a condition known as “dry socket.” In this condition, normal healing of the vacant tooth socket is delayed by the failure of a blood clot to form. Infection instead causes the socket to remain empty. In the study, pain on the day after the operation was experienced by 30 percent of pill takers compared to just 11 percent of non-users. Five days after the operation the difference was 14 percent compared to 5 percent. The researchers said these results suggest that the pill may reduce the pain threshold. The differential was similar when the development of dry socket was compared. Here, 11 percent of pill users were affected compared to 4 percent of non-pill users.

SOURCE: British Dental Journal 2003;194:453-455.

  • Australian Dental Council
  • Royal Australasian College of Dental Surgeons
  • The Royal College of Surgeons of Edinburgh
  • Australian Dental Association
  • Health Engine

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