What to Expect When You Get Your Wisdom Teeth Out
Parents! If your child’s dentist or orthodontist has told you it is time to have their wisdom teeth removed and has referred you to an oral surgeon, take heart. This is a routine surgery that we perform daily in our Upland practice and accredited surgery center facility. The extraction of wisdom teeth is a relatively minor disruption in the life of a teen, and once the surgery has been completed, they will be up and around and back to regular life within a few days.
Why do wisdom teeth need to be removed?
When wisdom teeth develop and attempt coming in, during the late teens and early twenties, they are the third set of molars, and your mouth is already quite full. We advise our patients consider being screened by their dentist and oral surgeon optimally between ages 14-18. A recommendation to have their wisdom teeth removed is considered when one of the following is true.
- There’s simply not enough room in your mouth, and overcrowding leads to crooked teeth and tooth decay.
- The third molars become impacted, or unable to erupt because there is so little room in your jaw and the back of your mouth.
- Their location makes them hard to clean, so cavities and gum disease are likely to result.
- They erupt at odd angles, because of the lack of space, and disrupt adjacent teeth.
What do I need to do before a wisdom teeth removal?
Schedule an appointment for you and your teen to meet with Dr. Gilbert to talk about their health history and discuss any questions you may have. At that visit, we will also discuss the kind of anesthesia your child would desire for the best possible experience. They’ll want to plan to take the day off from school or work to rest at home after their surgery. And you’ll need to be their driver, so make the appropriate arrangements for yourself as well.
What happens during wisdom teeth removal?
We begin by giving your child anesthesia to ensure they’re comfortable, pain-free, and relaxed. The surgery itself takes about an hour. The anesthesia they choose may require a brief recovery phase in our facility. The sedation options are as follows:
Nitrous Oxide and a Local
This is only likely to result in a great experience if the procedure is predictably very simple and the patient has no anxiety. We numb the mouth with a shot of local anesthesia (Lidocaine, Mepivacaine, or Marcaine) and have the patient inhale laughing gas which relaxes them a bit. Once the surgery is over, they return to being alert.
This form of sedation is most common for our patients and results in the most predictable relaxing experiences. Most patients sleep through the surgery and do not have much recollection of the procedure. We start by placing a topical numbing gel on the arm to allow an IV to be established without discomfort. We slowly and incrementally administer medications that make them drowsy to a point of maximal relaxation while maintaining spontaneous breathing on their own. We numb the mouth and begin the surgical procedure relaxed and without any pain. The level of sedation varies on the needs of the patient and so we customize the degree of sedation (light, moderate or deep). Patients feel like they were totally asleep.
This is a more profound form of sedation and is rarely used for simple procedures, but we discuss all options with you. With an IV or via inhalation anesthesia gas, patients receive medicine that induces sleep throughout the surgery. The medications used are very short-acting and patients are awake shortly after the procedure is completed.
While your child is sedated, we may need to incise the gums or bone to remove wisdom teeth. We use dissolvable sutures to close the incisions and ensure they heal quickly. And we also place gauze in their mouth as a pressure bandage to reduce and stop the post-surgical bleeding.
What should we expect after surgery?
Most of our patients choose local anesthesia with sedation, so they wake up in our surgical chair. As they become alert, your teen will slowly regain feeling in their mouth. It is not unusual for the numbness of the local anesthesia to last 2-3 hours after surgery.
Make sure to come with your child to the procedure. We will not release a patient without an adult driver.
On your way home, pick up the prescription medications. We also get your child a smoothie, pick it up and start having it using a spoon right away. It is OK to take the gauze out for this. After having at least ¾ of the smoothie, take one each of the prescribed medications (on a full stomach) and finish the remaining ¼ smoothie. The medication starts working before the local anesthesia numbness wears off. This way they never have pain. They can then replace the gauze and discontinue it when the bleeding ceases. Keep this cycle of eating and taking medications on a full stomach as prescribed.
Expect swelling to peak on the 3rd day and remain till the 5th-7th day. While the child should have no pain, they should minimize all activity for 5 days. To have a great predictable recovery, “anything more than laying on the couch and eating smoothies is too much for the first 5 days”. Resist the temptation to do more activity or chew hard foods in the first week.
Your child should be fully recovered from wisdom teeth surgery within a week. Help your child avoid infection by encouraging them to refrain from smoking, spitting, drinking from a straw, eating particulate foods, and strenuous exercise. These activities can dislodge the blood clot or the stitches. The wound itself takes several months to fully heal and close up.
What are signs that I might have an infection?
Call us right away if you have a fever, trouble swallowing, swelling that gets worse instead of better, numbness, blood or pus coming out of your nose, the medication that’s not effective, or bleeding that does not stop when you apply pressure. The biggest reason for an infection is food becoming stuck in the wound or patients forgetting to rinse.
What can we do to avoid getting an infection?
We will give you detailed instructions on how to help your teen care for their mouth after surgery. The most important things to remember are:
- Don’t brush or floss the day of surgery.
- For the first 48 hours, gently rinse with salt water (teaspoon of salt in 8 oz glass of water), and rather than spitting the water out, let it run out of your mouth.
- From day 3 and the following 2 weeks, rinse diligently with salt water after every meal with a 60-second swish and irrigating the sockets with the syringe provided.
- Use gauze to dab the wound for excess blood.
- Stay ahead of the pain by using an ice pack on your face in the first 48 hours and taking medications on a full stomach.
- Stay hydrated.
- Start with very soft foods, such as apple sauce, cottage cheese, smoothies, soup, and ice cream.
- Stay away from extremely hot food, nuts, seeds, and straws.
It is important to follow all our at-home care instructions as you care for your child and wait for them to heal. Wisdom teeth removal is a common procedure, and recovery is predictably easy when you stick to these guidelines. While most patients do not look forward to a procedure, it should not be anything more than a minor inconvenience from their daily routine.
Are you or Your Loved ones suffering from Wisdom Tooth Pain?
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Please call our Upland CA office at (909) 982-8888 with any questions or
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