Analgesics can manage the inflammatory signs in wisdom teeth; however, extraction is the ultimate solution if the problem bothers frequently.
Wisdom teeth
Third molars, or the wisdom teeth, collectively four in number in the oral cavity, are the last tooth of the upper and lower dental arches. Interestingly, dentists frequently extract these teeth, owing to the lack of space in the dental arches for complete eruption and inappropriate positioning.
Alteration in position
The inappropriate positioning or angulation of the third molar or incomplete eruption causes a sequel of painful events commencing from infection, pocket formation (space formed between the wisdom tooth and overlying gums), food and debris accumulation in the pocket, increased severity of infection, swelling, and extension of swelling to adjacent areas such as inner cheek and cheek biting. Furthermore, inappropriate angulation of the third molar may also cause cavity formation in the adjacent second molar. Often, analgesics can manage the inflammatory signs; however, if the problem bothers frequently, extraction is the ultimate solution.
Extraction of Wisdom teeth
Here is what you should know before you go to the dentist for third molar extraction.
Emergency Pain Relief:
Remedies and over the counter (OTC) analgesics can manage intense pain due to the third molar at home. However, these OTCs should not be continued for a long time. A patient should schedule a dentist as soon as possible to rule out the cause of pain and for a permanent solution.
Prerequisites:
An oral surgeon is a right person to be visited when scheduling an appointment for a third molar. The dentist may examine and provide you with the best treatment options as per your condition. You will be prescribed some radiographs if extraction of the wisdom tooth is planned. It is because the lower and the upper wisdom teeth, sometimes, are close to nerves and sinus, respectively. Interpretation of radiographs such as an OPG or CBCT allows the surgeon to plan the extraction following a risk-free protocol.
Premedication:
You may be prescribed antibiotics and analgesics before the extraction. Sometimes, the prescribed medicines to be taken before the procedure can help combat the discomfort during extraction. Especially, it may be beneficial for patients with low pain threshold, high anxiety or severe infection. Your surgeon will explain to you the type of discomfort which you may experience during the surgery. However, this varies from person to person and case to case.
Anaesthesia and the Procedure:
Usually, the surgeon carried out the procedure under local anaesthesia. He may also use conscious sedation, which makes the patient drowsy and also eliminates discomfort. However, all dental practices may not have the facility of conscious sedation and may offer general anaesthesia. General anaesthesia is especially beneficial for cases where all four wisdom teeth need extraction in a single visit.
In some cases, the dental surgeon can remove the tissue and bone around the wisdom to facilitate extraction from the socket. Stitches can close the surgical area and enhance the healing of the overlying tissue. The stitches may either be dissolvable that come out on their own after three to five days or undissolvable that need to be removed by the surgeon after a certain period.
Healing and Recovery:
It takes approximately 3 to 5 days to recover after removing the wisdom tooth. The term ‘recovery’ describes the resolution of discomfort which the patient has experienced post-operatively. It may include pain, bleeding, muscles stiffness in the operated area, and limited mouth opening. The surgeon will prescribe you post-operative instructions, precautions and medicines to deal with the problems mentioned above. Following the instructions religiously will make the recovery period smooth. Complete healing of gums and the underlying bone takes 3 to 4 weeks and does not hinder daily routine.
Risks and Complications:
Although the post-operative recovery is usually uneventful, problems can occur, especially if there is poor planning before surgery or the patient has not followed post-operative instructions. A dry socket, which results due to dislodged blood clot from the wound area, is one such excruciatingly painful condition. The clot usually dislodges accidentally or due to aggressive spitting. If a dry socket occurs, you should contact the surgeon. This complication is treatable. It resolves quickly with medication or stimulation of a new blood clot. Other serious complications are rare but can include:
Damage to the nerve or sinus.
Damage to adjacent teeth.
Prolonged numbness or paresthesia of the tongue.
Lip.
Gum tissue
TMJ issues
A Sneak Peek of the Advanced Dentistry
In some cases, the second molar is compromised due to trauma or disease and is deemed to be extracted. The dentist can extract sound third molar of the same patient and place it in the extraction site of the second molar. It is called autotransplantation of the third molars. Although this procedure is not very common in dental clinics, it has proven benefits. However, it needs thorough treatment planning. Nevertheless, some patient-related factors have to be evaluated before opting for this procedure.
