Wisdom Tooth FAQ

Why do we have wisdom teeth?

While our DNA is programmed to produce 32 teeth, the third molars (wisdom teeth) are the last to come into the mouth, near the end of skeletal growth completion, and very often there is not enough room in the jaw for them. They then become impacted, that is, covered all or in part by bone and gum tissue. Dietary changes, over the centuries, to more processed foods and commonly performed orthodontic treatment are a couple reasons for this lack of space.

Why should wisdom teeth be removed?

When there is a lack of room for proper eruption of these teeth, a variety of problems can occur. Some of these are: gum inflammation, infection, and decay due to the difficulty in cleaning all the way in the back of the mouth; damage to the adjacent second molar teeth when pressure causes bone loss, tooth shifting, or decay; and the possible growth of cysts or tumors from the wisdom tooth growth sac that remains in the bone.

When should I have my third molars removed?

Once it is clear that there is no room for these teeth and there is only the potential for problems, most surgeons feel they should be removed at an early age, even if there is no discomfort yet. The teenage years through the early 20’s is the ideal time for treatment: surgery is the easiest; healing is the fastest; and any problems that we find are usually small ones. Removal of wisdom teeth can be performed at any age, but healing complications are more common from this procedure as we get older.

How many wisdom teeth can be removed at one time?

In general, patients do best with a single surgical procedure and, if there are four impacted teeth, they can most often be removed at a single visit. The discomfort from the removal of multiple teeth is not much more than that from a single tooth and we use a number of medications and techniques that make your recovery as easy as possible. Although there may be some soreness and swelling on both sides when four are treated, discomfort is not double that of a single side and the problem is fixed with a single surgery and single recovery period. Alternatively, two procedures (one side at a time) can be performed for four third molars, limiting any swelling to one side, but requiring a second surgery.

How uncomfortable will I be?

How an individual recovers from a procedure is quite variable, depending on the person as well as on the difficulty of the surgery. Discomfort and any swelling are usually the worst in the first couple of days and improve over the week. A small percentage of patients will develop a delay in healing that will require medicated dressings to relieve pain. There are a number of steps that our office takes to minimize patient discomfort at all phases of treatment: pre-operative rinses and medications to improve outcome, long lasting local anesthetics, and customized prescription pain medication post-operatively, to name a few.

Should I stay awake or go to sleep?

The choice of anesthetics is yours. And with our office of trained anesthesiologists, you have the luxury of choosing what is best for you. Staying awake (local anesthesia) involves making the area numb with a couple of dental injections in each area being treated. After the area is numbed, there is no pain, but tolerable pressure and the sounds associated with the surgery are experienced. You are not drowsy afterwards and can drive yourself home.

With an intravenous (general) anesthetic, you are generally unaware of the surgery and have little or no memory of the procedure. You will need someone to be with you and to drive you home. Nitrous oxide (sweet air) is also available and, while it does not put you to sleep, it can relieve anxiety and discomfort without having a general anesthetic.

Nitrous oxide (sweet air) is also available and, while it does not put you to sleep, it can relieve anxiety and discomfort without having a general anesthetic.

What do I do if my stitches loosen or come out?

Stitches in the mouth frequently get loose and can start to come out, in some cases, soon after surgery. If a portion of the thread is dangling, it will probably come out as you begin rinsing. If a suture “tail” is irritating, it can be carefully snipped with a small scissor. Provided there is no excessive bleeding, losing a suture should not affect the healing. Certainly, if there is any concern, call us to schedule a check-up.

If you have any questions or to schedule an appointment with Dr. Schabes or Dr. Sacks: