Procedures
Wisdom Teeth
Wisdom Teeth Presentation
To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth at our offices in Fairfax, Reston, Centreville, Burke and Woodbridge, VA are discussed.
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Wisdom Tooth Removal Overview
For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our flash educational mini module in a separate window that may answer some of your questions about wisdom teeth.
Having trouble? Please make sure you have version 7 of the Flash browser plugin in order to correctly view this presentation. This software is available as a free download.
Wisdom Teeth or third molars are the last of your 32 teeth to develop. Eruption usually occurs around the age of 16 to 21 years of age. Your dentist or orthodontist will monitor the development of these teeth and determine if you have adequate space for normal healthy development.
Why Should I Remove My Wisdom Teeth?
When there is sufficient room for the eruption of wisdom teeth to align properly and the gum tissue remains healthy, they need not be removed. Unfortunately, what occurs more frequently is that there is inadequate space for the wisdom teeth to erupt normally. Consequently, they may grow sideways, partially emerge from the gum, or even remain completely trapped beneath the gum and bone.
These poorly positioned impacted teeth can cause many problems. Teeth that are partially erupted are partially exposed to the oral environment and partially covered with gum tissue and bone. Food and bacteria can become trapped under the gum tissue and prevent proper cleaning. This results in painful swelling of the gums which often waxes and wanes until an infection develops. This is called “pericoronitis” and warrants examination and treatment as soon as possible.
Pressure from wisdom teeth which are developing sideways can cause damage to adjacent teeth which may disrupt the natural alignment of teeth. This is particularly of concern for patients who have invested the time and money for orthodontic correction of the teeth.
The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth.
Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
Oral Examination
With an oral examination and x-rays of the mouth, our doctors can evaluate the position of the wisdom teeth and discuss the indications for removal of teeth specific to your needs. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. (Please see anesthesia options.) Our doctors have the training and experience to provide various types of anesthesia.
Your surgeon will examine you, review your medical history, including medications and allergies, and help you decide the right anesthesia option for you.
Special considerations following removal of impacted teeth:
Removal of impacted teeth is a surgical procedure. Following post-operative care instructions are essential.
After Care
Following your Surgery
Following surgery there are certain expected effects which may vary in magnitude.
SWELLING - Swelling peaks on 2nd and 3rd postoperative day. To reduce the magnitude of swelling we recommend the use of ice (on the face) for the first 24 hours. Apply ice for 20 minutes on and 10 minutes off. Bags of frozen peas also work well.
BLEEDING - Bleeding can last several hours after surgery and then mild oozing may continue for up to 5 hours. Apply pressure to the surgical area by biting firmly on the rolled gauze provided to you at the time of discharge. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. If bleeding persists, resume pressure on the site with moistened tea bags (this will aid in clotting). Bite firmly for 1 hour. Repeat, if necessary. If bleeding still persists contact our office.
PAIN - The duration and extent of pain varies from person to person, but is expected for one week to ten days. Your doctor will provide prescriptions and directions for their use. It is recommended that the pain medication (narcotics) be taken prior to cessation of the local anesthesia. Nausea and vomiting often accompany use of narcotics so make sure the medication is taken with a full stomach.
EATING - Begin on the first surgical day with cool, soft foods (ice cream, Jell-O, pudding etc...) and then progress to warmer non-chewy foods once the local anesthesia has worn-off (soup, pastas, mashed potatoes etc..) You may advance your diet as the week progresses. Avoid hard crunchy foods such as popcorn, nuts, pretzels for approximately 2 weeks.
STIFFNESS - Expect stiffness with opening for several days after surgery. Gently massage the muscles and stretch them with opening. As the inflammation in the muscles subsides opening will become easier.
HYGIENE - After the first postoperative day, brush all of your teeth as you normally do. Use warm salt-water rinses 3-4 times a day to gently flush out particles of food, which lodge in the surgical areas (sockets). At your one-week post-op visit a syringe will be given to you along with instructions to aid in flushing the sockets.
DRY SOCKETS - Dry sockets occur when the blood clot which normally forms in the socket, dissolves prematurely. While pain is expected for 7-10 days following surgery, pain should gradually decrease. The pain of a dry socket actually gets worse beginning from about day 4 to 5 following surgery. Call your doctor and dressings can be placed into the wounds for relief of pain. Physical exertion can be resumed only after doctor approval.
DO NOT SMOKE for 5 days following surgery. Smoking is considered a strong risk factor for "dry-sockets".
NURSING OR PREGNANT - women should consider consultation prior to surgery.