Extraction wisdom teeth

Before we remove your wisdom teeth, we'll examine your mouth and teeth, and we may take X-rays of the teeth we're going to remove so we can evaluate their roots and the bone that surrounds them. Be sure you tell us about any medical conditions you may have, or problems
you've had with previous extractions. You'll also need to tell us about any medicines or supplements you're taking, including aspirin, ibuprofen and any other over-the-counter medicines or herbal supplements. If you take oral contraceptives, we'll need to know about
that, too, as you could be prone to more problems with healing than those who don't.

Preparing for the extraction

An appointment to have all four of your wisdom teeth removed usually takes only an hour or two. Before we begin, we'll use anesthetic to numb the entire area around the teeth so you'll be entirely comfortable throughout the procedure.

What happens during the extraction?

If your wisdom teeth haven't yet erupted (grown in) above the gumline, we'll remove them through a small incision in your gums. To remove the wisdom teeth, we'll use either forceps or an instrument called an elevator. Elevators are placed next to your tooth, and are used to gently roll it out of its socket. Forceps carefully grip the tooth so we can remove it.

As the tooth is removed, you'll feel pressure, but not pain. If you feel any discomfort beyond just a sensation of pressure, be sure to let us know. We'll stop immediately and give you more anesthetic.

Sometimes, if your tooth's roots are curved or are tightly held in the socket, we might need to cut the tooth into sections and remove them one at a time. This is a very common practice, and can really reduce the amount of time and effort needed to remove an impacted
wisdom tooth. Once the tooth is removed, if an incision was necessary we will close it with a couple of stitches.

Taking care of yourself after the extraction

You may feel a bit groggy after the procedure, so you should arrange to have someone pick you up when you're ready. Then, to minimize problems after your tooth is removed, you'll need to follow our post-operative instructions carefully, especially for the first
twenty-four hours. These instructions will tell you how to control bleeding, how to relieve pain and minimize swelling, how to prevent dry socket, and what to eat and not eat. We'll also give you a prescription for a pain reliever, which will help to keep you comfortable. We ay also prescribe an antibiotic; be sure to follow the directions precisely.

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Dry socket is an infection in your tooth socket after a tooth is extracted. The condition usually develops when a blood clot fails to form in the socket, or if the blood clot comes loose. Dry socket occurs in approximately 5 percent of all tooth extractions.

Normally, the blood clot that forms after a tooth is removed promotes healing, laying the foundation for the growth of new bone tissue. When dry socket occurs, this blood clot is lost and the infected, inflamed socket appears empty — hence the name. Nerves are exposed, and sometimes the bone is visible in the empty socket.

You may not have symptoms until three to five days after the extraction. Then, the condition will manifest itself as severe pain that doesn't subside, often accompanied by what feels like an earache. You may also have an unpleasant taste in your mouth, and bad breath.

Causes and prevention

Several things can cause the premature loss of a blood clot from an extraction site, including smoking, forceful spitting, sucking through a straw, coughing or sneezing. You should also avoid consuming carbonated or alcoholic beverages after an extraction, as these have also been associated with the development of dry socket.

Also, you should:

·  Keep your fingers and tongue away from the extraction site.

·  Apply an ice pack to your jaw for the first twenty-four hours following surgery — on for fifteen to twenty minutes, and off for thirty to forty minutes — to prevent pain and swelling and stop excessive bleeding.

·  Do not rinse your mouth the day of surgery. The next day, you can rinse gently with warm salt water; dissolve one teaspoon of salt in a cup of warm water. Be sure to rinse and spit gently.

Call our office right away if you notice any symptoms of dry socket. Treatment for dry socket typically includes a gentle rinsing of the socket. We then pack it with topical anesthetic and a sterile gauze dressing. You'll usually need to return to our office two to three times over a two-week time period so we can change the dressing.

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Pain may be the first symptom

Smoking can be a cause

Blood clot is missing