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Wisdom tooth extraction

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth from the mouth. Wisdom tooth extractions are a safe procedure. A thorough oral and radiological 3D exploration is mandatory before the extraction.

Sometimes the removal of all four wisdom teeth in a single session is recommended. If necessary, additional sedation could be administered. Tooth extraction must be carried out by an experienced dental professional so as not to damage the walls of the jawbone.

At Dental Esthetic BCN maxillofacial surgeons with more than 20 years of experience perform all extractions.

A correct wisdom tooth extraction should be a painless procedure. Removal of wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Complications such as: painful dry socket, socket infection or damage to nearby teeth, nerves or sinuses are rare.

  • How many wisdom teeth need to be removed?
  • What type of anesthesia will I receive?
  • How complicated do you expect the procedure to be?
  • How long is the procedure likely to last?
  • Have the impacted wisdom teeth caused damage to other teeth?
  • Is there a risk that I might have nerve damage?
  • What other dental treatments might I need at a later date?
  • How long does it take to completely heal and return to normal activity?

Wisdom tooth extraction is an outpatient procedure. This means that you go home the same day. You will receive instructions from the dental clinic staff on what to do before surgery and the day of your scheduled surgery.

You should ask the dental clinic staff these questions:

  • Will I need to make arrangements for someone to drive me home after the procedure?
  • When do I need to arrive at the dental clinic?
  • Do I need to avoid eating or drinking or both (fast)? If so, when do I begin?
  • Can I take my prescription medication before surgery? If so, how soon before surgery can it be taken?
  • Should I avoid nonprescription drugs before the surgery?

Your maxillofacial surgeon may use one of two types of anesthesia depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:

  • Local anesthesia. Your maxillofacial surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You are awake during tooth extraction. You will feel some pressure and movement, but not pain.
  • Sedation anesthesia. Your anesthesiologist administers sedation anesthesia intravenously in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You do not feel any pain and will have a limited memory of the procedure. You will also receive local anesthesia to numb your gums.

During wisdom tooth extraction, your maxillofacial surgeon:

  • Makes an incision in the gum tissue to expose the tooth and bone
  • Removes bone that blocks access to the tooth root
  • Divides the tooth into sections if removing it in pieces makes it easier
  • Removes the tooth
  • Cleans any debris of the tooth or bone from the site of the removed tooth
  • Stitches the wound closed to promote healing, though this is not always necessary

If you receive sedation anesthesia, you’re taken to a recovery room after the procedure.

As you recover from your surgery, follow your dentist’s instructions regarding:

  • Bleeding. Some bleeding may occur the first day after wisdom tooth removal. Try to avoid excessive spitting to not dislodge the blood clot from the socket. Replace the gauze over the extraction site as instructed by your maxillofacial surgeon.
  • Pain management. You may be able to manage pain with painkillers like paracetamol and anti-inflammatories like ibuprofen. Antibiotics like amoxicillin will also be prescribed. Holding a cold pack against your jaw may also relieve pain.
  • Swelling and bruising. Use an ice pack as directed by your surgeon. Any swelling of cheeks usually improves in two or three days. Bruising may take several more days to clear up.
  • Activity. After surgery, plan to rest for the remainder of the day. Start normal activities the next day, but for at least a week, avoid strenuous activity that might result in dislodging the blood clot from the socket.
  • Beverages. Drink lots of water after the surgery. Do not drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Do not drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
  • Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
  • Cleaning your mouth. Do not brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. You will be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
  • Tobacco use. If you smoke, do not do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, do not do so for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
  • Stitches. You may have stitches that dissolve within a few weeks. If your stitches need to be removed, schedule an appointment to have them taken out.

Call your maxillofacial surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complications:

  • Difficulty swallowing or breathing
  • Excessive bleeding
  • Fever
  • Severe pain not relieved by prescribed pain medication
  • Swelling that worsens after two or three days
  • Persistent numbness or loss of feeling
  • Blood or pus in nasal discharge