Wisdom Teeth Extractions

What are Wisdom Teeth?

“Wisdom Teeth” is term that we use to refer to someone’s 3rd molars – usually the furthest-back teeth in the mouth on the top and bottom jaws.

Why do I need my wisdom teeth out?

The primary reason that many people need their Wisdom Teeth taken out is because there is no room in their mouth for the Wisdom Teeth to erupt. Sometimes a Wisdom Tooth can stay buried under the gum and in the bone and thus never needs to be addressed. However, other Wisdom Teeth can be in a position that is very close to the tooth in front of it (the second molar); and when a 3rd molar is too close to the 2nd molar, it can lead to problems with the 2nd molar, including cavities and gum problems.

What does it mean to have an impacted wisdom tooth?

When we say that a Wisdom Tooth is impacted, we are referring to the fact that the tooth is at an angle. Teeth at an angle can be more difficult to remove.

Can you do a filling in a wisdom tooth?

Yes. We can sometimes do fillings in erupted Wisdom Teeth, but sometimes it doesn’t make sense to do so. For example, if a patient is missing their upper left Wisdom Tooth, it doesn’t make sense to fill the lower left Wisdom Tooth because the tooth is opposite an empty space! In this situation it makes sense to remove the unopposed Wisdom Tooth if it starts to get decay.

But, for a patient that still has all of their Wisdom Teeth erupted in their mouth and in function (that is, the Wisdom Teeth are erupted like the rest of the teeth), we can certainly do fillings if there is decay and we can access the tooth.

Do you do crowns and root canals in Wisdom Teeth?

Rarely. Wisdom Teeth are often so far back in the mouth that simply getting to the teeth to perform a root canal or make a crown is very difficult. Plus, root canals on Wisdom Teeth are not often performed because the anatomy of Wisdom Teeth makes successful root canal very difficult.

Wisdom Teeth Extraction (Removal Procedure)

The overall process of taking out wisdom teeth is similar to that of taking out any other type of tooth with a few differences. The reason we are more aware of wisdom teeth extractions vs. other teeth extractions is because wisdom teeth are commonly removed in early adulthood (often between the ages of 18-26), and thus people hear more about the procedures. In addition wisdom teeth are often removed because they don’t grow properly into your mouth and thus have to be extracted.  Because wisdom teeth can be unerupted (under the gum) at the time of extraction, it can take longer to remove wisdom teeth as extra care is needed to safely access the tooth.

Will I need stiches?

Yes. In most cases we will place stiches over the areas where your wisdom teeth are taken out. Depending upon the type of extraction (erupted tooth, impacted tooth, etc.) we may put in dissolvable stitches that will go away on their own, or non-dissolvable stiches where you’ll have to come back to see us to remove them.  Ultimately we want to make you as comfortable as possible and have your extraction procedure and healing time be as safe as possible.

Why take out a wisdom tooth if it doesn’t hurt?

We take out wisdom teeth even if they aren’t bothering you for a few reason:

1. The wisdom tooth is unopposed – meaning that there is no tooth opposite the wisdom tooth. If a tooth has no other tooth opposite it in the opposing arch (e.g. you have a top tooth but not a bottom one to meet it), then the tooth isn’t useful for chewing and can be removed. We normally do not take out teeth simply because the opposite tooth is missing, but wisdom teeth are a special case (see the next point below).
2.  The presence of wisdom teeth can lead to gum or periodontal problems in some patients.  Because there is such a “tight fit” in the back of the jaws, even erupted wisdom teeth can cause food to get stuck in between the wisdom tooth and the tooth in front of it, leading to gum problems. Add the fact that wisdom teeth are far back and are often very difficult to clean, this buildup and inflammation can cause bone loss in the tooth in front of it.
3. The presence of wisdom teeth can lead to cavities in the neighboring teeth. Similar to the situation above, when there’s an excess buildup of food and plaque and debris that’s hard to clean and remove, this accumulation can lead to cavities forming on the back portion of the teeth directly in front of the wisdom tooth.

Wisdom Teeth Extraction Recovery

What can I eat after my wisdom teeth are removed? 

We will give you specific post-operative instructions so you’ll know what do to after your wisdom teeth are extracted. But in general, you will be restricted to a soft-food diet for at least the first 24 hours. Soft foods include items such as warm liquids or clear soup (nothing too hot and nothing too cold).  Do not use a straw and do not smoke or do anything that would result in a suction motion. A suction motion as you’d use with a straw can cause the extraction areas to bleed and we want to leave the extraction areas alone so they can start to heal.  Your jaw may also be sore after the extractions and it may be uncomfortable to open your mouth to eat (another reason why we recommend liquids and soft foods right after your extraction).

We may prescribe medications for you after your teeth are removed, and we will discuss with you whether or not you need to take these medicines with food.

When can I brush my teeth again after wisdom tooth extraction?

You can usually brush your teeth the next day after your extractions. Be careful to avoid the wisdom teeth areas in the beginning as the area will be tender and brushing the area may cause slight bleeding as you are still healing.  Also be careful not to brush any areas with stiches, as the toothbrushing motion may pull on the stitches which can be uncomfortable.

Will I have pain in my other teeth after my wisdom teeth are taken out?

Maybe – but it should get better over time.  Depending upon where your wisdom teeth are positioned, the extraction sockets may cause the gums to shrink on the back part of the teeth that are in front of the wisdom tooth.  This back part of the tooth can be sensitive to the air and to cold foods, and should improve over time. If the sensitivity doesn’t improve, there are toothpastes and treatments we can provide to help make you more comfortable.

Will my teeth shift after my wisdom teeth are taken out?

Generally speaking, after wisdom teeth are removed your other teeth do not shift. Teeth have a tendency to move in the forward direction (towards the front of your mouth), so if you were to have a first molar taken out, for example, then the second molar behind it may start to angle slightly forward. But since the wisdom tooth is the last tooth in the mouth, it doesn’t affect the teeth in front of it.