Wisdom Tooth Extraction

Overview
Wisdom tooth, buddhi-bangara, or a third molar, is the last tooth to erupt in the back corner of our oral cavity. Most adults have four wisdom teeth, one each per quadrant. Generally, wisdom teeth erupt between late teens to early twenties.

Sometimes, there is not enough space in the jaw for wisdom teeth to move into the right position. They might partially erupt through the gums at an odd angle or stay completely inside the jaw bone or gum tissue. When this occurs, they are called impacted wisdom teeth, and they can cause problems, such as pain or an infection.

Why do you have to remove the wisdom teeth?
Sometimes, wisdom teeth that are partially erupted or impacted can cause dental problems. Food particles and bacteria can get trapped around the edge of the wisdom teeth and cause plaque formation, which can lead to:

* Tooth decay or dental caries
* Gum disease (gingivitis or periodontitis)
* Pericoronitis, or swelling and infection around the gum tissue of wisdom tooth, that may cause severe pain near your back teeth, pain in swallowing, and difficulty in opening the mouth (trismus)
* Cellulitis or bacterial infection in cheeks, oral floor, or neck
* Abscess or pus formation
* Cysts formation (possibility of fluid filled sac around un-erupted wisdom teeth)

Many of these problems can be treated with antibiotics and antiseptic mouthwash. However, wisdom teeth removal is recommended if other treatment don’t work.

How are wisdom teeth removed?
Wisdom teeth removal is one of the most common dental surgeries. Dental x-rays or orthopantomogram (OPG) is recommended for planning the procedure. Generally, a wisdom tooth extraction is performed as an outpatient procedure under local anesthesia by oral maxillofacial surgeon or dentist. During wisdom tooth extraction, the surgeon:
* Makes an incision on the gum tissue to expose the bone and tooth
* Removes bone that blocks access to the tooth root
* Divides the tooth into sections for easier removal
* Removes the tooth and pieces
* Irrigates and cleans the extracted site
* Stitches are placed to close the wound and promote healing
* Places gauze pad over the extraction site to control bleeding and to form blood clot

After the procedure
As you heal from the surgery, the following tips will help speed your recovery:
* Bleeding: Some oozing of blood may be present on the first day of the extraction. Bite gently on the gauze pad periodically and change as they become soaked with blood. Avoid excessive mouth rinsing and spitting. If you experience bleeding 24 hours after surgery, call your dentist or oral surgeon.
* Medications: Take analgesics or painkillers as prescribed for pain management. Antibiotics may be prescribed in some cases.
* Swelling and bruising: Use an ice pack on the outside of your cheek for the first 24 hours to contain swelling. You can use moist heat for the following 2 or 3 days.
*`Relax after surgery as physical activity may increase bleeding.
* Eat soft foods and soups; preferably cold for the first day. Gradually add solid foods to your diet as healing progresses.
* Drink plenty of water: Avoid using straw for the first few days. Sucking on a straw can loosen the blood clot and delay wound healing.
* Do not drink alcoholic, caffeinated, carbonated, or hot beverages in the first 24 hours.
* After the first day, gently rinse your mouth with warm salt water a few times to reduce swelling and relieve pain. Thereafter, continue to brush your teeth and tongue gently.

* Do not smoke for at least 72 hours after surgery to promote good healing and early recovery.

* Stitches: For sutures that do not dissolve on their own, schedule your appointment after a week to remove them.

Possible risks
Most wisdom tooth extractions do not result in long-term complications. If present, they may include:
* Painful dry socket, or exposure of bone when the blood clot is lost from the extracted socket.
* Infection in the socket from bacteria or trapped food particles.
* Damage to nearby tooth roots, nerve (lower jaw), or sinuses (upper jaw), or jaw bone.

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