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Oral Surgery (Wisdom Teeth)

What is an Impacted Tooth?

All teeth are formed deep within the jaw bones.  As the root of a tooth forms, most teeth move upward toward their future place in the mouth.  This movement is called eruption.  If a tooth travels in the wrong direction or is blocked by another tooth or dense bone, it is said to be impacted or unerupted.

What Harm Can Impacted Teeth Do?

Since it is not normal for a tooth to remain beneath the surface after the late teenage years, it is easy to understand why problems develop.
Whenever saliva can reach the crown (and this may happen even though the impacted tooth cannot be seen in the mouth), decay may occur just as in ordinary teeth.  There is no way to fill such cavities, and severe toothaches finally result.
Gum infections such as pyorrhea or more severe infections may also result from inability to keep this area clean with normal tooth brushing and flossing.

The germs in the saliva may also cause pericoronitis, an infection around the crown of the tooth.  This infection may spread to the cheek, throat or neck, with severe pain, stiffness of the jaws, and general bodily illness.
As impacted teeth press against other teeth, they may injure the roots or push these teeth out of position.
Sometimes the sac in which the tooth develops may form a large cyst, causing destruction of much bone and damage the other teeth in the area.

Why Should Impacted Teeth be Removed if They Have Not Caused any Trouble?

While it is true that not all impacted teeth cause the problems that have been described, no one can tell by an x-ray picture which ones are going to have problems or when.  Trouble usually comes at unexpected and inconvenient times.  Also, if a patient with an impacted tooth waits until it causes trouble, he will usually first have to be treated for the infection or other complication before the operation for removal of the tooth can be done.  This means additional loss of time, expense and discomfort, as well as some added risk.
Younger individuals tolerate the surgery for removal of impacted teeth better than older people, and heal more quickly.  For these reasons, it is best to have impacted teeth removed before trouble begins.  The only exceptions are people with certain serious medical illnesses.

What is it Like to Have an Impacted Tooth Removed?

Many ordinary teeth can be removed simply by grasping them with an instrument and carefully removing them from the mouth.  This is, of course, not possible with impacted teeth since they are partially or completely beneath the surface.  The removal of an impacted tooth is an operation in every sense of the word.  This is not said to frighten the patient but to give better understanding about the careful preparation, cost, and need for good care following surgery.  The actual removal of the tooth is done very carefully using good surgical technique.  Sterile instruments, good lighting, emergency equipment and well trained personnel have been provided so that you may receive the finest care available.  Depending on the difficulty of the procedure, it may last from 10 to 60 minutes.  Stitches may be placed to help the healing process.  You will also be provided with instructions to help you better care for yourself at home.

What Can I Expect After the Surgery?

You can expect the following three things to occur after the surgery:

1. Bleeding

Instructions for the control of bleeding after surgery will be given to you.  It will be normal to expect a slight red tinge in your saliva for two to three days after surgery. 

2. Swelling

The amount of swelling to expect varies with each person.  We will be giving you a medicine to cut down on the total amount of swelling.  However, some swelling does occur, especially with the lower third molars.  Whatever swelling you do get will tend to increase for two to three days.  On the third day, the swelling will begin to go away and is completely gone by about one week after surgery.

3. Pain

A moderate amount of pain can be expected after the removal of impacted teeth.  Depending on the difficulty of your particular teeth, a pain medicine will be given.  Usually people require some medicine the day of surgery and some the following day.  By the following day, most people are able to remain comfortable with Tylenol and ibuprofen.

Are there any Complications?

Although the removal of wisdom teeth or impacted teeth is generally safe, any surgical procedures carries some risks of injury.  At the time of your consultation, you will be made aware of the possible complications and have the opportunity to discuss them with Dr. Dean prior to consenting to surgery.