By the age of eighteen, and average adult has 32 teeth in the mouth.
Generally an average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are THIRD MOLARS also known as WISDOM TEETH two in the upper jaw and two in the lower jaw.

» Why should Wisdom teeth be removed
Wisdom teeth are the last teeth to erupt within the mouth. When they are properly aligned in the mouth and gum tissue surrounding them is healthy wisdom teeth are not to be removed. But this is highly unlikely as when the time for their eruption comes, the jaw growth is over and there isn’t sufficient space to accommodate them.

The extraction becomes necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone and remain impacted.

These impacted and poorly positioned teeth can cause following problems:

1. When they are partially erupted, the opening around the tooth allows food to accumulate which further favors bacterial growth and leads to infection resulting in pain, swelling, diffliculty in mouth opening and generalised illness.
2. The infection may cause a cavity in the adjacent tooth.
3. The pressure from the erupting wisdom tooth may move to other teeth and disrupt the orthodontic or natural alignment of teeth.
4. The most serious problems occur when tumors or cyst form around the impacted wisdom tooth, resulting in destruction of the jaw bone and healthy teeth.
5. An impacted wisdom tooth also causes jaw to fracture easily in case of minor injuries to the jaw as jaw in the area of third molar is very thin and the presence of wisdom teeth in it further weakens it.

Removal of offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

» Oral Examination
With an Oral Examination and X-ray of the mouth, the doctor can evaluate the position of the wisdom teeth and predict future problems. Studies have shown that early evaluation and treatment results in superior out come for the patient.

» Removal of the Wisdom Tooth
In most of the cases, the removal of wisdom teeth is performed under local anesthesia, conscious sedation or general anesthesia. These options as well as the surgical risks (i.e. sensory nerve damage, sinus complication) will be discussed with you before the procedure is performed. Once the teeth are removed the gum is sutured and gauze is placed in patient’s mouth to bite upon to control bleeding. The patient is made to rest in the office. Upon discharge antibiotics and pain killers are prescribed. The sutures are removed in one week’s time.

» After Wisdom Tooth Removal
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

- Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
• Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
• Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
• Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
• Place ice packs to the sides of your face where surgery was performed.
• Avoid taking hot food or beverages like tea as this can cause bleeding.
• Take cold food items like milk shake, icecream and liquids like juice.

» Complications

• Bleeding - Slight oozing from the mouth is common after oral surgery and most of it is red saliva i.e. saliva mixed with blood. So avoid spitting too much and if bleeding continues then bite on a clean gauze piece for ten minutes.
• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call our office if you have any questions.
• Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Paracetamol or ibuprofen should be taken to reduce the fever.
• Swelling after surgery is common and is an inflammatory sign. It reduces on its on after three to four days.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by your doctor.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as petroleum jelly.
• Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
• Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

» Finally
Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call the office for instructions. There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem or questions with your surgeon.