Wisdom teeth, also known as the “third molars”, are located at the rear of the upper and lower teeth.

Most people have four wisdom teeth that generally grow in between the ages of 16 and 25. Some have fewer while others have an extra one or two. Although these extra teeth were useful for our human ancestors who had to grind down plant cellulose in their larger jaws, they can be problematic today. The average mouth is designed to hold 28 teeth comfortably, not the 32 created by the addition of wisdom teeth.

A Source of Dental Problems Today

As long as wisdom teeth grow in completely and fully erupted through the gums, and are positioned correctly to allow proper fit and bite, they can receive consistent dental care and remain healthy and intact.

When those third molars grow in only partially through the gums, at an angle or sideways, crowd neighboring teeth, or develop near the nerve of the lower jaw, they can affect overall dental health. Sometimes, wisdom teeth remain completely hidden and become impacted or trapped within the jaw. According to the American Dental Association (ADA), wisdom teeth should be removed if they result in:

• Pain
• Repeated infection of the soft tissue behind the lower last tooth.
• Cysts (fluid-filled sacs)
• Tumors
• Damage to nearby teeth or adjacent jaw bone
• Periodontal (gum) disease
• Extensive tooth decay

When one or more of these symptoms occur, it’s time to consult with an oral and maxillofacial surgeon.

What to Expect During Surgery

The extraction of wisdom teeth is a simple, virtually pain-free procedure performed by an oral maxillofacial surgeon in the office. It is usually completed within an hour. In almost all cases, all four wisdom teeth are extracted at the same time, in office based setting with minimal postoperative discomfort. Usually, a general anesthetic is administered with use of adjunctive local anesthesia.

If any infection is present, a course of antibiotics will be prescribed before surgery. Patients are instructed not to eat or drink for 6 hours before surgery and to have someone drive them to and from the oral surgeon’s office.

The surgery itself is a simple procedure. The gum tissue is opened and any bone tissue covering the tooth is removed. After separating the tissue connecting the tooth to the bone, the tooth is carefully extracted. If necessary, the tooth may have to be cut into smaller pieces for easy removal. The wound is stitched closed with dissolving sutures and a folded cotton gauze pad put in place to help stop any mild oozing or bleeding.

A follow-up visit would be scheduled a week or so later to check the progress of healing.

What to Expect After Surgery

The recovery period for wisdom tooth surgery is, in general, mildly uncomfortable but in most cases, it lasts just a couple of days. A painkiller may be prescribed and can be supplemented with over-the-counter medication like Advil or Tylenol, if necessary. Each patient leaves the office with a list of post-operative care instructions, including:

• Bite down gently on the gauze pad every so often; change pads as needed. Call the office if the bleeding has not stopped after 24 hours.
• Be careful not to bite the inside of your cheek, tongue or lips while the mouth is numb.
• Do not touch the area with your tongue or fingers.
• Prop your head up with pillows; do not lie flat.
• Use an ice pack on the outside of the cheek—15 to 20 minutes on, 15 to 20 minutes off—for the first 24 hours to reduce swelling. After that period, apply moist heat from a washcloth periodically over the next two or three days.
• Starting on day two, gently rinse out your mouth with warm, salty water several times a day to reduce swelling and relieve pain.
• Eat soft foods, such as thin soup or broth, gelatin or pudding. Add solid foods gradually, beginning with softer choices like mashed vegetables.
• Do not use a straw for several days. Sucking can loosen the blood clot and delay healing.
• Do not smoke (if you still do) for at least 24 hours after surgery. Smoking decreases the blood supply and brings germs and bacteria to the area.
• Brush teeth and gums very carefully.

The surgical team at Bergen Oral & Maxillofacial Surgery (BOMS) is here to answer any and all of your questions about your wisdom teeth—from the initial consultation to form a treatment plan, through the surgical procedure and recovery process. We have the most experienced and best surgically trained team of oral and maxillofacial surgeons in Bergen County, and the support staff you need at your service.

For more information on wisdom teeth surgery and other surgical treatment choices, contact us at one of our offices: Hackensack: 201.343.8297, Westwood: 201.664.5656, or Ridgewood: 201.444.4137.