Wisdom Tooth / Third Molar Problems

What are steps of Wisdom tooth extraction or tooth removal ?

If a wisdom tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other dental treatment. But when there's too much damage for the wisdom tooth to be repaired, the tooth may need to be extracted or removed from its socket in the bone.

Third molar extraction, Impacted Wisdom tooth, Pain in wisdom tooth Upper / Lower

FAQ

1. How many Wisdom tooth are there ? When they erupt ?

Wisdom teeth are the last molars on each side of the jaws. ( Total 4 ) They are also the last teeth to emerge, or erupt ( Usually between age 18 to 30 years ) so there is often not enough room left in your mouth to accommodate them.

This can lead to Wisdom tooth impaction - teeth that are trapped beneath the gum tissue or by other teeth or bone.

If teeth are impacted, swelling and tenderness may occur.

2. What are most common problems with wisdom teeth ?

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease.

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5. Why it is advisable to get them evaluated ? Why MDS Oral Surgeon ?

A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral surgeon, will recommend either "going to sleep" using general anesthesia, or numbing this area in your mouth with a local anesthesia.

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Pre-Operative :-

1) Blood sugar, blood pressure & thyroid levels should be under control prior to surgery. (Consult physician for the same)

2) Start taking prescribed medications 2 days prior to the date of surgery or as instructed by the doctor.

3) Patients should have heavy breakfast or meal 1 hr prior to coming for surgery.

4) Patient should avoid all health hazardous habits (if any) like smoking, alcohol consumptions, tobacco chewing or use of mishri 48 hrs. Prior to surgery & 72 hrs past surgery.

5) Patient should be accompanied by close friend or relative on the day of surgery.

6) Kindly refrain from using any kind of make up or cosmetics on the day of surgery. It may lead to contamination.

7) Patient should be present in clinic premises 15-20 mins before the surgery timing to avoid anxiety.

Kindly Note - Experience of extraction process is unique for each person - We have to consider many points before going for surgery and it's possible outcome.

1. Stage of infection / swelling - before meeting doctor.
2. Current pain killer medications and role of antibiotics.
3. Medical conditions - BP, Sugar or thyroid levels.

4. Chronic illness or history of heart surgeries, epilepsy or major surgeries of vital organs if any.
5. e.g. Ecosprin - blood thinner medicinies if any.
6. Patients willingness, fear of surgery, stress level due to work or financial pressure.

7. Doubt in mind - multiple opinions, wrong guidance, excessive research on Dr. Google or You tube.

delayed response time for undergoing requied treatment is most common cause for poor outcome in dental world, which comes with cost of adjacent tooth extra treatments like Cavity filling, RCT or Extraction of adjacent teeth.

( Appointment 1 ) - Day 1 - MDS Oral Sugeon Appointment - Time - 1 Hour

Step 1

Giving Anaesthesia

Carefully Administration of Lignocaine
( L.A. / Local Anaesthesia )
wait for least 5 to 10 mins so as to get numbness around working tooth

Step 2

Gums Preparation

We have to make sure there is enough working access and visibility of whole crown of wisdom tooth.

Step 3

Bone Preparation

here with help of handpiece we make sure that surrounding bone is shaped in a way that it will be easy to move tooth and get better visibility.

Step 4

Using Elevators

using specialized instruments we try to luxate / move tooth side to side or up and down to create gap in adjacent bone near roots of wisdom tooth.

Step 5

Taking care of Mandibular nerve

in case of lower tooth we have to make sure that it should be minimal invasive procedure, so as to prevent any nerve damage.

if not done properly may lead to temporary or permanent numbness in jaw and few teeth.

Step 6

Application of forceps / elevators

this is most crucial step where your tooth will be pulled out of the socket.

you may feel force used to remove tooth and my be discomfortable or little painful sometimes.

Step 7

Debridement of wound

this is final step where we look for any bony spicule or remaining fractions of tooth or bone

Step 8

Suturing of wound.

it is indicated when the size of wound is bigger and to reduce chances of food getting locked in socket and for facilitating faster healing sutures are given usually 2 to 3 in numbers.

Kindly Note - You have to vist back after 8 days for removal of sutures and monitoring healing progress,

Post-operative Do’s & Don’ts

1) Do not leave hospital premises immediately after root canal

2) Relax for 10-15 min and then patient can go home accompanied by family person or friend.

3) Avoid eating till the effect of anaesthesia goes off completely as patient may end up biting lips, tongue or cheeks accidentally.

4) Patient may consume liquid diet till the effect of anaesthesia goes off. Do not consume hot & spicy beverages.

5) Do not touch the operated site with fingers, tongue or by any other means.

6) Refrain from using straw, smoking, mouth rinsing, spitting saliva or blood, brushing, consumption of alcoholic beverages, tobacco consumption for next 24 hrs. It can lead to complications.

7) Once the effect of anaesthesia is over, patient can start taking soft diet.

8) Do not eat hot / spicy / hard / fried / sticky food or beverages for 2-3 days

9) Patient should avoid all types of health hazardous habits like tobacco chewing / smoking / alcohol consumption for at least 4-5 days after surgery.

10) Patients are advised to complete the course of prescribed medicines.

11) Some bruising, swelling, slight pain & discomfort, tightness & stiffness to jaw & joint areas is common, In complicated surgeries reduced mouth opening is also prevalent.

12) Avoid exertion or over strainful activities. Try to take rest for 24 hrs. (Not bed rest).

13) Patients should visit for follow up after 3 days of surgery.

14) Call or visit doctor if patient suffers severe pain, swelling, bleeding, low blood pressure or palpitations.

15) Strictly refrain yourself from any kind of home remedies or superstitious remedies.

( Appointment 2 ) - Day 8 - Time - 5 mins

Step 9

Removal of stiches

carefully removing stiches given and irrigating socket if recommonded.