How will I feel after the surgery?

Patients will feel groggy and tired upon waking form the anesthesia. The time it takes to wake up and be completely alert varies with each individual. It all depends on how quickly that particular person's biological components can metabolize the medications. Some people have a higher tolerance level than others making the effects of the medications not last very long. This will require the doctor to give a higher dose of the medications during the surgery. This is also a sign that the patient will wake up fairly quickly after surgery.

Some other common feelings reported by patients after surgery consist of dry mouth and numbness. Having the gauze in the mouth causes the dry mouth. As it is meant to soak up the blood, inevitably, it will also soak up the saliva. A tip to help with this is to wet a separate piece of gauze or cloth and have the patient gently close their jaw on it to squeeze the water over the tongue. Once the tongue and back of the throat is moistened, the patient will feel better. The numbness is caused by the local anesthetic. This can last anywhere fro 2-8 hours. The numbness will wear off progressively over time.

What to do and what not to do...

Post-operative instructions are always given after the removal of wisdom teeth.

Gauze will be placed in the location of the extraction sites. The patient should bite down on the gauze to apply firm but gentle pressure. This will help stop the bleeding. The gauze should be checked every half hour to forty-five minutes. If the sites are still bleeding new gauze should be placed at the sites. Continue until the sites stop bleeding.

Ice packs can be placed on the outside oh the cheek 20 minutes on, 20 minutes off for the first 24 hours as much as possible. The more it’s done, the less swelling will be seen. After the first 24 hours, the ice can be switched to a warm moist compress on the outside of the cheek, 20 minutes on, 20 minutes off. This will help the swelling that has accumulated to reduce at a faster rate.

Diet should consist of softer foods such as mashed potatoes, scrambled eggs, jello, pudding etc.

Elevation of the head will also help. Use pillows to prop the head up or relax in a recliner to keep the head above the level of the heart.

No forceful rinsing of the mouth, no spitting, and no using a straw/sucking/smoking. These actions will create pressure in the mouth and cause the blood clot in the extraction sites to dislodge and expose the bone. This is called a dry socket and can be extremely painful and will need to be treated by the doctor.

Lastly, stay on a scheduled dose of ibuprofen (if medically able to) to help with inflammation and pain management. If there is break through pain, a prescription pain medication prescribed by the doctor can be taken as prescribed and instructed by the doctor. 

How is the surgery completed?

First, precautions are made by screening off the back of the throat to ensure nothing falls or leaks down into the airway.

The lowers are extracted by making a release incision in the gum tissue. This tissue is peeled back. The bone encasing the teeth is also removed. The teeth are then either removed whole or sectioned in 2 to 4 pieces depending on the tooth’s position. Each section is removed and the socket is irrigated and cleaned out. A stich or two will close the tissue back together.

The uppers are removed making a release incision in the gum tissue. This tissue is peeled back and the layer of bone covering the teeth is removed. The tooth is then elevated out of the upper jaw. A stich is not typically necessary to close the site. This is due to the way the human anatomy allows the tissue to fall together.

After cleaning everything up, gauze is placed on both sides of the oral cavity over the surgical sites.

Check out the animated video below!

I can sleep throughout my surgery?

Yes! General anesthesia is extremely common during third molar (wisdom teeth) surgeries. These teeth are located deep inside of the oral cavity. They are the last teeth all the way in the back, closest to the throat. You can imagine how uncomfortable it would be to be awake and aware of people working all the way back there. Especially with the natural human gag reflex and the airway being so close. Who wants to be conscious for that?

            General Anesthesia is a very simple procedure. It starts by receiving 50% oxygen and 50% nitrous gases (nitrous oxide) through a plastic hood that sits comfortably over the nose. We all know oxygen is the natural gas that we breathe in everyday to keep us alive. Nitrous is another gas that holds the nickname of laughing gas. As you can imagine, this gas helps to relax the patient and make them feel a little better and less anxious.

            After a few minutes of breathing the nitrous oxide the doctor will use a stretchy rubber band and tie it firmly around the arm a few inches above the elbow. This helps the doctor find the patient’s veins. A small catheter needle with a small rubber tube surrounding it is used to enter the vein of choice. The small rubber tube can then be gently advanced into the vein and the needle removed. This catheter is attached to an IV line that leads to a bag of 0.9% sodium chloride fluids (the same fluids that the human body consists of). The IV line has a port near the catheter attachment end. This allows the doctor access to administer medications, which will be what puts the patient to sleep. The typical medications used are Versed, Fentanyl, and Propofol.

            Once the medications take affect, which is within seconds, the patient is sleeping. Next thing you know you’re waking up asking, “when are we going to get started?” General anesthesia is definitely recommended for third molar surgeries. View the testimonial video on the right of this post to get a feel on the experience!

Why should I have my wisdom teeth removed?

Normally you would think that we would want to keep our naturally developing body structures. So why is it that our dentists recommend us to oral and maxillofacial surgeons to have our wisdom teeth removed?

            As mentioned in the previous blog, evolution has taken its toll throughout the years. Because these teeth have become functionless due to a softer diet and the invention of eating tools, the human body stopped developing these teeth correctly. Not only did the teeth stop developing correctly, but the jaw has also shrunk. This has caused more complications and risks. There is simply not enough room for these teeth anymore.

There are many reasons to have wisdom teeth removed. Many times dentist will find that the third molars grow in on an angle of even horizontally causing damage to the adjacent teeth (sometimes requiring the removal of the affected second molars as well). Sometimes impacted third molars will develop cysts around them, which can grow bigger and eat away the bone. This will damage the bone as well as other structure in it such as nerves and vessels. Because of these reasons, it has become standard practice for the dentistry field to recommend removal.

Why do they call them wisdom teeth, do they make you smarter?

 As the story is told, our ancestor’s diet required the need for more chewing power than what is necessary today. Think about it, their diet consisted of harder and tougher foods such as leaves, roots, nuts, meats etc.. Not only that, but they didn’t have the tools and equipment that we have in todays day in age. No forks, knives, food processors…It’s a no brainer that the human body needed all the teeth they could get to get the job done.

Time went on and humans became smarter by implementing new and simpler ways to chew their food. Over the years evolution took its toll and third molar teeth became functionless. So why are they

called wisdom teeth if the need for them has decreased? Humans got smarter and wisdom teeth stopped developing correctly. Clearly they weren’t called wisdom teeth because they make you smarter. The name actually came from the time at which wisdom teeth develop. These teeth are the last teeth in the human mouth to develop and erupt, which in theory is at a “wiser” stage in human life. Therefore third molars were named wisdom teeth. Daily Mail and Science Line are two great sources with much more detailed information. Check out the video posted below for an interesting insight on the whole idea!
Also, listen to this audio clip to learn more about wisdom teeth!