How Wisdom Teeth Are Removed

X ray of teeth

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If you developed wisdom teeth (and no, not everyone does), chances are you will require wisdom tooth extraction at some point in your lifetime. It's understandable to be nervous about a procedure, especially one that requires sedation. It may help to understand exactly what will happen when your dentist or oral surgeon is removing your wisdom teeth.

Before Your Procedure

Thoroughly follow the instructions your dentist gives you before your oral surgery. Be sure to inform your dentist of any medications or supplements you may be taking. Arrange for someone to come along with you the day of your procedure, so they can drive you home.

Wisdom Teeth Removal, Step-by-Step

Wisdom teeth may be removed in your regular dentist's office or in a surgical dentist's office. Regardless, these are the steps that will be followed:

  1. Selection and administration of sedation: Your dentist will tailor one of a few sedation options to your comfort level as well as the extractions required. These could include nitrous oxide, oral medications (such as Halcion or Valium) to be taken shortly beforehand, or IV sedation, which is generally considered the most comfortable since you're unlikely to remember the procedure afterward.
  2. Numbing and imaging: After the selected method of sedation has taken effect, the oral surgeon or dentist starts by numbing the wisdom teeth and their surrounding tissues with a local anesthetic. You've probably already had an X-ray, known as a panorex, taken of your wisdom teeth, but sometimes the dentist requires additional X-rays at this point.
  3. Tissue removal: The dentist begins the surgical part of the procedure by removing any gum tissue covering the area where the wisdom tooth is located. If the wisdom tooth is impacted, an incision is made in the tissue in order to access the tooth. The gum tissue is then pushed out of the way with a surgical instrument until the tooth is visible.
  4. Bone removal: There is a good chance that an impacted wisdom tooth could be fully or partially covered in bone. If this is the case, a high-speed handpiece is used to drill through and remove the bone covering the tooth. If the wisdom tooth has already erupted into your mouth, the dentist will loosen the connective tissue from around the wisdom tooth.
  5. Loosening and sectioning of the tooth: When the impacted wisdom teeth are visible to the dentist, various surgical instruments are used to gently loosen the wisdom tooth from any connective tissue in the tooth's socket. The use of the high-speed handpiece may be used on and off throughout the extraction. The same procedure applies for a wisdom tooth that has already erupted. The dentist may also cut the tooth into sections to prevent the tooth from breaking before it is removed from the socket.
  6. Tooth removal: Once the wisdom tooth is loose or has been completely sectioned, it is ready to be removed. The dentist will use surgical instruments specially designed to fully remove the tooth.
  7. Stitches: Now that the wisdom teeth are gone, the dentist may add stitches to close up the area. This is sometimes necessary when impacted wisdom teeth are removed, or when the dentist feels the patient will better heal with stitches in place.
  8. Recovery: With removal complete, you'll be brought slowly out of sedation. The dentist will provide gauze for you to bite down on to help blood clot in the area.

After Your Procedure

Though it might seem nerve-racking, wisdom tooth removal is a very common dental procedure, and complications are rare. For a successful recovery, it's important to closely follow the post-operative instructions you receive, particularly during the first seven to 10 days following your procedure.

Take time to ask any questions you have so you fully understand how to care for your healing socket.

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Article Sources
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  2. Guerrero ME, Botetano R, Beltran J, Horner K, Jacobs R. Can preoperative imaging help to predict postoperative outcome after wisdom tooth removal? A randomized controlled trial using panoramic radiography versus cone-beam CT. Clin Oral Investig. 2014;18(1):335-42. doi:10.1007/s00784-013-0971-x

  3. Coulthard P, Bailey E, Esposito M, Furness S, Renton TF, Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2014;(7):CD004345. doi:10.1002/14651858.CD004345.pub2

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