Wisdom teeth are the last adult teeth to erupt into the mouth, generally emerging between the ages of seventeen and twenty-one. They are the third set of molars and are in pairs: two each on the top and bottom arch of teeth. While some patients don’t have wisdom teeth, most do. Many of those who do have them don’t have enough room for those teeth to erupt fully, causing them to be wedged under the back of another tooth, impacted in the gum.
Impacted wisdom teeth are very difficult to clean, and can negatively affect the surrounding teeth. They are highly vulnerable to disease and decay and may lead to tooth pain and damage to adjacent teeth. For these and other reasons, a dentist may recommend that the teeth be extracted through oral surgery as soon as necessary to prevent any problems.
Extraction of wisdom teeth is typically an outpatient procedure done in an oral surgeon’s office. A healthy patient can proceed with a typical surgery, but if any infection is detected, the surgery can’t move forward until the infection is cleared up through the use of a full course of antibiotics. Once the surgery is moving forward, the surgeon’s team will administer some form of anesthesia to numb the area surrounding the tooth or to possibly sedate the patient through IV sedation dentistry.
After the anesthesia has fully taken effect, the surgeon makes an incision to open the gum and to remove any bone that is blocking the tooth from extraction. The tissue connecting the bone to the tooth will be separated and the tooth will be removed. In some cases, the surgeon will have to break the tooth into smaller pieces to make it easier to remove. After thoroughly cleaning the area and removing any remaining debris, the incision will be closed, stitched and packed with sterile cotton gauze to staunch any bleeding.
The surgeon will provide aftercare instructions. Patients should follow these instructions to the letter in order to ensure the best and fastest healing of the surgical site.
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While minor gum recession can be treated by your dentist with deep cleaning and antibiotics, serious gum recession can only be treated with oral surgery. A loss of bone and gum pockets that are very deep require gum surgery to address the pain and damage left by acute gum recession.
Three treatments are used primarily in the treatment of serious gum recession, in order of invasiveness: pocket depth reduction, regeneration, and soft tissue graft. Pocket depth reduction involves a deep cleaning of the affected area. The periodontist folds the gum tissue back and utilizes tooth scaling and root planing to remove any tartar and plaque built up around the tooth. Once the gum pockets are clean, the surgeon pulls the gum tissue gently around the tooth, eliminating the deep pockets altogether or significantly reducing their depth.
Regeneration utilizes a similar treatment to pocket depth reduction, but it also addresses any bone loss that occurred due to acute gum recession. In this process, a regenerative agent such as graft tissue, membranes or tissue stimulating proteins is added to the affected area. The gum tissue is then tucked into place and stitched down. Over time, the regenerative agent will work to rebuild lost bone and tissue, leaving healthy and thriving tissue behind.
The most common soft tissue graft is taken from the patient’s own mouth, either by removing tissue from the roof of the mouth or from the gum tissue near the affected tooth. The healthy gum tissue is placed in the affected area, over the exposed tooth root, protecting it from infection and damage.
To prevent the need for oral surgery to address your receding gums, have good oral hygiene habits. Brush, floss and see your dentist twice a year for checkups and professional cleanings. Talk to your dentist if you have any other questions about how to reverse or prevent gum recession.
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If you or a loved one is scheduled to have or has recently had oral surgery, you probably have a lot of questions. Here are some of the most common questions:
- One of my stitches came out after my surgery, should I be worried? Losing a stitch isn’t a problem. In the majority of cases, stitches are put in place during surgery to assist in clot formation and bleeding control. If you have undergone a bone-graft procedure, however, contact your surgeon because you may need to be seen immediately.
- What can I eat after surgery? Immediately following surgery, eat only soft foods of tepid temperature. Avoid very hot or very cold foods. Eat nothing that is crunchy or chewy so you won’t damage the surgical site.
- I am having a lot of pain following my procedure, what should I do? If you have been prescribed pain medication, take it as recommended. If no prescription was given, use over-the-counter medicines containing natural anti-inflammatory properties such as ibuprofen. Stay hydrated by drinking room temperature water and get plenty of rest.
- I had a tooth extracted, how can I tell if I have a dry socket? Dry socket is the result of the loss of the blood clot present in the extraction site. Smoking, using a straw, poor oral hygiene or failure to rest properly following the extraction procedure can lead to this condition. Typically dry socket will present within one week of extraction and is treated with sterile wash and pain-relieving, medicated gauze.
- I had a procedure this morning and am still bleeding. Is that normal? Bleeding following extractions or other surgical procedures is common. If you are bleeding more than normal, bite down on some sterile gauze or a damp teabag for twenty or thirty minutes. Don’t keep removing the gauze to look for blood; that can make the bleeding worse. Call your surgeon if you feel your bleeding is excessive.
Your oral surgeon can answer these questions and more. Don’t hesitate to call the surgeon’s office to get the peace of mind you require to heal comfortably following your procedure.
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