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The average adult has thirty-two teeth by age eighteen, sixteen teeth on the top and sixteen teeth on the bottom. Each tooth in the mouth has a specific design and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces while the back, or molar teeth, are used to grind food up into a consistency suitable for swallowing.
The average mouth, however, is only large enough to hold 28 teeth. It can be painful when 32 teeth try to fit in a mouth that has room for only 28 teeth. These four other teeth, the last to form, are called Third Molars, also known as "wisdom teeth."
Should I have my Wisdom Teeth removed?
Wisdom teeth are the last teeth to erupt into the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when there is insufficient space for normal and complete eruption. Wisdom teeth may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.
Poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and may eventually cause an infection. The result is swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and adjacent healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal, between the ages of 14 and 18, is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. At this age risk is less because the roots have not completely formed and healing is quicker.
Oral Examination
With an oral examination and x-rays of the mouth, Dr. Guyette will evaluate the position of the wisdom teeth and determine if there are present or potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid- teenage years by their Dentist, Orthodontist or by an Oral and Maxillofacial Surgeon.
Wisdom teeth removal and all office surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Guyette has the training, license and experience to provide various types of anesthesia. Together with the patient, the best anesthetic alternative is selected to maximize patient comfort. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and staff experienced in anesthesia techniques.
Before Surgery
| Preoperative Instructions for Patients Undergoing Intravenous (IV) Anesthesia |
- The patient may not have anything to eat or drink (including water) for six (6) hours prior to the appointment except to take your normal medication or medication prescribed by our office.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home after the procedure.
- The patient should not drive a vehicle for 24 hours following anesthesia or for 4 hours after taking narcotic
- pain medication.
- Wear loose fitting clothing with short-sleeved shirts or sleeves, which can be rolled up past the elbow. Contact lenses, jewelry and dentures should be removed before the time of surgery.
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After Surgery
The removal of impacted wisdom teeth and surgical extraction of teeth are usually more involved than the extraction of erupted teeth.
The following conditions may occur, all of which are considered normal:
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- The surgical area will swell.
- Swelling peaks on the 2nd or 3rd postoperative day.
- Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
- You may have a slight earache.
- Your throat may be sore.
- Your other teeth may ache. This is referred pain and is a temporary condition.
- The corners of the mouth may be stretched to gain access for treatment. Your lips may dry and crack and should be kept moist with cream or ointment.
- There will be a space where the tooth was removed. After 24 hours, this area should be rinsed following meals gently with salt water until it is healed. This area will gradually fill in with new tissue.
- There may be a slight elevation of temperature for 24 to 48 hours. If fever continues beyond this time frame or reaches 101.5, notify us.
- It is not unusual to develop bruising in the area of an extraction.
- Please take all prescriptions as directed.
- Women please note: Antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist or physician.
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Care of the mouth after surgery
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- Do not rinse or spit for 24 hours after surgery. This may dislodge the blood clot and cause a dry socket
- Keep fingers and tongue away from socket or surgical area.
- Use ice packs on surgical area (side of face) for first 24 hours, apply ice 20 minutes on - 20 minutes off. Bags of frozen peas work well.
- For mild discomfort take Ibuprofen as directed, (if you are not allergic), every 4 hours.
- For severe pain use the prescription pain medication given to you.
- Drink plenty of fluids. (Do not use a straw).
- If the muscles of the jaw become stiff, place warm, moist heat on the outside of your face over these muscles.
- After the first post-operative day, use a salt-water rinse following meals for the first week to flush out particles of food and debris, which may lodge in the surgical area, and to promote healing, (1/2 teaspoon of salt in 1/2 glass of water). A small amount of mouthwash can be added for better taste.
- Diet may consist of soft foods, which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc for two weeks.
- A certain amount of bleeding is to be expected following surgery. Bleeding is controlled with pressure by continuously biting on the gauze that is placed at the time of surgery. When normal feeling has returned to the surgical area (usually 1 _ -3 hours) remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be placed directly over the area of bleeding. Bite firmly and continuously for one hour. This will aid in blood clotting. Repeat if necessary. If bleeding still persists, call our office.
- We suggest that you do not smoke for at least 2 days after surgery. Nicotine may break down the blood clot and cause a "Dry-Socket".
- Feel free to contact us if any doubt arises as to your progress and recovery.
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Oral hygiene is important
24 hours after surgery, begin rinsing your mouth gently with a solution of _ teaspoonful of salt dissolved in _ glass of water. Repeat after every meal or snack for 7 days. Rinsing is important because it removes food particles and debris from the socket area. The salt thus helps prevent infection and promote healing. Brush your tongue with a toothbrush to keep bacterial growth down. Resume your regular tooth brushing the night of surgery, but avoid disturbing the surgical site so as not to loosen or remove the blood clot causing a dry socket.
Maintain a proper diet
Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids with meals and in between. Avoid foods such as popcorn, chips and rice as they can become lodged in the healing wound and cause infection. Add solid foods to your diet as soon as they are comfortable to chew.
In case of problems
Most patients experience few problems if the instructions and suggestions are followed as outlined. But if you should have problems such as excessive bleeding, pain, or swelling, call Dr. Guyette for further instructions or additional treatment.
Remember your follow-up visit
It is important to return for a postoperative visit to make certain healing is progressing satisfactorily. A follow-up visit will be scheduled at the time of surgery. In the meantime, maintain a healthy diet and observe rules for proper oral hygiene.
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