Have you ever had trouble with your last tooth, at the back of your mouth? Perhaps your dentist told you that you will have to remove your 'last tooth' or as we all know it, your 'Wisdom Tooth'? It is very normal to feel a little scared and nervous when you hear this. Many people are afraid of this. But don't be afraid. This is a very common and safe surgery. Today, we will talk about everything in detail and simply.
What is this last tooth (Wisdom Tooth)?
Simply put, these are the four third molars that come from the back of our mouth, on both sides, at the top and bottom. These teeth usually erupt between the ages of 17 and 25. That's why they're called "Wisdom Teeth" in English, because we're a bit 'mature' when they come in.
Think about it, these teeth may have been very useful for our ancestors in the past, for chewing raw things, such as meat, nuts, and potatoes. But today, because we cook, chop, and eat food in a soft way, we don't really need these last teeth. Scientists say that they are a `Vestigial Structure` that no longer serves a significant purpose in our bodies.
Some people get all four of these teeth. Others may get one, two, or three. Some people don't get any at all. There's nothing wrong with how many you get or not. It's very normal.
Why do you need to extract this last tooth?
Most of the time, these last teeth can be knocked out without any problems. But sometimes, these teeth can cause various problems. In that case, doctors recommend removing them. Let's see what the main reasons are.
| Reason for tooth extraction | Simply explained |
|---|---|
| Impacted Wisdom Tooth | Because the tooth cannot fully come out, it becomes trapped in the gums or jawbone. This can cause pain and swelling. |
| Coming to bed or to the side | The tooth does not come out straight, but instead comes in and pushes against the root of the healthy tooth in front. This can also damage the other tooth. |
| Pain in the back of the mouth | There is a constant pain in the back of the mouth when these teeth come in or after they come in. |
| Food getting stuck and difficult to clean | Because they are located at the back of the mouth, they are difficult to clean properly with a toothbrush. As a result, food can get stuck around the teeth, causing germs to build up, leading to gum disease and cavities . |
| Cyst | Sometimes a fluid-filled abscess can form around an impacted tooth. This can cause damage to the jawbone, nerves, and other teeth. |
The important thing is that sometimes, even if there are no symptoms, after an X-ray examination, the doctor may recommend removing these teeth to prevent the possibility of such problems in the future. This is called 'preventive' removal.
How do you prepare before surgery?
Before your tooth is extracted, an oral surgeon will examine you.
- Checking the health of your teeth.
- An X-ray of the teeth is performed to see exactly how the tooth is positioned and where its roots are.
- You should definitely tell your doctor about any medications, vitamins, or supplements you are currently taking.
- Next, the doctor will talk to you about anesthesia. There are different methods depending on your fears and the nature of the surgery.
- Local Anesthesia: An injection that numbs only the area where the tooth is. You are conscious, but you don't feel any pain.
- Sedation Anesthesia: A drug given intravenously (IV Sedation) or a gas (Nitrous Oxide) puts you in a relaxed, calm state. You will be conscious, but not remember much of what is happening.
- General Anesthesia: You will be put completely to sleep. You will not feel anything until the surgery is over.
If you are given `IV Sedation` or `General Anesthesia`, your doctor will give you special instructions, such as not eating or drinking anything after midnight the night before the surgery. It is very important to follow all of these instructions exactly.
What happens during surgery?
On the day of surgery, the doctor will follow these steps:
1. First, you will be given the chosen anesthesia method to make you feel no pain and relax.
2. If the tooth is stuck inside the gum, a small incision is made in the gum to remove it.
3. Then, the tooth is slowly loosened and removed from the socket. Sometimes, if the tooth is large, it is broken into pieces to make it easier to remove.
4. After the tooth is removed, the area is thoroughly cleaned and any germs are removed.
5. If necessary, one or two dissolvable stitches are placed to close the incision.
6. Finally, you will be asked to place a piece of clean gauze over the wound and hold it in place to control the bleeding.
The entire process usually takes about 45 minutes to an hour . Depending on how impacted the tooth is, it may take a little longer.
Do's and don'ts after tooth extraction
It is normal to experience some pain, a taste of blood in your mouth, and some swelling in your face after surgery. Your doctor will advise you on how to manage these. Since you have been given anesthesia, it is important to have someone you trust drive you home . Take care of these things after you go home.
| ✔️ Things to do (DOs) | ❌ Things not to do (DON'Ts) |
|---|---|
| Hold the gauze in place for about 30 minutes. Remove it when the bleeding has subsided. | Do not use a drinking straw. When you drink, the blood clot that has formed in the wound can come loose, causing a painful condition called dry socket . |
| Get as much rest as possible. Rest at home for at least 3-5 days. | Do not exercise, run, or jump. Increased heart rate can increase bleeding, pain, and swelling. |
| Apply an ice pack to reduce swelling. Apply an ice pack wrapped in a towel for 20 minutes, then remove it for 20 minutes. | Do not lift weights. This can also increase complications. |
| Keep the wound clean. Rinse your mouth thoroughly with an alcohol-free mouthwash. Do not gargle. Turn your head from side to side and allow the mouthwash to flow over the wound. | Avoid eating foods that are hard, dry, or spicy, as these can interfere with wound healing. |
| Brush your other teeth thoroughly, but don't brush the area where the wound is. | Avoid alcohol and carbonated drinks (like cola). These can also cause blood clots to break loose. |
| Take all medications prescribed by the doctor (painkillers, antibiotics) at the right time and for the right amount of time. |
How long does it take to heal? What day is the most painful?
It usually takes a week or two to fully recover, but most people can return to normal activities (school, office) after 3-5 days .
Many people may experience a little more pain and swelling on the third or fourth day . This is normal. After a few days, the pain and swelling should gradually decrease.
But remember, if the pain and swelling do not subside after four days and instead increase, definitely talk to your doctor. It could be a sign of an infection.
When should you talk to the doctor?
If you have any of the following symptoms, call your doctor immediately.
- Fever higher than 38.8 degrees Celsius (102 Fahrenheit).
- Uncontrollable heavy bleeding.
- Severe pain that doesn't subside even after taking painkillers.
- Difficulty breathing or swallowing.
- If the swelling does not go down after three days and even increases.
- If something like pus comes out of the wound.
Take-Home Message
- Wisdom tooth removal is a very common and safe surgery performed all over the world, so don't be unnecessarily afraid of it.
- This is often done as a measure to prevent future tooth decay, gum disease, and other complications.
- To recover quickly and well after surgery, it is extremely important to follow your doctor's instructions exactly .
- If you have any questions about the surgery, don't be afraid to ask your doctor.
- If the pain or swelling does not subside or increases after a few days of surgery, do not ignore it and seek medical advice immediately.
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