Wisdom Teeth Extraction

Extracting Wisdom Teeth

wisdom teeth pasadenaFor many people, the best treatment for wisdom teeth is to remove them. This treatment helps prevent future dental problems and maintain a healthy mouth and smile.

Wisdom teeth can cause problems

Your last molars, called the third molars or wisdom teeth, typically begin to come in (erupt) during the late teens or early twenties. When they don’t have room to grow in properly, they are considered impacted. This can cause serious problems:

  •  A very painful infection, called pericoronitis, can affect a partially erupted wisdom tooth and the surrounding gums. This infection can spread into the face and jaw.
  • When a wisdom tooth tries to erupt at an angle, it can cause decay in the neighboring tooth. This happens because wisdom teeth are nearly impossible to keep free of plaque, and the area between the two teeth becomes a trap for the bacteria in plaque that cause tooth decay.
  • Additional bacteria in plaque cause periodontal (gum) disease, which may start near the wisdom teeth and spread throughout the mouth.
  • A fluid-filled sac called a cyst may develop around an impacted tooth. A cyst can destroy a great deal of bone in the jaw before it’s noticed.

Diagnosis and treatment

To determine if extracting wisdom teeth is right for your situation, we’ll do a thorough examination, which typically includes x-rays.

It’s often better to remove wisdom teeth early, while their roots are still small, even before the teeth have come in through the gums. This allows for easier removal, fewer complications, and faster healing.


wisdom teeth pasadenaAlternatives to Extracting Wisdom Teeth

 When we’re considering wisdom teeth, there are only two possibilities:
  • Keep them.
  • Remove them.

Keeping wisdom teeth
A few lucky people are able to keep their wisdom teeth and take proper care of them. In many cases, though, there isn’t enough room in the jaw for wisdom teeth to come in properly. When a tooth cannot come in properly, we call it an impacted tooth.

Removing wisdom teeth
Removing wisdom teeth is sometimes the best choice for keeping your mouth healthy. If you delay extracting a wisdom tooth that should come out, serious problems can result, including —
  • painful infection of the gums.
  • tooth decay.
  • periodontal disease.
  • destruction of the jawbone.

You should also know that it’s often better to remove wisdom teeth while their roots are still small. Early removal can make the procedure easier and the healing process faster. Sometimes this means that wisdom teeth should be removed even before they have come in through the gums. If you wait too long before having wisdom teeth extracted, the roots can grow around or close to a nerve in the jaw, which may then be damaged during extraction. This could leave your lip and chin permanently numb.

For all these reasons, we often recommend extracting wisdom teeth early to help you keep your mouth and smile healthy.

Will I need to have x-rays taken?

In order to diagnose and treat any problems involving the teeth or jaw, X-rays are necessary. If your dentist does not have current X-rays to forward to us with your referral, we can take X-rays here in our office.

If I’m a smoker, how long should I wait to smoke after surgery?

Smoking is harmful to the healing process and makes numerous complications more likely.  If you must smoke, avoid it for the first 48 hours after surgery. Consider a nicotine substitute in this short period: gum, patch.

When can I brush my teeth after surgery?

Teeth can be brushed immediately, being careful to avoid the surgical areas for the first day or so.

When can I take the gauze out that I was biting on when I left the office?

The gauze may be removed when you get home, to be replaced with new gauze if significant bleeding continues, or if it feels better to have gauze in place.  If the bleeding is not tapering off within a few hours of surgery, you should call the oral surgeon.  A small amount of blood on your pillow on the night following surgery is nothing to be alarmed about if there is no active bleeding.

Diagnosing Wisdom Teeth


Wisdom Tooth Extraction Procedure

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply.  Common sense will often dictate what you should do.  However, if you have a question, follow these guidelines or call our office for clarification.  Our number is:  626-304-3004.                                                                                           


FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

EXERCISE CARE:  Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.

OOZING:  Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

PERSISTENT BLEEDING:  Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.

SWELLING:  Swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen vegetables (such as peas) wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN:  Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, it will reduce the chance that nausea will occur. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

NAUSEA:  Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.

DIET:  Eat any nourishing food that can be eaten with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.


 MOUTH RINSES:  Keeping your mouth clean after surgery is essential. Use ¼ teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.

BRUSHING:  Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS:  You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

HEALING:  Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

 It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office where you had surgery. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern.

PLEASE NOTE:  telephone calls for narcotic (pain killer) prescription renewal are ONLY accepted during office hours.