Wisdom Teeth Removal

We take great pride in the way we treat patients who require wisdom teeth extraction. Although the Canadian and American Associations of Oral and Maxillofacial Surgeons (CAOMS & AAOMS) consider the best time for removal of impacted and unerupted teeth to occur between the ages of 15 and 25, wisdom teeth removal is an important part of preventive dentistry at any age. Waiting for impacted and unerupted teeth to cause pain or complex clinical complications results only in more extensive and costly treatment. Our patients report excellent recovery rates following tooth removal.

What are wisdom teeth?

Third molars, better known as “wisdom teeth”, are the third set of teeth, usually the last teeth in the back of the mouth, that in some people don’t have enough space to come out completely and can stay partially or completely in bone. They are also very often in inappropriate positions which can cause problems such as difficulty with oral hygiene, caries, periodontal problems, pain, and infections.

Why should you have your wisdom teeth removed?

Third molars which are impacted (unable to erupt normally) can interfere with adjacent teeth and other facial structures. For example, a wisdom tooth has the potential of pushing on the roots of the adjacent tooth, often causing significant problems. They can also be the cause of abscesses, gum infections (pericoronitis), as well as other lesions such as cysts.

When should you have your wisdom teeth removed?

Wisdom teeth typically start erupting around age 16. When a third molar has been identified as potentially problematic, it is best to have it removed sooner rather than later. This timing serves two main purposes. Firstly, we want to make sure the roots are not fully formed to minimize any damage to the sinuses or the inferior alveolar nerve. Secondly, younger patients tend to recuperate more easily and at a faster rate.

We will be happy to explain wisdom teeth extraction procedure to you in detail, call us today for further information!

Instructions

What to expect when having your wisdom teeth removed?

We strive to make all our procedures as comfortable as possible.

  1. After the initial consultation visit with the surgeon, a convenient appointment is scheduled for the procedure.
  2. In the vast majority of cases, the removal of wisdom teeth is an outpatient procedure which can be performed under local anaesthetic only, or with the possibility of intravenous sedation to help patients relax if they are anxious.
  3. After the procedure, the patient is allowed to go home and is encouraged to be at rest for about 48 hours to minimize swelling and ease their recovery.
  4. During that time period, analgesics (pain medication) and other appropriate medication will be prescribed and available to the patient should they require it.
  5. Verbal and written instructions are given to all patients.
  6. A follow-up appointment is typically given 7 to 14 days after the procedure to ensure normal healing and clean the area as needed. At this appointment, a syringe is given to patients to wash out food debris until the sockets close.

Pre-Op Instructions

Pre-operative instructions with intravenous sedation

Intravenous sedation is a technique of administering medications through a vein to help relax you and reduce discomfort. This is done without putting you completely to sleep. It is most important that you follow the instructions below very closely.

  1. The meal before your appointment should consist of light food and fluids such as broth, tea, or Jello, and should be taken no less than 6 hours prior to your appointment. Do not eat meat, fried or fatty foods. You may drink clear fluids (water, fruit juices, carbonated beverages, clear tea, and black coffee) until 2 hours before your appointment.
  2. If you are given medication to take before your appointment, it should be taken with a small amount of water, one hour prior to the appointment.
  3. Do not take other medications on the day of surgery without checking with your surgeon. Let us know of any changes to your health status or your medications before your appointment.
  4. It is advisable to wear loose-fitting clothing to make you more comfortable. Short sleeve shirts or blouses are necessary, so we can see your arm for monitor placement and intravenous access.

After your appointment the medications used will still be in your system. The following precautions should be followed:

  • You MUST be accompanied home in a car or taxi by a responsible adult who will stay with you for the remainder of the day. No public transportation.
  • Change position slowly. Sudden standing or sitting up may cause dizziness.
  • No driving or operating machinery for the rest of the day after surgery.
  • No alcoholic beverages for 24 hours.
  • Rest at home with your head slightly elevated for the rest of the day.

If you follow these guidelines along with your surgeon’s post-operative instructions, you will find the procedure will go smoothly and comfortably.

Post-Op Instructions

Post-operative instructions

The following instructions have been compiled to assist you in the post-operative period. If you follow these guidelines, your recovery will be more comfortable.

  • After this surgical procedure, there is often swelling of the face and sometimes bruising of the skin. This is normal. An ice pack applied to the area (30 minutes on and 30 minutes off) for 48 hours will keep swelling to a minimum. Maximum swelling usually occurs within 24 – 48 hours after surgery. Swelling can persist for 7 to 10 days. If the swelling resolves but then returns, you should contact our office.
  • Eat a light diet for the first two days; e.g. yogurt, soup, jello, milk drinks, etc. and then progress to a more normal diet. Avoid hot foods and do not use straws for the first 48 hours after surgery, as this may cause bleeding.
  • Rest for the remainder of the day following your operation and keep your head slightly elevated.
  • Refrain from smoking.
  • Some bleeding is normal for the first 24 – 48 hours. If bleeding is heavy, use gauze squares folded in 4 and apply firm pressure to the bleeding area by biting on the gauze for 20 minutes. Do not spit for the first 72 hours following your surgery, as this tends to cause bleeding.
  • Gentle tooth brushing can be resumed the day after surgery. Do not brush the area of surgery until your next appointment with your surgeon.
  • It is important to keep your mouth clean. Starting tomorrow, a saltwater rinse (1 teaspoon salt in 1 glass of warm water) should be used twice a day after eating (ex: after your breakfast and before going to bed).
  • If necessary, the doctor will have prescribed medication to be taken for relief of discomfort. The instructions for taking this medication will be on the bottle. Please follow them carefully.
  • You will be given a follow-up appointment to check the healing, if necessary. If your surgery was performed at the hospital, please call the office the following day to arrange this appointment.
  • Dissolving stitches are used for most operations. It is normal for these to begin to fall out after 3 – 4 days.

If you have any questions or problems, please call our office (514-486-1002) and we will be pleased to help you. Outside of business hours you can contact the oral surgery Resident on call at the Montreal General Hospital ((514) 934-8075 or (514) 934-1934 extension 53333). It is very important that you ask to speak to the oral surgery resident on call at the Montreal General Hospital.