Your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:
- Local anesthesia. Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You're awake during the tooth extraction. Although you'll feel some pressure and movement, you shouldn't experience pain.
- Sedation anesthesia. Your dentist or oral surgeon gives you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don't feel any pain and will have limited memory of the procedure. You'll also receive local anesthesia to numb your gums.
- General anesthesia. In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You'll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.
During wisdom tooth extraction, your dentist or oral surgeon:
- Makes an incision in the gum tissue to expose the tooth and bone
- Removes bone that blocks access to the tooth root
- Divides the tooth into sections if it's easier to remove in pieces
- Removes the tooth
- Cleans the site of the removed tooth of any debris from the tooth or bone
- Stitches the wound closed to promote healing, though this isn't always necessary
- Places gauze over the extraction site to control bleeding and to help a blood clot form
After the procedure
If you receive sedation anesthesia or general anesthesia, you're taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.
As you heal from your surgery, follow your dentist's instructions on:
- Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don't dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
- Pain management. You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist or oral surgeon. Prescription pain medication may be especially helpful if bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.
- Swelling and bruising. Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
- Activity. After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.
- Beverages. Drink lots of water after the surgery. Don't drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don't drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
- Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
- Cleaning your mouth. Don't brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you'll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
- Tobacco use. If you smoke, don't do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don't use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
- Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.
When to call your dentist or surgeon
Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:
March 31, 2015
- Difficulty swallowing or breathing
- Excessive bleeding
- Severe pain not relieved by prescribed pain medications
- Swelling that worsens after two or three days
- A bad taste in your mouth not removed with saltwater rinsing
- Pus in or oozing from the socket
- Persistent numbness or loss of feeling
- Blood or pus in nasal discharge
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- Coulthard P, et al. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004345.pub2/abstract. Accessed March 9, 2015.
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