Nobody knows why we have wisdom teeth, but the fact of the matter is that most of our young people simply do not have enough room for those particular teeth. They are the last teeth in the mouth to form, and they get crowded out by the other teeth. We call this condition, “impacted wisdom teeth.”
Even in a healthy young person with a clean mouth, the wisdom teeth usually do not have enough room to fully erupt into a position that allows brushing, flossing, and cleaning like the other teeth toward the front. It's simply impossible to reach them because they are partially or completely buried under the gum and bone. Infection and decay develop.
Unfortunately, in the case of wisdom teeth, it means decay and gum disease on the teeth in FRONT of the wisdom teeth. If left unchecked, this will result in loss of those teeth. It sometimes means the development of a cyst or tumor around the impacted wisdom tooth that would damage the entire jaw.
When the skeletal growth of the child nears maturity in the early teens, a panoramic x-ray should be taken to determine if space is available for the wisdom teeth. If the answer is no, then the wisdom teeth should be removed before the roots get too long.
Long, crooked roots on wisdom teeth can cause significant complications during surgery. These include injuries to the sinus cavity, the sensory nerve of the lower jaw, and the adjacent teeth. The risk of these complications goes up with age simply because of the developed root structure. If the wisdom teeth are removed before the roots develop, the chance of complications is much less. Your oral surgeon will address these issues in great detail. This is an important part of the before-surgery consultation.
Most wisdom tooth surgery is performed under a light general anesthetic in the oral surgeon's clinic. Oral surgeons are specifically licensed by the Sate of Tennessee to administer anesthesia because of their extensive training. A brief, controlled exposure to a general anesthetic for this difficult procedure is most appropriate, and we at OSST strive to make this experience a safe and painless one.
Safety is key, and the patient should come for the surgery with a completely empty stomach. That means no food or drink for at least 6 hours before the procedure. The surgery will be cancelled if this critical issue is not in compliance.
Our anesthesia is delivered with an IV because the dosage of medicine can be carefully controlled, and the IV is the method of choice in administering emergency drugs. Our nurses work hard to allay apprehension, and they use numbing medicine on the skin prior to the IV. Once the IV is in place, the sedative is quickly given. After the patient is asleep, the local anesthesia numbing medicine is administered so that the dose of general anesthetic is lessened, and the recovery from the surgery will be free from pain.
Please refer to our section on after-surgery care, but for wisdom tooth surgery, keeping the person quiet, iced, and propped-up is the name of the game.
Pain control is best utilized in a preventive manner, so the patient should be given a non-narcotic pill as soon as they get home and before the numbing medicine wears off. Thereafter, if the patient needs it, give the narcotic. Please be aware that the narcotic pain pills are notorious for causing an upset stomach, so use them as needed. We also prescribe medicine for nausea along with our other post op medicines.
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