n left untreated, periodontal disease, which affects the hard and soft tissues supporting your teeth, can lead to gingival pocket formation, gum recession, and diminishing alveolar bone. As advanced and untreated gum disease progresses, the teeth ultimately loosen, fall out, or require extractions.
Poorly positioned, impacted, or decayed wisdom teeth
Wisdom teeth, which are also known as the third molars, are the last permanent teeth to develop in the oral cavity and the final ones to come into place. However, as is often the case, many wisdom teeth do not have sufficient room to erupt, are not developing correctly, develop extensive decay, or cause issues for the adjacent teeth and the surrounding tissues. Although the extraction of wisdom teeth sometimes gets recommended for an older patient, the early removal of troublesome or potentially problematic third molars in young adults is more often the case.
A tooth size to jaw size discrepancy often results in a crowded and misaligned smile. More simply put, the upper and lower jaws are not large enough to accommodate all the permanent teeth. As part of an orthodontic treatment plan to optimally align teeth and establish an attractive, healthy, and functional bite, the extraction of select permanent teeth may be required.
At the time of the extraction, your doctor will numb the tooth and surrounding areas with a local anesthetic. Once you are completely numb, we will wiggle the tooth and use an ultrasonic tool to widen the ligament space within the bone for gentle removal. During this process, you will feel pressure but not pain. If you are anxious about having your tooth extracted, please let your provider know, who may discuss an anxiety alleviating medication to help you feel relaxed and comfortable during the procedure. We also recommend to bring some headphones along with your favorite playlist to put you most at ease!
Once your procedure is complete, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for at least 45 minutes after the appointment. Do NOT talk. Do NOT spit. If the bleeding or oozing still persists, change the gauze when it becomes saturated or every 2 to 3 hours. When the bleeding stops, the gauze may be removed. A small amount of ooze (bloody saliva) is normal for the first 24-48 hours. Hint: cover your pillow with a towel to prevent blood stains.
After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, smoke, use straws, spit, drink alcohol or brush teeth next to the extraction site for 72 hours. Also, avoid heavy exercise. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.
Warm salt water rinses (1 tsp./6 oz. water), 3-4 times per day, beginning the day after your surgery will aid in healing. Do not rinse or spit forcefully.
After the tooth is extracted you may feel some pain and experience some swelling. Keep your head elevated (use some extra pillows) relative to the rest of your body. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum (Do not apply ice directly on the skin). Use the ice pack as much as possible for 24-48 hours (30 minutes on and 30 minutes off). Stop using ice after 48 hours. Start utilizing heat on the 3rd day. If you have a removable gel pack then place it in the microwave at 5 second increments until hot. Place gel packs into a sleeve or wrap to avoid injury and direct contact of the heat with your skin. Swelling usually peaks between 48 to 72 hours.
Take pain medications as prescribed for pain. Hint: Do NOT take any medication on an empty stomach especially pain medications. Usually pain is greatest after the local anesthesia wears off and gradually improves within the first 48 hours. Even if you have no pain whatsoever, it is recommended you take ibupro