Patient Instruction Tooth Extraction / Surgery

1. General Information

   Wisdom tooth Surgery  is a procedure to treat impacted wisdom teeth that are either still beneath the gums or have partially erupted but not fully. This process is more complex, time-consuming, and generally more expensive. Typically, stitches are required to close the wound, and patients must return for suture removal as scheduled by the dentist.

Wisdom tooth removal is for fully erupted wisdom teeth. This procedure is quicker, less costly, and does not require stitches to close the wound.

When Should You Consider Wisdom Tooth Surgery?

            Most people have four wisdom teeth, with two on the upper jaw and two on the lower jaw, typically emerging between the ages of 17 and 25. However, some individuals may have no wisdom teeth at all, or more than four, depending on various factors such as jaw size, dental abnormalities, or genetics. While some patients may experience no symptoms, others may exhibit the following:

• Pain, swelling, and possible bleeding in the gums due to periodontal disease.
• Swollen gums, sometimes extending to the cheeks or jaw, as a result of inflammation or infection.
• Jaw pain.
• Tooth decay, as brushing and flossing become more difficult.
• Abnormal taste and bad breath due to trapped food particles in hard-to-clean areas.
• Difficulty or pain when opening the mouth, especially if the inflammation spreads outside the mouth.

2. Purpose of the Procedure/Treatment

• Gingivitis: Food particles easily get trapped around the wisdom teeth, leading to inflammation.
• Tooth Decay: Difficulty in cleaning makes wisdom teeth prone to cavities.
• Cyst Formation: Cysts around wisdom teeth can damage the surrounding gums and bone.

3. Advantages of  the Procedure/Treatment

• Pain Relief: Eliminates pain from various causes.
• Infection Control: Removes oral bacteria, preventing facial infections.
• Cavity Prevention: Reduces the risk of tooth decay.

4. Potential Consequences of Not Undergoing the Procedure/Treatment

• Gum Inflammation: The gum covering the partially erupted wisdom tooth can easily trap food particles, leading to inflammation. This can complicate breathing and pose a life-threatening risk.
• Tooth Decay: The close and abnormal positioning of the wisdom tooth and the second molar makes cleaning difficult, allowing food particles to accumulate and cause decay in both teeth.
• Bone Loss: The pressure exerted by the emerging wisdom tooth can destroy the surrounding bone near the roots of adjacent teeth.
• Cyst Formation: Wisdom teeth can cause cysts, which can expand and damage neighbouring teeth and surrounding bone.
• Bad Breath: Inflammation, tooth decay, and trapped food particles can lead to bad breath, making wisdom teeth a primary cause of halitosis and affecting personal image.

5. Pre / Post Care

Before Wisdom Tooth Surgery

• Follow your dentist’s advice regarding any medications you should stop or continue taking. Inform your dentist of all medications you are currently taking, especially those affecting blood clotting.
• If you are on blood thinners, discontinue them as instructed by your treating physician prior to the surgery.

 Treatment Procedure

• The dentist conducts a thorough examination and devises a treatment plan, often supported by X-rays, to confirm the treatment approach. The specific teeth to be extracted are clearly identified and discussed with the patient or their relatives.
• Local anesthesia is administered to the area around the tooth to be extracted. The anesthesia usually takes effect within 5 to 10 minutes.
• The extraction or surgical procedure is performed according to the predetermined treatment plan. In cases where extraction is difficult, surgical instruments may be used to assist. After extraction, the patient is instructed to bite down on gauze to control bleeding.
• If there is significant bleeding after the extraction or surgery, or if the gums are movable, or if there are abnormalities in blood clotting, additional measures may be taken to control bleeding. This may include the use of hemostatic agents along with suturing of the wound. The patient is instructed to bite down firmly on gauze or may require the application of specialized instruments and materials to assist in achieving hemostasis.
• After the procedure, the patient is provided with pain relief medication, and in some cases, antibiotics may also be prescribed.
• The dentist provides guidance and instructions for post-operative care and follow-up appointments to ensure proper healing and recovery.

Post-Extraction / Surgery Care Instructions

• Bite down firmly on the gauze pad for 1 hour after the extraction. Avoid talking or chewing on the gauze.
• If bleeding continues after removing the gauze, place a new gauze pad on the extraction site and bite down firmly for another 30 minutes.
• Do not rinse or spit forcefully for 24 hours after the extraction. Brush your teeth gently after meals and before bedtime, being careful to avoid the extraction site.
• Apply a cold compress (ice wrapped in a cloth) to the outside of your mouth near the extraction site for the first and second days to reduce swelling. Do not suck on ice.
• On the third day, switch to a warm compress (a cloth soaked in warm water and wrung out). Swelling should subside within a week.
• For the first week post-extraction, rinse your mouth gently with salt water (½ teaspoon of salt in a glass of warm water) after meals and before bed. Eat soft foods and avoid spicy or very hot foods.
• Avoid using the side of your mouth where the extraction was done until the wound has healed. Refrain from strenuous exercise and water sports that could increase the risk of infection.
• Medication : 
• Take pain medication as prescribed: 1-2 tablets as needed for pain.
• If prescribed antibiotics, complete the entire course as directed.
• Return to the dentist as scheduled (usually 1-2 weeks) for suture removal and to check the healing progress of the extraction site.