If you’ve been on the internet long enough, you’ve seen a video or two of someone post-wisdom tooth removal acting hilarious. And while the post-sedation funnies are always a good time, it got us thinking: what is it like to get your wisdom teeth removed these days? We tapped expert cosmetic dentists to learn the ins-and-outs of this critical oral surgery to learn what the process is like, what you can expect after the sillies wear off and what’s new in the world of wisdom teeth.
Featured Experts:
- Guy M. Lewis, DDS is a cosmetic dentist based in Houston
- Husam Almunajed, DMD is a cosmetic dentist based in New York
- Joseph Field, DDS is a cosmetic dentist based in Los Altos, CA
What Are Wisdom Teeth?
Losing more teeth after you’re out of middle school is usually a bad sign, with one major exception.
“Wisdom teeth are your third molars, or the teeth that develop behind your second molar tooth in each side of your mouth,” explains New York cosmetic dentist Husam Almunajed, DMD. “They usually peak in around the ages of 17 to 25, and that is why they are called wisdom teeth as they come during the ‘age of wisdom.'”
Most of us will have four wisdom teeth, but it isn’t uncommon for people to have more or even none at all.
“We normally start looking for them to grow in between ages 16 and 18,” agrees Los Altos, CA cosmetic dentist Joseph Field, DDS. And that process, while we’ve made advancements in surgical technique and recovery, is still a surgical extraction process. Depending on the state of the tooth, it could be very complicated to remove.”
They tend to cause problems due to one main factor: a lack of space in our mouths.
“These teeth are known for being problematic because they tend to move other teeth during development by coming in crooked or possibly becoming ‘impacted,'” explains Houston cosmetic dentist Guy M. Lewis, DDS. “Impaction is a phenomenon whereby a tooth becomes so crammed within its socket that normal eruption is made difficult or impossible.”
Do They Have to Get Removed?
Not everyone will get their wisdom teeth removed, but a lot of us will. According to the American Association of Oral and Maxillofacial Surgeons, about 90% of people will have an impacted wisdom tooth that needs removal.
“A tooth that is fully impacted by bone and fully entombed can be left alone in some people for a long time,” Dr. Field explains. “It’s when they start to erupt that they become a problem.”
Impaction happens because our mouths are just too small to hold all our teeth. The crowding has an effect on the development of wisdom teeth, resulting in teeth that are at the wrong angle.
“Because impacted wisdom teeth don’t always cause pain, it’s highly recommended that patients receive regular dental checkups during the ages of 17 and 25,” Dr. Lewis says. “A person could have problems without even realizing it, and if left untreated, there is a risk of infection or loss of jawbone. Other times an impacted wisdom tooth will become inflamed and can cause moderate to severe pain. This usually occurs during partial tooth eruption and it’s often chronic.”
Is it harder to get wisdom teeth removed as an adult?
You love hearing this answer as much as we love typing it, but it just depends.
“You heal faster as a child, definitely,” Dr. Field says. “But also if you wait until you’re an adult, the bone itself will be denser, which exacerbates the amount of trauma involved to get the teeth out. Also the roots would be fully developed, which is a much more challenging surgery.”
That said, it isn’t always going to be so complicated.
“A lot of the idea that this surgery gets harder when you’re older also has to do with your availability,” Dr. Almunajed explains. “Its usually when we have the most plans, or an important occasion occurring that the wisdom teeth discomfort creeps in and we need them to be extracted.”
Waiting as an adult for an eruption to occur and your wisdom teeth to start causing you problems may put your plans at risk.
“We just had a patient with a wedding in two days need to have wisdom teeth extractions,” Dr. Almunajed says. “Wisdom teeth pain always comes when you have important plans. This is why we always preach to have them extracted when you have free time and not wait too long.”
That said, if you are waiting to have your wisdom teeth removed, you’ll likely end up at the dentist when eruption occurs and the pain begins.
Getting Your Wisdom Teeth Removed
Your wisdom teeth can grow in long after you’ve left your teen years, and when they start to show in through your gums, it can get pretty painful. Eruption is the term for wisdom teeth pushing their way into our mouths. For a good rule of thumb, if you’re starting to feel pain, it’s probably time to see a dentist.
“I’ve definitely seen patients that have erupted and their wisdom teeth have grown in with no problems,” Dr. Field says. “But they are by far in the minority.”
Because of that overcrowding problem, leaving your wisdom teeth alone to grow in can cause changes in your bite, leading to discomfort and hygienic issues.
“They can cause discomfort or pain,” Dr. Almunajed says. “If they come into your mouth in a manner that do not align with the teeth in front of them, they can cause bite discomfort and jaw pain. And because the back of the mouth is an area that is hard to clean, gum disease may develop around the wisdom tooth that is erupting in a tight area that gets infected, causes inflammation and results in pain.”
“Of course, not all wisdom teeth erupt,” Dr. Lewis adds. “And even if they do appear, there is no guarantee that they will surface healthy as this depends on the condition of the surrounding gums.”
Is wisdom teeth removal easier if they are grown in?
These days, most removals are conducted by oral surgeons who specialize in wisdom teeth removal.
“When you do only one surgery a thousand times, you get really really good at it,” Dr. Field explains. “These surgeons are efficient and effective at removing wisdom teeth that are still developing, which is usually a straightforward surgery. They’re also able to remove wisdom teeth that are fully developed, which have full roots that can sometimes wrap entirely around a nerve.”
While your teeth are still developing, those roots aren’t buried nearly as deep in your jaw, making the surgery a lot simpler and easier to recover from. If you are older, the chances are that there will be more bone to remove, which means more trauma to recover from.
Keeping the procedure in the hands of an experienced oral surgeon can also benefit you during recovery.
“The surgery is easier on the patient when we have a qualified oral surgeon performing it. We have an oral surgeon in our office, who is skilled and talented for this surgical procedure,” Dr. Almunajed explains. “They have the best training, skills, and equipment to provide the best treatment and experience to the patient.”
How painful is wisdom teeth removal for adults?
If your wisdom teeth aren’t heavily impacted, you may not end up in that much pain at all.
Most of the time, wisdom teeth can be removed with little to no discomfort, and options of local anesthesia is given,” Dr. Alumanjed says. “We also offer an option to be sedated with IV sedation is a great option so you are not aware of the surgery.”
When it comes to heavily impacted teeth that need a lot of bone removal to extract, sedation may be the suggested option.
“Sedation is your friend for this surgery,” Dr. Field explains. “Most of the time, this surgery is performed under monitored sedation, which helps keep you still and safe.”
What to Expect After Wisdom Teeth Removal
Because pain after the surgery is common, you’ll likely leave with a prescription for pain relief medication, and you’ll see swelling for the first few days. After your stitches are removed, you may experience lingering jaw pain for roughly a week as you finish healing, with any bruising resolving within two weeks.
“Following surgery, you may experience some swelling and mild discomfort, which is the body’s normal healing process,” Dr. Alumanjed explains. “Everyone is different, and some people swell a lot, and some people do not swell at all. Cold compresses may help with swelling, and pain medications will help with the discomfort. In addition, ice cream does wonders for the day after.”
Luckily, his bridal patient didn’t need a long time to recover, and was able to make her wedding with no visible swelling.
“Our patient was very lucky, she had her wisdom tooth removed as an emergency appointment with our oral surgeon, and she was ready for her wedding with one day to spare,” Dr. Alumanjed says. “Ice cream and ice packs helped in preventing swelling, and she was able to be a happy wedding day with no pain.”
What are Dry Sockets?
There’s one major part of wisdom teeth extraction recovery that we still have to touch on, and that’s dry sockets.
In the first 24 hours after your surgery, a blood clot is going to form in the spot where your tooth used to be. That blood clot is essential to the healing process.
“A dry socket is when that blood clot becomes dislodged,” Dr. Field says. “Which exposes raw bone and nerves.”
And yes, you guessed it, that’s painful.
Preventing Dry Sockets
Anything that can dislodge that blood clot is a bad idea when you’ve just had a wisdom tooth removed. That includes any kind of suction like using a straw, spitting and smoking.
“This happens when you spit or use a straw after an extraction, the negative pressure takes out the healing clot of the area,” Dr. Alumanjed explains. “Smoking also causes a dry socket as it inhibits the area to heal. Not smoking for at least two weeks after an extraction, and no spitting and not using a straw for two days always helps greatly in preventing a dry socket.”
Your dentist can also help prevent them by using a collagen graft.
“A lot of surgeons will use a collagen graft to add volume and maintain the matrix of the clot,” Dr. Field says.
