Smera Clinic - Extraction of wisdom Teeth

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The last teeth to develop and erupt into the jaws are called the third molars. Third molars usually erupt in the late teen years, which coincides with passage into adulthood and is referred to by some as the age of wisdom; hence "wisdom teeth".

What are indications for extraction / removal of a tooth?

Wisdom teeth used to serve a useful purpose, but are now considered vestigial organs. A vestige is a degenerative or imperfectly formed organ or structure which no longer performs a useful function.

Wisdom teeth have become "outdated" for many reasons. Our ancestors' diet was made up of far coarser food than our own and a lack of hygiene meant that impurities such as dirt and sand were consumed regularly.

This caused teeth to abrade significantly which meant they took up less space in the jaw.

Permanent teeth were also frequently lost at an early age, which would create more space in the jaw. Due to the coarseness of the food it was harder to chew and the jaw itself would develop into a larger bone as it was working much harder. All of these factors would create more space for the wisdom teeth when they came in.

Unfortunately, the wisdom teeth are now usually trying to erupt into a jaw that is too small. The heavily processed diet of today does not produce the tooth abrasion or jaw development that we used to see. Modern dentistry has pretty much eliminated significant loss of permanent teeth at an early age. This leaves us with too many teeth and not enough space in the jaws. As a result of this these teeth errupt tilted or sometimes placed horizontal in the jaw. As there is no space in the jaw these teeth are mostly Impacted in the jaw bone.

Wisdom teeth serve no useful function and will often cause damage because when a wisdom tooth becomes partially exposed through the gums it cannot be cleaned properly and can collect food debris, bacteria and plaque around itself. This can result in tooth decay, gum disease, infection and abscess of not only the wisdom teeth, but of the nearby molars and surrounding gum tissue. The molars in front of the wisdom teeth are sometimes lost because of cavities and gum disease caused by the inability to clean the wisdom teeth properly. Cyst formation and other destructive pathology are also seen around impacted wisdom teeth. There may be pain and swelling, or you may have no symptoms at all, even though the other teeth in your mouth may be at risk of damage.

If removal of the wisdom teeth is necessary, the procedure is recommended in the late teenage years, before the roots are completely formed. Surgical procedures in general are better tolerated when one is young and healthy, and the gum tissues tend to heal better and more predictably when young. Most people experience minimal disruption of their normal routines, and time off from work or school is usually minimal. At this point it is worth noting that the removal of wisdom teeth can be of great benefit to your ultimate oral and general health.

Wisdom teeth can be extremely problematic and more often than not I advise patients to have their wisdom teeth removed. However, not everyone has problems with their wisdom teeth. If you're genetically lucky, the jaws are long enough to accommodate the wisdom teeth in a proper erupted position. In this position, if they can be kept clean, they may be used.

Is extraction of teeth a painful procedure?

No it is not a painful procedure. Various pain management procedures need to be taken care of before & after the extraction to minimise discomfort.
Prior to extraction it is always advisible to start a course of antibiotics & analgesics to minimise the infection thereby minimising pain.
Also the area is anesthetised with a local anesthetic before the procedure thereby making it a relatively painless procedure.
However post-extraction care is required.

What are the post - extraction instructions?
  • Do not spit or talk for half an hour after the tooth has been extracted.
  • Allow the cotton to remain there for half an hour after that dispose the cotton off and do not replace it with a new cotton. Apply ice from outside, i.e. externally in the area where the tooth was extracted.
  • Do not eat for half an hour. After an hour also restrict your diet to something soft and cold for atleast that day.
  • Continue your prescribed medicines (The Antibiotic and Pain Killer) for two more days.
  • In case of any kind of allergic reaction to the prescribed drugs immediately discontinue them and consult your Physician or call us up.
  • Minor Bleeding can be anticipated. Moderate to severe bleeding needs to be reported to us.
  • Minor Swelling and Discomfort can be anticipated for a Day or so.
  • In case of any serious problem or undesirable.