Questions About Wisdom Teeth

Third Molar Answers from Dr. Won

Below find questions from people about wisdom teeth and the removal procedure and the answers that Dr. Won provides. For assistance or to schedule an appointment, please call our Raleigh Oral Surgery office: POMS Facial Surgery Brier Creek Medical Building Phone Number 919-293-0299.

How much will it hurt to get 4 wisdom teeth pulled out?

Depending on difficulty of them. On average most patients take high strength pain pills for about two days after surgery then switch to lesser medicine such as ibuprofen.

Is it normal to feel pain in my jaw after almost 3 months of recovery from a wisdom tooth extraction?

Definitely not normal. I recommend going back to original surgeon and do work up for osteomyelitis and other source of pain.

Why am I still in pain 7 months after my wisdom tooth was removed?

This is not usual. 7 mo is very long time. Hope that you’ve had follow up with your original surgeon on regular basis. Osteomyelitis and other source of pain should been ruled out many months ago.

Why are my stitches falling out after removing my wisdom teeth?

Most surgeons today use dissolving suite material. They are designed to fall out after few days.

Can impacted wisdom tooth cause clenching and dizziness?

Not directly. However there are high percentage of patients who described symptoms you’ve mentioned here that resolved after removal of wisdom teeth.

Why is only one section of my mouth/lips (lower left not including the tongue), still numb 12 hours after wisdom teeth removal but the rest of my mouth is not?

This is not abnormal at this stage. It would be more of concern if this asymmetric symptoms persist more than 2 weeks after surgery. But I would anticipate that your symptoms will gradually improve.

Can I travel after my wisdom teeth removal?

Yes you can. If you are traveling by car I wouldn’t recommend driving if you are taking pain medication. If you are flying I recommend taking Advil about 30 min prior go flight. However if you are planning on very long flight you should at least recover for a week.

What should I do if one of my wisdom sutures come out in the first 3 days?

It should be okay if it’s third day from surgery. Socket under it should be granulating. Unless you have increased pain. Then we need to suspect it’s acute alveolitis (dry socket).

Is it ok to keep a broken lower wisdom tooth if there is no infection? Will the root fall out on its own?

No. It needs to be removed. It will get infected.

What is the procedure to get rid of quite a large pericoronitis that’s covering the wisdom teeth and how long does it take to heal?

Definite way is to remove the wisdom tooth. Procedure that just remove the pericoronitis (Operculectomy) is simple but temporary.

Can I take Tylenol 3 with ibuprofen 800 at the same time? I got my wisdom teeth pulled today and I’m in excruciating pain.

Short answer is yes. They are two different class of medicine and metabolized in two different partway. However few things needs to be considered.

800 mg of ibuprofen is high dose even for an adult. If you are smaller adults or someone skinny or someone with any kidney issues, it’s not recommended to take such high dose more than few days isn’t recommended.

Tylenol 3 contains acetaminophen. Also at high doses it can strain the liver or very worst case scenario can cause liver failure.

Have that in mind and take medicine judiciously.

The wisdom tooth on my top left is erupting and there’s a loose gum flap. What should I do?

If there is one coming through there might be more. Have a panoramic X-ray and see what other wisdom teeth are doing and if they are erupting correctly. What to do next is based on how they are erupting. That’s big picture.

For the loose guy flap you have now, just keep it clean with brushing and oral rinse. It shouldn’t be a big issue for the most part.

What did people do with wisdom teeth before modern dentistry?

Good question. I get asked that same question a lot. Us humans had larger jaws in the past. Natural selection favored larger jaw because diet and larger chewing muscle based on dietary habit. Modern humans have much smaller jaws compared to past. When you have larger jaw it will accommodate third molars (wisdom teeth) and they don’t typically give any issues. So yes in the many thousands years ago, wisdom teeth rarely caused any issues. More toward modern era before dentistry people had serious problem due to dental infections. Sometimes fatal as seen in some of Egyptian mummies. Dentistry came a long way. Visit your dentist regularly!

Why do I have a numb tongue after a wisdom tooth removal?

Most typical cause of numbness of tongue is due to inflammation after surgery. Along with facial swelling, all the internal parts of the area surgery was done will temporarily swell or also described as inflammatory process. As nerve tissue goes through inflammatory process, it’s function is temporarily affected.

Rare but common cause of numbness of the nerve that give sensation to tongue (lingual nerve) is injury caused during injection of local anesthetics. Since clinicians cannot see whats under the gum, injection is based on landmarks. However, not everyone’s nerve runs at typical location and you may have abnormal position of lingual nerve and may get traumatized during the injection. However, it’s usually has long term effect. Patient usually achieve full recovery.

Very rare cause of numbness of lingual nerve is actual surgical trauma. This is extremely rare case. Nerve can be potentially damaged during removal of wisdom teeth. However, because of location of the nerve, it’s very rare that somehow it can be damaged during surgery with modern technique. I don’t recommend you lose sleep over this one. It’s extremely rare.

Typically numbness will last days to few months. As long as there are small increments of improvement, prognosis of full or close full recovery is very good.

How did you heal pericoronitis without going to the dentist?

Pericoronitis is caused by the flap of tissue that partially covering the erupting third molar (wisdom teeth). It straps food and bacterial and that leads to intense inflammation and sometimes infection. Depending on the depth of the pocket created by the flap of tissue, sometime it’s very difficult to clean out the pocket. Majority of the cases will require your doctor to either remove the flap (operculectomy) or have that involved third molar removed.

If it was healed spontaneously without above mentioned process, then it is likely that the pocket was very small or the inflammation was minor enough that it resolved itself.

Is it safe for my dentist to pull all four of my wisdom teeth on the same day?

Real question is what is the risk and benefit of getting all done versus doing it on multiple occasions. Benefit of getting all done at one time is that you are done after that. Potential risk of getting all four done at the same time is “perceived” risk of too many were done. But millions of case studies has shown that getting all four out is very well tolerated and heals at about same time as if you were to get one done. Therefore, argument “for” getting all four done is that you are over it after one surgery.

Benefit of getting one at a time is that surgical site is limited to one site and it’s easier to take care of. You can eat on the other side with normal food sooner. But the argument against would be now you KNOW you have to get another surgery done in the future. Another surgery means there are risk for surgery all over again: extensive bleeding, numbness for lower wisdom teeth, infection etc. Also later means you are older. This kind of surgeries are better tolerated at younger age than older.

However, one factor didn’t mention was cost. It is very real and very important. If cost is an issue, getting one out that is hurting really bad and doing the rest later is perfectly good decision.

What happens if the stitch, above my wisdom teeth removal site fell off with the gum attached to it? It left a hole.

It should be okay since sockets heal inside out. However be mindful since food debris can fall into socket. Make sure to rinse your mouth out after meal. But incision will close in few days and you shouldn’t have to rinse long term unless you want to continue do it for hygiene purposes.

Is it normal for my dentist to have taken my second molar out because my impacted horizontal growing wisdom tooth decayed it but left wisdom tooth partially erupted growing into extraction site?

I wouldn’t say it’s normal. Horizontally impacted wisdom tooth rarely (if not ever) grow into normal position into second molar position. It will require orthodontic intervention to move and upright the tooth in the correct position. There are just too many variables including: unpredictable duration of uprighting process and chances of resorption of roots.

Typically, it’s better to remove both infected second molar and impacted third molar first. Then place implant once the socket heals.

What can you eat 3 days after having 4 wisdom teeth extracted?

It all depend on how difficult it was and how big the incision. But typically by third day after surgery you can eat almost all normal food except crunchy food such as chips. Hope your surgery goes well!

I’m 14 and I have 28 teeth and there is not enough room for any other teeth. Will I have to extract my wisdom teeth once it appears or will my mouth expand to accommodate new teeth over the years?

Without radiograph my answer would be incomplete. However I can answer your question in parts.

For males there will be more growth of upper and lower jaw. Depending on individual amount may vary. However it’s safe to assume that overall size of jaw will grow. But it’s impossible to know if that’s enough to accommodate your third molars. Statistically speaking, typically expansion of jaw will not accommodate full eruption of the third molars.

By 16–17 years of age, your clinician would have a good idea if you have enough space or not. If there isn’t enough space it’s recommended to remove third molars. Furthermore there could be instances you may not have enough space for remaining 28 teeth. Sometimes orthodontists would recommend removing one premolars from each quadrant.

I recommend close follow up with your dentist and/or orthodontist. Hope this was helpful!

What are some homemade remedies for a wisdom tooth pain?

It’s all depends on what is causing pain. Generally pain can be due to inflammation from teeth erupting and due to infection. Inflammation can be mitigated moderately by using anti-inflammatory medicine such as Advil or Motrin. But if it’s due to infection there aren’t much you can do to make the pain go away. You could try to use combination of anti-inflammatory medicine and mouth rinse such as Listerine or Scope. Ultimately, once you start having pain, it will only going to get worse as time passes. I would recommend quick visit to local oral surgeon for x-ray and evaluation. Antibiotics can buy you some time in certain cases! Hope you feel better!

Can you work mere hours after a major wisdom teeth (all four) surgery?

There are different factors involved in choosing what to eat immediately after surgery: size of incision, difficulty of surgery, duration of anesthesia, amount of bleeding, presence of nausea/vomiting, amount of numbness, amount a patient can open and close mouth, etc etc.

Since these factors vary greatly we tend to give parent global recommendation. We typically discourage patients from eating solid food immediately after surgery. We recommend clear liquids, smoothies, or full liquid diet first day to avoid any complications due to food. Then we gradually increase the consistency of food next 3–4 days.

Of course there care many cases where patients eating normal food in same day and other extreme of not being able to do so for a week! But for the most part of you follow the generalized recommendation mentioned above you can assure that you’d avoid food or chewing related complication.

Hope this helps!

Will I say anything bad after I get my wisdom teeth out?

hi there,

it’s all depends on what kind of medication and how much medication were used in anesthesia. also, it’s depending your body’s tolerance to medicine and to a lesser degree, state of mind patient is in just prior to induction of anesthesia.

every surgeon has difference preference on anesthetic depending on their desired effect of medicine. there isn’t one standard way to do it. however, generally speaking benzodiazepine medications such as midazolam (versed) can induce patients to be talkative when they wake up. the effect is called disinhibition. so whatever you had it in mind, you would say that if you had higher dose of benzodiazepine. for example if you were happy mood but you were just little nervous before surgery, you gonna be laughing and giggling the whole time when you wake up. if you had some sadness or anxiety even before the surgery, you are likely to express that. if you were angry before surgery, you get the point…

but in general vast majority of patients are relaxed and happy after anesthesia regardless of which medicine. so i wouldn’t worry too much!

hope this helps!

What are some wisdom teeth removal infection signs?

Short answer is pain and swelling. However, incidence of infection from wisdom teeth removal is extremely rare now days. Less than 1%. Dry sockets and late inflammatory response from surgery and/or food impaction within the sockets are more likely reason for pain and swelling.

Typically, infection from surgery such as this takes about a week to show signs. Therefore, if you are showing signs of pain and swelling first week of surgery, it would be prudent to manage the symptoms and close observation. However, worsening pain and swelling after a week, immediate follow up is needed.

If it is indeed infection, patient may show signs of malaise, fever, chills, generalized fatigue in addition to pain and swelling. Professional attention is needed for proper management.

When should you consider getting wisdom tooth removed?

There are two main reasons to consider removal of wisdom teeth. By far most common reason is pain due to infection. Wisdom teeth are last teeth to erupt and commonly we do not have enough space therefore it can trap food and bacteria. Due to it’s far back position also it’s very difficult keep them clean if not impossible. If there are enough food debris and bacteria accumulates around wisdom teeth it can cause local inflammation and/or infection which leads to pain. In order to permanently prevent from pain from occurring again, it is recommended to remove them.

Second main reason is prevention of wisdom teeth from pushing other teeth and causing crowding. Modern human jawbone isn’t big enough to accommodate widsom teeth’s full eruption. They are competing for space in the jawbone. Especially with patients who have had braces in the past because of crowded teeth, these pushing from wisdom teeth can cause relapse of the crowding of teeth. Especially on the bottom front teeth. Patients who does not enough space for wisdom teeth (this can be easily evaluated by your doctor via Pan-Tomogram X-ray or Cone Beam CT scan) it is strongly recommended to have them removed before crowding occurs.