Having Your Wisdom Teeth Taken Out
The scope of this article is to look at the operation to remove your wisdom teeth and the means of making a quick recovery from having your wisdom teeth or tooth removed underlocal anaesthetic.
I have just had my lower jaw wisdom teeth removed (I have none in the top jaw) so it seemed particularly pertinent to look into how best to recover from this small operation.
You will only be referred to have your wisdom teeth taken out if they are causing pain, are regularly becoming infected or are impacted - i.e. growing at an wrong angle and affecting other teeth or growing into the gum making them hard to clean properly or if they have crumbled. I was initially referred for my lower wisdom teeth to be removed because one had partially disintegrated, x-rays showed the other was also decaying and both were impacted partly growing into the gum rather then erupting properly. Between referral and when they were removed, one did become infected, which was painful.
In the UK you are very likely to have your wisdom teeth taken out in hospital by a dental surgeon rather then at your local dentist. This is because the location of the wisdom teeth makes them more difficult to extract and the lower wisdom teeth often have a more complicated root system then your other teeth. This also makes extraction harder. The advantage of having your wisdom teeth out in hospital is that this is free at the point of service. However you will have to wait. I waited 4 months between my initial dental appointment and the wisdom tooth removal date.
In most cases removal of wisdom teeth takes place under local anaesthetic. You can opt for a general anaesthetic, but there are slightly greater risks if you do so and recovery from a general anaesthetic takes longer then recovery from a local anaesthetic.
Preparing to Have your Wisdom Teeth Taken Out
1) Before you have your wisdom teeth removed it is important to keep them as clean as possible and prevent infection. The Dental surgeon won't remove your tooth whilst it is infected so if need be visit your dentist for an antibiotic prescription.
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Mouthwash can help keep your wisdom teeth free from infection in the weeks before they are removed.
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2) You might find a mouthwash helps to keep your wisdom teeth clean and infection free if they are impossible to clean thoroughly with a toothbrush.
3) Give up smoking - if you are a smoker it is worth giving up smoking at least a fortnight before you have your wisdom teeth removed. Non smokers and ex smokers have better circulation and immune systems (nhs.uk/livewell 2012) so you will be able to fight off infection and heal more efficiently after your wisdom teeth are removed.
4) Stock up on soft foods that don't need chewing.
5) Practice pendulum breathing. This is where you breath in counting to 5 and breath out counting to 5, breath in counting to 4 and breath out counting to 4 and so on - down to 1. This is a useful technique to use whilst you have the local anaesthetic injections.
Pain Killers for Wisdom Teeth Extraction
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An ibuprofen based pain killer
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a paracetamol (acetaminophen) based pain killer
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6) Take a bottle of water with you to the hospital - having your wisdom teeth removed can leave you with a very dry mouth.
7) If you are going to the hospital alone, ask a friend if they will pick you up and take you home after the operation. You may not feel well enough to travel alone and you certainly shouldn't drive a car for a few hours following a local anaesthetic. Also the local anaesthetic will make it impossible to take clearly for a few hours, which would make ordering a taxi difficult.
8) Stock up on painkillers. It is ideal to have one which is ibuprofen based and one which is paracetamol based.
A difficult lower jaw wisdom tooth to extract. This came out in 3 pieces. Note the decay at the crown end (left) and the hooked root (right).
Source: nettlemere
An easy lower jaw wisdom tooth to extract. This came out in 2 pieces. Note the crown which had partially crumbled prior to being removed.
Source: nettlemere
The Operation
The worst part of the operation is the local anesthetic injections into your mouth. You will have 3 for each wisdom tooth that is removed. This is where the pendulum breathing will come in useful. There is no point trying to pretend the injections won't hurt, but doing pendulum breathing whilst the local anaesthetic is being injected will help.
The anaesthetic will completly numb the area around your tooth - the dental surgeon will test this before proceding. A straight forward tooth will be removed in 5 minutes. Top jaw wisdom teeth are usually straightforward. A wisdom tooth with a complicated root system or significant decay can take 45 minutes to remove. For my wisdom tooth removal the first tooth took nearly 40 minutes from injections to completion but the second one only took 5 minutes.
If the first tooth has been difficult to remove the surgeon will offer you the option to have the second one removed at a later date.
During the operation you will feel tugging and pressure, but not pain. You will hear cracks and crunches but this is nothing to be alarmed by. If the surgeon has to cut into the gum to remove the tooth you will receive stitches - I had thee stitches on one side. If one of the teeth breaks through the dentin you will be given a prescription for an antibiotic to reduce the chance of infection.
Tips for Making a Quick Recovery from Having your Wisdom Teeth Removed
There are plenty of things you can do to speed your recovery, but it is important to be realistic. If your wisdom teeth were quick to extract you will recover faster then if one of more of your teeth were difficult to extract.
What to do immediately after your wisdom tooth operation:
1) When you get home take a dose of ibuprophen and then rest.
2) Two hours later have a small liquid meal such as a smoothie or soup at room temperature and a dose of paracetamol – this will act as an anti-inflammatory as well as a pain killer. Do not eat hot or cold food; it will make your mouth hurt more.
3) If you have been issued with a prescription for antibiotics, take these as instructed.
4) If any of the tooth sockets bleed fold up some gauze or a cotton handkerchief, place it in the socket and bit down on it to apply pressure, for 15 minutes
The day after your wisdom tooth operation:
1) Most people will need to take at least one day off work. If your teeth were difficult to remove and your face is very swollen, you may need to take up to 5 days. You should spend this day resting.
2) Continue to alternate a dose of ibuprophen with a dose of paracetamol. Continue to take your antibiotics as instructed.
3) Mix a teaspoonful of salt in with a pint of hot water and rinse your mouth with this solution after meals and before going to bed. Try to keep the solution around the empty tooth sockets for half a minute.
4) Continue to eat soft foods at room temperature, such as rice pudding, soup, finely sliced or mashed banana.
Two days after your wisdom tooth operation:
1) Experiment by eating harder foods – perhaps starting with bread soaked in soup, moist cake or pears. You should also be able to have hot food and drinks without discomfort.
2) Start to reduce the number of painkiller doses you take, but continue to take your antibiotics as instructed.
3) Continue to rinse your mouth with salt water solution after meals and before bed.
4) Take some gentle exercise such as a walk, but avoid doing anything very strenuous as your body still needs its reserves to continue the healing process.
How Will You Feel After the Operation to have your Wisdom Tooth or Teeth Removed
The Same Day: For around 3 hours your mouth will feel numb and it will be hard to speak coherently. I couldn't even tell if my tongue was poking out of my mouth or not and felt like Herman Munster - as though my lower jaw was enormous and square. I had numbness as far as my earlobes. You may have a very dry mouth and be able to taste blood especially if the surgeon had to cut into your gums. You will be glad of the water you brought with you to drink, but are advised not to swill and rinse your mouth out because it is important for any blood to form a clot.
After that you are likely to have some swelling - especially if a tooth was difficult to remove. You are likely to feel a bit cold because of the shock of having a small operation.
The Next Day: You are likely to feel tired and headachy from the local anaesthetic. You will only be able to open your mouth part way. If your tooth was easy to extract you may have minimal swelling, however for a difficult tooth you could have swelling under your chin and around your jaw and cheek. Eating will be uncomfortable. I have found it less painful than toothache from an infected tooth.
Day 2 and onward: The swelling will begin to go down and you will be able to open your mouth wider. Eating will become easier.
Day 7 If you have had stitches they will be dissolvable and should start to break down. This can take several week. By now the swelling should have gone.
If you are worried at any point phone the hospital dental department - they will give you the number before you leave. If you live in the UK you could alternatively phone NHS direct on 0845 4647.
Be prepared to get some swelling. On the left side of the picture you can see that the right side of my face (which had the difficult tooth) is swollen
Source: nettlemere
Summary of Tips for a Quick Recovery Following Wisdom Tooth removal
Before the operation
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During the operation
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After the operation
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Stop smoking
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Use pendulum breathing to reduce feelings of stress and pain
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Alternate doses of ibuprophen with paracetamol
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Stock up on soft foods and have a bottle of water to take to the hospital
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Rinse your mouth with salty water
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Arrange for a friend to collect you from the hospital
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Eat soft foods such as soup and smoothies at room temperature
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Practice pendulum breathing
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Rest - you will probably need to take at least one day off work.
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Take antibiotics if instructed to do so by the dental surgeon.
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Links to Further Information
- Wisdom Tooth Removal - NHS Choices
Find out everything about removing wisdom teeth, including why it needs to be done, how it is performed, the recovery period and complications. Plus links to other useful resources. - How to find an NHS dentist
For UK readers, find out how to find an NHS dentist, including where to get help if you have difficulties finding one in your area. - 10 health benefits of stopping smoking - Live Well - NHS Choices
Find out about the benefits of quitting smoking including improved oral health and better immune system.
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