Wisdom teeth

Extraction of the third molars

In some cases, extraction of the third molars may be necessary to prevent or treat oral health problems. Preventing infection or damage to the neighboring tooth is a priority. The procedure must be carried out carefully by a specialist maxillofacial surgeon.

The extraction procedure

Third molar extraction is performed under local, regional, or general anesthesia, depending on the complexity of the case and the patient's preferences. The oral surgeon or dentist makes an incision in the gum to reach the tooth and then removes it carefully. In some cases, the tooth may be divided into fragments to make removal easier.

Recovery and postoperative care

After third molar extraction, it is important to follow the professional's instructions to ensure a proper recovery. These include using pain relievers and anti-inflammatory medication, maintaining good oral hygiene, and avoiding activities that could affect the extraction site.

Care and instructions after a third molar extraction

After a third molar extraction, it is essential to follow the postoperative instructions given by your dentist or oral surgeon to ensure a successful recovery and avoid complications. Some of the care measures and recommendations include:

1. Bite down on the gauze for 30 minutes. Remove it without spitting to check the area, and only place a new piece of gauze if your mouth fills with blood. If this continues, call your surgeon.
2. Apply ice to the area: During the first 24 hours, applying ice to the extraction site can help reduce swelling and pain. Apply an ice pack wrapped in a towel or cloth for 20 minutes, followed by a 20-minute break.
3. Take pain relievers and anti-inflammatory medication: Your dentist may prescribe medication to control pain and swelling. Be sure to follow the instructions and take it exactly as directed.
4. Keep your head elevated: For the first few nights after the extraction, try to sleep with your head raised using extra pillows to reduce swelling and pressure in the area.
5. Avoid rinsing: Do not rinse your mouth or spit forcefully during the first 24 hours, as this could dislodge the clot and delay healing.
6. Maintain good oral hygiene: Continue brushing your teeth and flossing carefully, avoiding the extraction site during the first few days.
7. Follow a soft diet: For the first few days after the extraction, eat soft, cool foods such as yogurt, mashed potatoes, soups, and ice cream. As the area heals, you can gradually add more solid foods back into your diet.
8. Avoid tobacco and alcohol: Using tobacco and drinking alcohol can hinder healing and increase the risk of infection. Avoid these for at least a week after the extraction.
9. Do not use straws: Avoid drinking through a straw for the first 48 hours, as the suction can dislodge the clot and cause a complication known as dry socket.
10. Take it easy with physical activity: Avoid strenuous exercise or lifting heavy objects during the first few days after the extraction to prevent bleeding and increased pressure in the area.
11. Attend your follow-up appointments: It is important to attend follow-up visits with your dentist to make sure the extraction site is healing properly and there are no signs of infection or complications.

If you experience symptoms such as severe pain, excessive bleeding, fever, swelling that worsens after 48 hours, or difficulty opening your mouth, it is important to contact your dentist right away.

What care should you take after wisdom teeth extraction?

Rest on the first day after the extraction.

Apply ice to the affected area to reduce swelling.

Avoid smoking or using tobacco products.

Avoid drinking hot liquids or eating hard or crunchy foods.

Gently rinse with warm salt water to promote healing.

How are wisdom teeth extracted?

Third molar extraction technique

The extraction of the third molars, also known as wisdom teeth, is one of the most common procedures in dental surgery [1]. Although the indications for removing symptomatic third molars are clear, the routine removal of asymptomatic teeth remains controversial [1]. In this article, we will discuss in detail the extraction techniques for upper and lower third molars and how the procedure is carried out.

Pre-procedure evaluation

Before proceeding with third molar extraction, a clinical and radiographic evaluation is essential. The radiographic findings must be correlated with the clinical picture to ensure an accurate diagnosis [3]. The position of the teeth and their relationship to the adjacent anatomical structures are key factors to consider before the extraction.

Extraction techniques for upper third molars

The technique for extracting upper third molars involves the following steps:

1. Local anesthesia: Local anesthetic is administered to the palatal and buccal regions of the tooth to be removed.
2. Incision: An incision is made in the mucosa covering the tooth, exposing the underlying bone and the tooth.
3. Raising the mucoperiosteal flap: The mucoperiosteal flap is lifted to fully expose the tooth and the surrounding bone.
4. Osteotomy: An osteotomy is performed around the tooth to facilitate removal.
5. Tooth removal: The tooth is removed using the appropriate forceps or elevators. In some cases, it may be necessary to divide the tooth into several sections to make removal easier.
6. Suturing: The mucoperiosteal flap is sutured back into its original position, ensuring proper healing and minimizing the risk of infection.

Extraction techniques for lower third molars

The technique for extracting lower third molars includes the following steps:

1. Local anesthesia: Local anesthetic is administered around the tooth to be removed and to the inferior alveolar nerve.
2. Incision: An incision is made in the mucosa covering the tooth and the underlying bone.
3. **Raising the mucoperiosteal flap
4. The area is cleared and the neighboring structures are checked.
5. Bone tissue is removed.
6. The molar is sectioned so it can be removed in small pieces.
7. The area is thoroughly cleaned.
8. Any remnants of the pericoronal flap (operculum) are removed. The site is then ready to be closed.
9. Suturing.
10. Compression with sterile gauze.

Afterward, you should carefully follow the list of instructions your surgeon provides. Remember that your surgeon should give you a phone number so they can be reached in case of an emergency.

Wisdom teeth extraction is a common procedure performed under local anesthesia or conscious sedation. The dentist or oral surgeon makes a small incision in the gums and removes the tooth or teeth. Recovery time can vary, but the gums usually take a few days to heal fully.

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