The extraction of wisdom teeth is a surgical procedure to remove the third molars situated at the very back of the teeth. They usually appear between the age of 17 to 21 years but sometimes may appear in the late twenties as well. The wisdom teeth usually are 4 in number, positioned 1 in each half (upper right and left, lower right and left) of the mouth. It is best to note that not all individuals have exactly 4 wisdom teeth, some individuals might have less as well. With the evolution of time, the human jaw has shrunk, providing minimal or very limited space for these sets of teeth to grow freely. So when they come through they might cause no or slight to severe discomfort that ultimately is injurious to the oral cavity and the whole body. Not everyone requires removal of the wisdom teeth but if the signs and symptoms appear and persist, it is best to consult and take advice from a dentist and oral surgeon. Eruption and growth of the wisdom teeth may or may not be normal, however certain signs may indicate the need for surgical removal of wisdom teeth.

1) Impacted wisdom teeth: Every so often the wisdom teeth get impacted or trapped beneath the gums and into the jaw bone because of the limited space in the oral cavity. This impaction causes radiating jaw pain, swelling and tenderness of the jaw, pus formation, difficulty in mouth opening, chewing, and bad breath. These are the manifestations that indicate an individual requires surgical extraction of impacted wisdom teeth from a certified dental professional. 2) Eruption of the wisdom teeth in the wrong direction: At times, wisdom teeth grow at an angle that is inappropriate to the adjacent teeth (second molar). It causes difficulties for the adjacent teeth by growing horizontal (backward or forward). In such cases, meticulous cleaning (brushing and flossing) of this particular area gets difficult and there is more chance of food impaction and bacterial growth around the erupted and adjacent teeth. The food impaction and bacterial growth trigger the caries process in teeth, pain, swelling, and infection of the gums that leads to cavity/decay formation and gum diseases respectively. 3) Cyst formation: In a few cases, the sac in which wisdom teeth form becomes filled with fluid to form a cyst. This fluid-filled sac initiates the pain and damages the surrounding nerves, jaw bone, gums, and teeth. Most commonly the cyst forms around impacted teeth (within the jawbone). In such circumstances, the dental professional advises for removal of the wisdom teeth at the earliest chance, to save the surrounding soft and hard tissues.

Process Of Surgical Extraction The dental professional will first take your medical and dental history. In addition to that, all the signs and symptoms of your dental concern or complaint will be recorded. A clinical and radio-graphical assessment will then be performed. The clinical and radio-graphical findings allow dental professionals to conduct a dental diagnosis. After the diagnosis of the wisdom teeth, the dentist in collaboration with the oral surgeon decides to perform the surgery under local, intravenous sedation, or general anesthesia either in the clinic or in day surgery depending on the severity. The process of surgical extraction requires a minimum of 45 minutes, some cases might take a longer time subject to the severity. The dental professional will guide you and your attendants to follow certain pre and post-operative instructions that need to be followed religiously.

Some common post-operative instructions are as follows- - Avoid rigorous spitting or sucking the saliva or blood - Replace and change the gauze over the treated area carefully - Use ice packs over the cheek on the treatment site to relieve swelling - Make sure to take rest and avoid any heavy activity for some days - Eat cold and soft food for the first 24 hours. Avoid spicy, crunchy, and chewy food for some days or until the treatment area heals - Drink healthy fluids from a cup or glass, avoid drinking fluids with a straw - Avoid brushing for the first 24 hours, rather use a mouth rinse and gently spit it out, resume gentle brushing after 24 hours - Avoid smoking and tobacco use

Slight to moderate bleeding, pain, and swelling can be noticed after the surgery and it is best to take the prescribed medications timely. However, if the pain, bleeding, and swelling persists, consult the dentist or oral surgeon immediately. Be present for your follow up appointment. The dental professional will check for healing and remove the sutures, if the sutures are non-absorbable, and advise you for future maintenance.