Wisdom teeth extraction: calling dentists and patients

Factual Questions
1

There is a lot of information on the internet about wisdom teeth extraction, but it all relates to impacted wisdom teeth. Mine are being taken out because of decay :frowning:

So I have some questions:

  1. How much swelling will I get? (The dentist says there shouldn’t be the same hamster-face as impacted people get, but I still want to know how much).

  2. I am having mine out under local anaesthetic. How normal/usual is this for non-impacted teeth?

  3. Is there a chance - although they are not impacted - that they still might have to cut the bone or break them up into piece to remove them?

  4. Will it be noticeable externally? I read somewhere that Hollywood stars used to get wisdoms (and maybe other molars) extracted to get more sunken, dramatic cheeks. Am I going to look like Marlene Dietrich?

  5. How long will the pain last and is it less than for impacted people?

Any other advice or information will be very gladly welcome.

2

Varies wildly between patients, as far as I know. I had two teeth out under local anaesthetic, ate nothing but Wendy’s Frosty-brand dessert beverages and ibuprofen, and experienced little to no swelling. The friend who recommended this post-op to me has a near-textbook extraction himself, but swelled up something awful.

That’s how I had mine done. A swab of needle-numbing goo, then a pair of sharp, hot pricks to the upper gums, and then a ten-minute wait while the surgeon explains the rest of the procedure. You will feel and simultaneously hear an earth-shattering CRUNCH when the surgeon pulls the tooth free, but you won’t feel any actual pain at the time.

Not sure. Mine was pretty much textbook, but one of my roots was so deep that it cracked a hole in my sinus cavity. I experienced mild nosebleeds for about a week. My surgeon used a scalpel to put long vertical slits in the gum before pulling; this caused extensive bleeding, but made the removal a snap (well, actually a CRUNCH but you get the idea). If the slits weren’t perfect and a root broke off under the gum because your teeth were fragile, then yes, he’d have to go in and get them. He explained some of the potential complications to me (and your surgeon should do the same!) before ever sitting me in the chair.

I didn’t notice any difference. I expect you’d need to get more than just that back row taken out before it was noticeable. Do you look like Marlene Dietrich already?

I experienced tenderness, but no real pain, for the first three or four days afterward (not impacted). I was on strong ibuprofen, however, and slept quite a bit. I also had a mild fever for a day or two. It is a considerable shock to your system, and I recommend that you get some sick leave (at least two days) approved ahead of time. On my way home from the surgery, I stopped by a Wendy’s and ordered eight Biggie Frosties in carryout containers. I placed these in my freezer and subsisted on them (with vitamin supplements and water, as well as sucking gently on ice cubes) for the next two days. This soothed my gums and also allowed my mouth to heal. Your dentist will probably recommend rinsing with salt water and/or hydrogen peroxide solution for at least a week afterward to keep the wounds from getting infected.

Again, your doctor should answer all of your questions before he ever lays a hand on you. If you still have questions going in, do not sit down in the chair until you are satisfied with his answers.

3

Have you had a consultation with your oral surgeon yet?

I had all four of mine (not impacted) out at the same time with local plus a little bit of nitrous. I didn’t have any pain even when he really had to yank on a stubborn one that had a curled root. If you do feel pain during the extraction you should indicate that you’re in pain and the surgeon should stop and give you more local. I believe it’s been proven that local anesthetic doesn’t work on women as well as on men and my dentist almost always has to stop and give me more just for fillings.

I was given prescriptions for pain and swelling meds at my consultation and was told to have them filled before the surgery, which I did. I was told to start taking them before the anesthetic wore off. It’s much easier to keep pain away than to try to get rid of it after you have it. I think I took the pain meds (tylenol + codeine) for a couple of days. I’m pretty sure I was instructed to take the swelling meds until they were gone. They were some kind of steroid. I didn’t experience any swelling or any ill effects from the meds.

The only pain I had came after I felt like eating solid foods again and would accidentally bite down hard on something with the healing areas. Pizza crust…owie! That kind of thing happened for about a month. I’m 40-ish so maybe if you’re younger you’ll heal more quickly.

There’s always a chance that the teeth will break, etc. during surgery. Your sugeon should explain all of this during your consultation and if you have questions, ask. I remember being told there was a possiblity that a nerve in the jaw could get damaged and there might be some permanent facial paralysis. It’s not common but they have to tell you about it.

I specifically had mine removed because I was tired of the pain from chomping down on the insides of my cheeks all the time. I even had little skin flaps on the insides of my cheeks from it. I don’t notice any difference in outward appearance but I don’t bite my cheeks any more!

Make sure you follow the post-op instructions you’re given. I’ve heard about how painful dry sockets are and it sounds way worse than any pain one might experience during the surgery.

4

I had three extracted by my dentist and the other by an oral surgeon. No noticable swelling.

see #1. For the fourth tooth, I had to be knocked out since the tooth had come in sideways and had to be broken into two sections.

If the holes fill in correctly, you shouldn’t see any difference. I didn’t, anyway.

Thanks to modern painkillers :), I had no residual pain once the meds wore off other than some tenderness of the gums (which is to be expected).

5

Thank you all SO much.

I have discussed some of it with my dental surgeon, but there are always things that I forget to ask :wink:

Unfortunately I have to go on an overseas business trip the day after the extraction (of two of the teeth) so I hope I won’t feel too ill. I will beg for some prescription painkillers, or take my big box of Paracetamol/Codeine with me.

<b>Jurph</b> - I freaked out when I read the word “crunch”! But then you saying that you felt no pain has reassured me.

<b>AllShookDown</b> - thanks for the mention of steroids - I will have to be careful she doesn’t prescribe them, because I’m not supposed to take any steroids (glaucoma risk).

<b>Mr. Blue Sky</b> - your sidesways tooth - was that something that wasn’t apparent until they tried to pull it? From the xrays of mine I have seen they all look pretty straight. Just full of cavities! :frowning:

6

It was quite obvious from the x-rays.

7

IANAD, but is your Dentist/Oral Surgeon aware of your scheduled trip? Depending upon possible complications, the changes in atmospheric pressure (assuming you’re flying) might cause you more discomfort than the extraction.

Good luck

8

You may also want to consider whether you’ll be allowed to bring the prescribed pain killer into the country you’re visiting.

I was 21 when mine were removed. The bottom two had roots which were wrapped around the central nerve of the jaw (IIRC), which meant that they both had to be cut off at the gumline and the roots wiggled out separately. And yet I had no swelling, a minor bruise on each side, and needed no prescription-strength pain killers after that first afternoon. The oral surgeon was surprised, which emphasizes the earlier point that every case is different.

9

I would be worried that the wound would re-open, or that the dehydration of flying might make you prone to infection, or any number of other things (plus, as above, atmospheric pressure pain and possibly illegal drugs). This is a bad idea as far as I can tell. You may not even be in any shape to drive to the airport the next day, let alone fly overseas!

Seriously, flying overseas takes a lot out of you and weakens your immune system something awful. Add to that the shock, the still-sore-and-bleeding-occasionally wounds, the possible fever, the dehydration and blood loss, the drugs in your system, and the fact that you don’t get to choose your meals on an airplane (what if they only serve pretzels? OUCH!) and you are just going to be miserable. Find a way to do the surgery sooner, or skip the trip and tell your boss it’s just not medically feasible.

It’s very loud, because it’s coming from inside your head. The sound carries directly from your jawbone to your skull, and then to your inner ear bones. Imagine if someone stuck a ribbed wooden dowel in your ear and then dragged a metal bar across the grooves sharply – that rattling CRUNCH sound is what you’ll hear. It is disconcerting. And it doesn’t hurt a bit. Knowing that, smile and enjoy it. It’s a pretty cool experience to hear your own bone breaking and not feel it.

10

Okay, I’ll relate my horror story here.

I had 3 wisdom teeth taken out under a local. The two bottom ones had partially erupted, while the upper one was wedged in underneath a back tooth which had to come out due to decay. No trouble with pain at all, however, the pressure was excruciating. None of the teeth came out very easily on the bottom, but that wasn’t the worst part. No, the worst part was getting the upper tooth out. When he started pulling on it, it felt like he’d grabbed the top part of my skull and was attempting to yank it out through the roof of my mouth. Again, no pain, just this intolerable pressure which would not let up.

By the time he got done, I was shaking from the experience. I didn’t have any swelling or dry sockets, but I did bruise from below my eyes to my shoulder blades. A coworker saw me a few days after I had the proceedure done, looked at me and said, “My god, man, what the hell happened to you?”

If I had to do it all over again, I’d have gone for the general.

11

I’ve been a patient, twice (should have listened to the oral surgeon the first time when he told me to do them all at once, but told him I didn’t believe in preventive surgery; the other 2 got impacted 5 years later. Hey it could have been worse - the first batch got impacted in late perestroika USSR, and - trust me on this - Soviet dentistry is not something you wanted to experience firsthand. I waited until I got home several months later). And my sister used to work for an oral surgery practice, so she’s seen it all. Our combined advice:

Local anesthesia is fairly common, even for impacted teeth. I made them give me IV sedation because I couldn’t deal with the idea of having body parts forcibly removed while conscious. Both times the teeth in question were impacted, and both times the extractions went off without a hitch.

However, I second the thoughts that a) there is no way to know in advance how your body will react, and b) you probably shouldn’t plan on travel, especially international travel, so soon afterward. The first time I felt fine in a day or two, except for a little residual soreness. The second time, I was pretty much knocked on my butt for the better part of a week: not much swelling, but it just sucked all my energy, and even though I stopped painkillers after a couple of days (I detest them), I wasn’t entirely lucid for nearly a week. I stayed home from work, because a semi-conscious court interpreter who can’t open her mouth isn’t terribly useful.

My sister says dentists who overestimated their abilities were the source of much grief both to patients, and to the oral surgeons in her office who had to fix their meses. Sounds like you’ve got an oral surgeon rather than a regular dentist, which is a Good Thing.

Is this a time-sensitive thing? If you have to go on this business trip, can’t you postpone the extraction until you get back? In either case, good luck, and make sure you have lots of mushy food in the house that isn’t repulsive when eaten lukewarm.

12

I had my bottom two out around nine years ago and my top two out around three months ago. I had some minor swelling from the bottom two, nothing with the top two. Watch any sucking you might do after the procedure. You may have to relearn to swallow some thing or avoid them altogether: if you feel any tugging back there from suction, stop! You don’t want dry sockets, I hear. Also, I’d be sure to take your meds until you are certain you don’t need them. My bottom two were really killers and I used my entire codeine script up followed by horse-pill ibuprofin. My top two, I “needed” two days of vicodin (ok, probably just a day and a half) and a day of regular old advil, then everything was kosher.

Don’t worry about the local anesthetic, it is plenty for a tooth extraction. I actually caught a quick nap during the lower extraction (I was in boot camp at the time and slept whenever I could!) and my only regret for the most recent one was that I didn’t bring a magazine. You’ll feel a lot of pressure, these anesthetics don’t mess with those nerves, but you shouldn’t feel any pain at all. If all goes well, the dentist will rock the tooth back and forth, widening the socket, and pop it out. It takes longer for the lidocaine or novocaine to kick in than the extraction, really.

  1. Their first choice will be to cut the tooth into sections and pull those individual sections out. I can’t imagine why they’d need to break bone but I guess anything is possible.

  2. Not that I’m aware of, but now you’ve got me paranoid. :wink:

  3. The lowers are worse than the uppers, but a weekend of rest is plenty. Still, you should get a care sheet that will recommend things like avoiding heavy exercise for a certain period, etc. Just because you aren’t actually in pain doesn’t mean you’re quite out of the woods. Follow the care sheet dutifully and you’ll not have any problems. Also, see what I said about the sucking thing. They say you can’t drink through a straw or smoke, but that’s not necessarily true (the not smoking is good for many other reasons directly related to oral care, though). The goal is not to create low pressure in your mouth that will reduce the clots–and this can happen from more than just sucking on a straw. Pay attention to how things feel back there and you’ll see what I mean.

Above all, try not to sweat it. It is a pretty humdrum affair. Be diligent in your care and it will mostly be over (pain and excessive care) in a week, though you’ll have gum-covered dents back there for quite some time while the bone grows back.

13

I had a lot of bleeding - some of the stitches pulled out. It was not bad sitting on the couch but I would not have wanted to be travelling.

14

Yes - this is a bit of a concern, given it’s Qatar. However if it’s like the last time, I will be travelling as a VIP, and going through a separate airport area on arrival. Anyway I was planning to ask the dentist about this, and possibly get a letter from her in case of problems. (I did this for migraine pills when going to Australia once).

Luckily Qatar is only an hour’s flight, and they presumably have excellent medical services there, having the world’s (second?) highest per capita income or GDP or something. I went to France the day after having my tonsils out, and survived. (Just. I ran out of painkillers on Christmas Day and all the local pharmacies were closed for the holiday season).

15

I had two pulled out under local. The dentist just yanked them out like pulling any other tooth. I went home for an hour or so, felt fine, and went back to work. Had bunches of bleeding ( probably because I was told not to go to work or do any activites) but otherwise had no effects at all.

16

Had all 4 of mine pulled when I was 16 or so. Absolute non-event.

A little sore for a couple of days & the stitches were becoming annoying by the time they were due for removal a week later.

Definitely plan on soft cool food only for 2 or 3 days.

I caught the 48-hour flu a couple of weeks later and that was definitely a LOT more miserable than pulling the teeth was.

17

Thanks again everyone for all your advice! The deed is done. Jurph was spot on - ghastly crunch sound/feel (not painful though) as they sort of lever the teeth with some implement, then the actual pulling out with pliers is literally over before you realised. Like feet crunching on a gravel drive is sort of the intensity, not like a huge boulder cracking or anything.

It took just SECONDS. I only realised the tooth was out because I saw this vile bloody thing in the pliers as the dentist moved them aside, and I had to ask: “Was that it?!”

The worst pain initially is one of the needle pricks which goes on a nasty nerve - BUT it is only one second. In some ways the (lesser but a few seconds longer) stinging of the first needle is worse. I didn’t have any stitches put in. All in all I was the easiest textbook case - straight, fully emerged, no nerves tangled up anywhere - a first week dental student would have probably breezed it (though I am somewhat glad my dentist has a little more experience).

Right afterwards I went and had a banana and blueberry smoothie, some lime and chilli cheesecake, and swallowed down my first painkiller. I am glad I ate then, because despite the analgesic pill, as the local anaesthetic wears off, the pain does increase.

I also went home and because my new DanceDanceDance board had arrived, spent about an hour on that, even though you’re not supposed to do any exercise. But the pace was slow and it took my mind off the gradually increasing pain.

It does ache and throb, but it is not unbearable (yet - I dread tonight) and putting a hot cloth against the face brings quite good relief. Men won’t get this, but it’s not unlike menstrual cramps in the cheek/jaw, in terms of intensity, dullness, and the desire for a hot compress.

The taste of blood in my mouth is not as strong or as unpleasant as I thought it might be.

Tonight I plan to dine on soup and Belgian Chocolate Haagen Dazs. Because if there is ever an occasion that is morally right to eat ice cream (sorry Dr Atkins!) this is it :wink:

18

shudders I’m so glad they knocked me out.

I had all four of mine out last summer. It was more annoying than anything; I managed to get by on lots of ibuprofen, even though they gave me a perscription for percoset. I watched, like, one movie when I got home and then was back at the computer complaining about it over IM. The swelling started a couple days later and I looked funny for a few days, but it wasn’t too bad. The worst part was having to sit through a band meeting two days afterwards with rapidly-melting ice packs and no drugs.

19

Be careful. I, too, was on top of the world the day I had my wisdoms out–it was the next two days that were hard.

20

I had one pulled out about 15 years ago (had a cavity in it), but it wasn’t a big deal. It was done under local. I didn’t have any real problems afterwards–just a little swelling and a faint throb. The doc gave me some antibiotics to prevent infection.