Understanding Your Third Molars
Hello, I’m Dr. Justin Raanan. If you have been feeling a dull ache in the back of your jaw or noticing some crowding in your smile, you aren’t alone. One of the most common questions I get in my practice revolves around one specific topic: wisdom teeth. It is a rite of passage for many young adults, yet there is still so much confusion about when they should stay and when they need to go.
My goal today is to walk you through everything you need to know about these late-blooming molars. We will look at why we have them, the clear signs that it is time for an extraction, and exactly what you can expect from the procedure and recovery. I want to replace your anxiety with knowledge so you can make the best decision for your oral health.
What Are Wisdom Teeth, Anyway?
Wisdom teeth are your third set of molars. They usually make their appearance between the ages of 17 and 25. Because they arrive at a more “mature” age compared to your other teeth, they earned the nickname “wisdom” teeth.
Thousands of years ago, our ancestors needed these extra large teeth to chew tough roots, raw meat, and coarse leaves. However, as human diets changed to softer foods and our bodies evolved, our jaws became smaller. The result? For many of us, there just isn’t enough room in the mouth to accommodate 32 teeth comfortably. This lack of space is the primary reason why these teeth cause problems.
Signs It Is Time for Extraction
Not everyone needs their wisdom teeth removed. In some lucky cases, they erupt straight, healthy, and fully functional. However, as an oral surgeon, I look for specific red flags that indicate keeping them will do more harm than good.
1. They Are Impacted
This is the most common issue I see. Because of space limitations, the teeth may become trapped (impacted) in your jawbone or gums. They might grow at odd angles—sometimes even horizontally toward your other teeth. An impacted tooth can result in pain and creates a trap for food and bacteria.
2. Crowding and Damage to Nearby Teeth
When a third molar pushes against your second molar, it can damage the healthy tooth or increase the risk of infection in that area. Furthermore, that pressure can cause crowding of the other teeth, potentially undoing years of orthodontic work like braces.
3. Infection or Gum Disease
When a wisdom tooth only breaks through the gum partially, it creates a flap of gum tissue. Food particles can easily get trapped under there, leading to a painful infection called pericoronitis. If you notice swollen, red, or bleeding gums in the back of your mouth, this is a strong sign we need to take a look.
4. Cysts or Tumors
While this sounds scary, it is important to be aware of. Wisdom teeth develop within a sac in the jawbone. If that sac fills with fluid, it forms a cyst that can damage the jawbone, teeth, and nerves. Removing the tooth prevents this damage from occurring.
According to the American Association of Oral and Maxillofacial Surgeons, an estimated 85% of wisdom teeth will eventually need to be removed because they are impacted or causing other dental issues. This high percentage shows just how common this procedure is.
The Consultation: The First Step
Before we schedule any surgery, you and I will sit down for a consultation. This is a stress-free appointment. I will take digital X-rays or a 3D scan of your mouth. These images allow me to see exactly where your wisdom teeth are positioned relative to your nerves and sinuses.
We will discuss your medical history and I will answer every question you have. Whether you are worried about anesthesia or just want to know how soon you can return to sports or work, we will cover it all. I believe that a well-informed patient is a calm patient.
The Procedure: What Really Happens
I know the word “surgery” can trigger nervousness, but wisdom teeth extraction is a routine procedure that we perform with a focus on your absolute comfort. Here is a breakdown of how the day usually goes.
Anesthesia and Comfort
Your comfort is my priority. Depending on the complexity of the extraction and your anxiety level, we have options:
- Local Anesthesia: We numb the area completely. You are awake, but you won’t feel pain, just some pressure.
- Sedation Anesthesia: This is given through an IV line. It suppresses your consciousness during the procedure. You won’t remember much, if anything, of the surgery.
- General Anesthesia: For more complex cases, this puts you completely to sleep.
The Removal Process
Once you are comfortable, I make a small incision in the gum tissue to expose the tooth and bone. If there is bone blocking access to the tooth root, I remove it gently. often, it is easier to divide the tooth into smaller sections to remove it piece by piece. This minimizes the size of the opening required and helps with faster healing.
After the tooth is out, I clean the site of any debris. In many cases, I will place a stitch or two to close the wound and promote healing. These are often dissolving stitches, so you won’t need to come back to get them removed.
Recovery: The Timeline of Healing
After the procedure, I will give you detailed instructions, but here is a general idea of what the recovery journey looks like. Most people are pleasantly surprised by how manageable it is.
The First 24 Hours
When you leave the office, you might feel groggy if you had sedation. You will need a friend or family member to drive you home. It is crucial to rest. You may experience some bleeding, which is normal. Biting down on gauze helps form a blood clot, which is the foundation of healing.
Tip: Avoid spitting or using a straw. The suction can dislodge the blood clot and lead to a painful condition called dry socket. While data suggests dry socket only occurs in about 2% to 5% of extractions, avoiding straws significantly lowers your risk.
Days 2 and 3
Swelling is usually at its peak during this time. This is a normal inflammatory response; it means your body is rushing white blood cells to the area to heal it. Use an ice pack on the outside of your cheek—20 minutes on, 20 minutes off. This makes a massive difference in reducing swelling and bruising.
The First Week
By day 4 or 5, you should start feeling much more like yourself. The stiffness in your jaw will begin to fade. You can start gently moving your jaw to regain mobility. If you were prescribed antibiotics, make sure to finish the full course to prevent any infection.
What to Eat (The Fun Part)
For the first few days, your diet will need to change. Think of this as an excuse to eat your favorite soft foods. However, nutrition is vital for healing, so try to balance the treats with protein and vitamins.
Here are some “Dr. Raanan Approved” foods for your recovery:
- Apple Sauce and Yogurt: smooth, cool, and easy to swallow.
- Smoothies: Packed with vitamins. Just remember—eat it with a spoon, do not use a straw!
- Mashed Potatoes: A great comfort food that fills you up.
- Scrambled Eggs: excellent source of protein to help repair tissue.
- Broth and Blended Soups: Wait until they are lukewarm, as hot liquids can irritate the surgical site.
- Ice Cream: The cold can actually feel soothing on the gums.
Avoid crunchy, spicy, or acidic foods for at least a week. Chips, nuts, and popcorn are off-limits because small pieces can get stuck in the healing sockets.
Managing Pain
Pain management has come a long way. For many of my patients, over-the-counter medications like Ibuprofen (Advil) or Acetaminophen (Tylenol) are sufficient to manage the discomfort. I will provide you with a specific schedule for these medications. Taking them at regular intervals before the pain sets in is the key to staying comfortable.
For more complex removals, I may prescribe stronger medication, but we always aim to use the minimum amount necessary for your comfort and safety.
The Long-Term Benefits
I know that undergoing a procedure isn’t how anyone wants to spend their week, but removing problematic wisdom teeth is an investment in your future health. By taking care of this now, you are preventing:
- Chronic pain in the jaw and head.
- Severe tooth decay in the second molars, which are hard to clean when crowded.
- Orthodontic relapse (teeth shifting back after braces).
- Serious infections that can spread to the neck or head.
For more detailed information on the implications of impacted teeth, you can read this article from the Mayo Clinic, which serves as an excellent resource for patient education.
Moving Forward with a Healthy Smile
If you suspect your wisdom teeth are coming in, or if you are simply at that age where it is time to check, don’t hesitate to reach out. At my practice, we combine advanced technology with a gentle, personalized approach. We want to make sure your smile stays healthy, straight, and pain-free for years to come.
Surgery sounds daunting, but with the right preparation and a skilled team by your side, it is just a small bump in the road toward optimal oral health. I look forward to helping you navigate this process smoothly.