Wisdom teeth erupt into the mouth after puberty. In dental parlance, they are called third molars, because that's exactly what they are. Your six-year molars are your first molars, and your twelve-year molars are your second molars.

They are often extracted because of problems with occlusion and the difficulty associated with plaque control so far back in the mouth. A dentist can perform a more routine extraction, but more difficult cases require an oral surgeon, who is better able to deal with, for example, widely divergent roots or other more severely impacted teeth.

Description of my wisdom teeth extraction:

6:30: I awaken, and put on some clothes. Since I will be under anesthesia, I have consumed nothing, solid or liquid, since the previous night.
7:00: I arrive at the office, and begin filling out insurance forms and waivers. I am then taken to the room where the operation will take place.
7:15: The operation begins by inserting an IV into my left arm, loaded with a saline and sodium brevitol solution. After the injection, unconsciousness comes on in about ten seconds.
7:45: The operation is completed and I am moved to a recovery room.
8:00: I awaken, feeling no pain. When I attempt to stand, I become extremely dizzy. Both walking and talking become difficult.
8:45: I arrive at home, and place two large bags of refridgerated peas on each side of my jaw. I also take an antibiotic, washing it down with Gatorade, which is when I learn that the lower part of my jaw, extending from the lips to the chin, is numb. After consuming this repast, I fall asleep.

After a few cycles of sleeping/drinking/drugging/icing/sleeping(approx. 3 hours), I feel well enough to move around. I take some pain medication and begin to relax. The area between my lower lip and chin is still numb, and the back edge of my jawline by the ear is mildly painful to the touch.

5:35: I begin noding my dental surgery experience on Everything.
5:38: I pause for thirty minutes to apply an ice pack.
6:00: I take another antibiotic. When drinking some water, I notice that sensations on the right side of my tongue differ. While water over the other areas of my tongue feels cool, the water on the right side of my mouth feels warm and tastes sulfurous.
I'm feeling tired now, so I go to bed.


The next day:
9:00: I wake up. The first thing I notice is that the taste sensations on both sides of my tongue coincide, which is nice; also, the numbness on my chin is better.
10:00: I get up and eat some breakfast. This is when I learn that it hurts A LOT to open my mouth, even a little bit. On my way back to bed, I take a look in the bathroom mirror and realize that the lower half of my jaw is mildly swollen. It's not that bad; in fact, I look handsome with a mildly swollen jaw. Heh.
12:00: I have lunch, comprised of chicken noodle soup and yogurt. It tastes good. Afterwards, I wash my mouth out with saline solution because I can't brush/floss.
12:30: I take three Advil to help with the swelling and pain.
3:00:I node today's section of my wisdom teeth recovery.
Wisdom teeth are, in fact, the result of a wide-reaching, global conspiracy of the dentistry industry. They have known about genetic engineering for years, but they have selfishly used this knowledge to introduce wisdom teeth into the human gene pool for their benefit. Ever notice how dentists are so eager to remove your wisdom teeth? In fact, we suspect the nitrous oxide manufacturing companies are in on this gig as well.

Think about it. Wisdom teeth are not necessary for eating food, nor for any normal vital activity. They do nothing but take up space and cause pain, and perhaps incur cavities in the victim, since they are conveniently hard to brush.

Sure, you might hear archeologists talking about finding wisdom teeth in the skeletal remains of homo erectus, but they, too, have been manipluated and brainwashed by the dentists of America. Humans have no need for wisdom teeth, nor have they ever. It is a money-making ploy, and nothing more. Any evidence you see the contrary is the work of the conspirators as well.

Don't believe the hype. Wisdom teeth are a hoax.

No matter what your oral surgeon says, know that when you get your wisdom teeth out (or even just one wisdom tooth), you won't be able to play any wind instruments (well, maybe flute) for a few weeks.

I asked the surgeon how long I should expect to wait before playing saxophone again and he said about three or four days. Dead wrong. I missed a band festival because of it. Bugger. I guess he didn't realize how much pressure playing a wind instrument puts on the oral cavity, because I tried to play sax about four days after I got a wisdom tooth out and it felt like I could've ripped the wound right open again if I played hard enough.
The worse aspect of having your wisdom teeth removed is not the procedure itself. While it is certainly not something to look foward to, having those bad boys pulled does not really hurt, thanks to the miracle that is anaesthesia. Whether they knock you out with nitrous oxide gas, or just numb up your mouth with novocaine, chances are good that you won't hardly feel it when they tear your teeth from their sockets. You will feel PRESSURE, not pain.

As soon as you step OUT of the dentist's office, however, you should prepare for unplesantness. First, you will most likely still be bleeding. Chances are good that your dentist stuffed your mouth full of gauze before you left, so it wouldn't be a bad idea to turn your cellphone off at this point. Try to accept the fact that, for the next couple of days, you will be forced to consume nothing but applesauce, yogurt, pudding, and jello. I don't reccomend you buy those meal-replacement shakes or PowerBar Gel. Trust me. You will probably remain numb for the remainder of the day. And that is a good thing.

A few tips. Do not spit, play wind instruments, or drink using a straw. All three of these actions interfere with the formation of blood clots. And that is bad. Also steer clear of citris juices --as they contain acid-- and carbonated beverages.

The following morning, you will wake up in pain. In fact, you will wake up BECAUSE you are in pain. If your doctor graciously prescribed percocet or vicodin (Although I received the former, I am told that that latter is sometimes given), take it now. You will spend the day in pain. Your jaw may appear as if it is swollen. This is because it is.

The next day, you will wake up in pain again. You will, by this time, be very sick of your soft/liquid diet. Take percocet and relax.

The third day is the same. It does not get better.

Which brings us to where I am now. I only have one day's dosage of percocet left. I am in pain. My breath stinks. My jaw is swollen. If you are planning on having this operation done soon, bear in mind that you will NOT be okay in two or three or even four days. Good luck!

Post-wisdom teeth extraction care guide

#include "e2stddisclaimer.h" :
This writeup is not intended to be medical advice, although it is reconstructed from what my doctor told me after my surgery. It is to be used for educational purposes only. If you have any questions, contact a medical professional. The after-effects of oral surgery vary from individual as should be evident from the number of "getting my wisdom teeth pulled" writeups. Reader discretion is advised. Don't sue anyone over what you read here.

Day of Surgery

If you received a general anesthetic (i.e., you went all the way under), have someone else drive you home, then lie down with your head elevated until all effects of anesthesia have disappeared. Just put some calm music on and enjoy the trip. Again, effects vary from individual to individual, and you may feel drowsy for several hours. DO NOT operate a motor vehicle or any mechanical equipment for at least 12 hours after the surgery. Don't node, either ;-).

Do not disturb the surgical area. You probably got gauze to bite down on. Keep it in, and keep firm pressure on the sockets (if it hurts, you're biting too hard). This is very important! Blood clots need to form down in the sockets, and if you knock them loose or prevent them from forming, you're going to be in for a few painful weeks.

After the first hour you've been home or so, you can change the gauze. You probably still won't be able to feel anything, so be careful! Gently remove the bloody gauze, and the just pack a few pieces of fresh gauze back in. Gently! But be sure the gauze is going over the sockets, and not being clenched between your remaining molars. Steady pressure is what it takes to form clots. If you change the gauze after another hour and there still seems to be a bit of blood, soak a tea bag in moist water, squeeze it dry, wrap it between gauze, then bite down on that for 30 minutes. The tannin will aid in the healing. If after the first two hours you feel the bleeding is still severe, please call your doctor/dentist/oral surgeon (see disclaimer above)!

Swelling is to be expected, and usually peaks around 48 hours after the surgery. To reduce swelling, wrap cold packs, ice bags, or bags of frozen vegetables in a towel and apply to your face near the surgical site, 20 minutes on, 20 minutes off. I recommend alternating either side of the face in this matter. Put the ice pack on your bed and lay your cheek on it. After 20 minutes, roll over. After an hour, change the ice and check the gauze. Keep this up for 2 days (during the day only) and you'll be in good shape. On the third day, switch to heat, either in chemical hot packs, hot water bottles, microwaved moist towels, or electric blanket-type heating pads. By now the swelling should be going down, so use heat until you get tired of it. If you were prescribed medicine for swelling (lucky S.O.B....), take it as directed.

You may have a few bruises, but they'll go away after a week. Your jaw muscles will feel tight and you may have difficulty opening your mouth. This too should subside within a week or two. Use lip balm (like Chap-Stick) to keep your lips from cracking.

Resist the urge to probe the sockets with your tongue, finger or anything else! Although it may seem convenient to do so, do not suck anything through a straw! Do not smoke cigarettes (or anything else; now could be that excuse to quit you've been looking for...). Do not spit (let it drain out of your mouth). If you play any wind instrument, woodwind or brass, give it a rest for at least a week. Ignore the urgings of your band director or fellow musicians, and forget about festival, contest, or the Friday night football game. It's not worth sacrificing your health!
All these actions will put pressure on the sockets and could dislodge the clots, which will put you in a world of pain.

Diet

A few after surgery, once you've changed the gauze and made sure there's no severe bleeding, you'll probably be feeling a little hungry. Eat anything that fits the following descriptors: Soft, Bland, Nourishing, Mushy, Pureed, Liquid, Cool, Lukewarm. Good examples are pudding, ice cream, gelatin, vegetable or fruit puree. Bananas, soups. One food I particularly enjoyed was a combination between a virgin daiquiri and a fruit smoothie: Fill up a blender with ice, and crush it finely. Add any of the following: Frozen orange juice concentrate, kool-aid mix, fresh fruits, ice cream. Blend some more. Pour into a cup; eat with a spoon. Goes down easy and the cold will soothe the pain and swelling.
Avoid anything really hot (caliente) or spicy (picante). Avoid anything that will force you to chew or move your mouth too much. Avoid anything with small, hard pieces that could get stuck in the sockets, like nuts or popcorn.
As the days go on gradually progress to more solid foods as you feel comfortable chewing them. Remember, proper nourishment is essential to the healing process!

Pain and Medications

The local anesthetic the doctor gave you (probably Novocain or Lidocaine) will wear off after a few hours, and then your mouth is going to hurt. If you were prescribed a painkiller like vicodin, now's the time to start taking it, preferably with your first meal. Resist the urge to take it any more often than the bottle recommends, you'll just run out faster and on day three you'll be sorry.. You'll have trouble getting a prescription like that renewed, as any painkiller strong enough for oral surgery is likely to be habit-forming. If you feel the standard dose is not enough, supplement it with an analgesic like aspirin or Tylenol. Taking your pain medication with food and water will help lessen any nausea.
Some painkillers are likely to mess up birth control pills; ask your doctor.
If you wear any orthodontic appliances (you have all the luck, dontcha?), put them in as soon as you get home. Putting them in after the swelling kicks in will not be fun.

For the Next Few Days

Keep your mouth clean! You don't want to be fighting an infection along with the rest of the pain from surgery. The day after surgery the blood clots in your sockets should be in place, and you can start rinsing your mouth with warm salt water. Mix 1/2 teaspoon NaCl with 1 cup H2O. Rinse gently every 2 hours for the first week, then 3 times a day for the next 2 weeks. Also being your normal toothbrushing routine the day after surgery, as long as it's comfortable to do so. Remember not to spit! Let the salt water/toothpaste drain out of your mouth. Don't swoosh water around in your mouth either. Roll your head around. You'll feel silly, but you'll be better off in the long run.

When you want to go back to work/school or whatever your normal daily routine consisted of is up to you. I stayed home for three days. I know guys who were back on the job the day after. I know other people that had it so bad they stayed home for two weeks. Use your best judgement, and be careful.

Bad stuff: Dry sockets. If you go ahead and smoke, or do any of the other stuff I said not to, or maybe just have bad luck, around the third day you'll probably lose a blood clot out of one of the sockets, exposing the soft tissue and nerves to the air. This will hurt. You'll feel the pain spiking down your jaw and back to your ear. Call your doctor.
Skin discoloration: Probably a bruise. Aspirin and heat will help it clear up. If you had an IV, there may be swelling and chemical irritation in the vein.
Numbness: If your lower wisdom teeth are taken out (and they usually are no matter what, for a number of reasons), you may experience some loss of sensation in your lips or jaw (after the Novocain has worn off). This is because the main nerve that supplies sensation to your mouth runs right beneath the roots of your teeth, and it may be damaged in the extraction. It usually disappears after a few weeks. It may continue for months. In rare cases the damage is permanent. As always, call your doctor if you have any questions.

And in the end..

After two or three weeks your sockets should be healed enough that you can safely use your tongue to poke out bits of food that will get stuck down in them. Go easy in them, and remember if don't like this you can always go back to the saltwater rinses. After two months you'll forget the holes are even there, and after 3 or months they'll be completely closed over. YMMV.



That's pretty much the drill I went through when I had all four of my wisdom teeth out. Read wisdom teeth and getting my wisdom teeth pulled for other noders' experiences. But only trust the advice of a trained medical professional!

December 17th - cry. Alright, I just got back into the office after having visited my brand new Oral Surgeon who I was referred to by my trusted dentist. I was, of course, referred to him for extraction of my wisdom teeth. Dr. Douglas Vincelli seems to be a very competant doctor, and he has a nicely run office. The people there, including himself, are very in touch with the reality associated with oral surgery. So, I thank my dentist for the good referral.

So far, everything sounds good, right? Well, now I'm scared. The doctor gave me three choices for my state during the activity. Choice one: local anesthetic. Awake, but feeling no pain. Well, frankly, I think the knowledge and sight of someone working in your mouth like that is probably going to be the worst part, so no, I don't like this option. Choice two: half asleep, half awake. Drugged to the point where I don't know and don't care about what is going on to me. Hm.. that sounds good.. but I tend to think of myself as pretty perceptive, so I might notice blood dripping out of my mouth and some guy drilling around in there and stuff. No matter how drugged I am. Choice three: general anesthetic. Oh, what's that? I'll be completely asleep, and not have a clue what's going on? Sleep? I like sleep. Sleep it is.

I take a look at the panoramic x-ray that the doctor has. Holy shit! Here's teeth, teeth, teeth.. they all look fine.. all straight in a little army of teeth. I'm amazed by how deep the roots go, being a bit more than two times the size of the teeth. No wonder my teeth feel strong, I think. I wonder, so, where are the wisdom teeth I need to get removed? Well, right at the end of the line.. Holy shit! The x-ray shows that on my bottom row of teeth, right next to the molars that look huge, are even bigger teeth. They're like 110% the size of my big molars... and they're sideways. The top of the wisdom teeth at a 45 degree angle to the rest of the teeth. A collision looks emminent.. and this x-ray was taken September 11, 2001. (it took that long to get an appointment for this consultation. :()

So the doctor does a quick inspection of my mouth, and then begins to run down a list of the possible side-effects, soem of which inclued permanent loss of feeling in some areas of my mouth. He explains the odds of these things happening as 0.5% of the people having numbness caused by bruising a nerve during the operation, and 99% of those people recovering completely (within a few weeks to a few months). Hm, 5 out of a hundred thousand people have permanent numbing.. and four teeth being removed.. I don't really like those odds, but I can live with them.

Finally we move onto the scariest part of the appointment. The billing. Luckily, I have 100% dental coverage for the minor dental surgery that this is. Still, being completely anesthesized has it's cost.. the bill is $110 CND for this consultation, and $942 CND for the teeth removal, and $175 CND for the anesthetic. $1227 CND.. not as bad as I feared. I need to pay this up front, but they expect my insurance will recover all but a couple hundred dollars. I guess it's affordable, but I would perfer to spend that money on something else. I mean, you know, paying to have some people induve pain in me isn't my idea of a good time. If it has to be something oral related, I'd much perfer to spend a few hundred dollars on white chocolate brownies rather than having teeth removed.

The worst part is still yet to come, as I am to find out. And I'm not talking about the removal. I talk to the lady there to make an appointment for my wisdom teeth removal. I ask for a date as soon as possible, of course, because this waiting is terrible. December 28, 2001 is the date I'm given. Gah! I didn't expect it to be that soon! I waited 4 months for this consultation, and now I don't even have one pay check between me and my removal. Doh! Well, now I really need that Christmas Bonus, because I have a large expenditure coming up.. even if my insurance company reimburses me, it's still a lot of money out of my pocket.

December 20th - The christmas bonus has come, and I can afford the surgery. Phew.

"... because the skull and jaw of modern man is much smaller than that of our ancestors, most people do not have enough room for wisdom teeth..." (1)

That's right. Wisdom teeth is a visible sign of evolution. It looks like the human lower jaw is shrinking over time. This leaves less room for those wisdom teeth. Some people never get wisdom teeth and there are children born today that aren't even born with the buds for them. Some say this is because people today are maturing faster. (2) Some say the early maturation isn't evolution but better nutrition. (2) Others say that the increased chewing that ancient man had to do stimulated the length of the lower jaw. (3) I didn't know that Cocoa Puffs were so nutritious! Better nutrition or evolution, wisdom teeth cause problems and the lucky kiddies of today and tomorrow won't have to deal with them.



(1) http://www.smiles4ever.com/oralsurgery.htm
(2) http://www.jackcuozzo.com/wisdom.html
(3) http://www.animated-teeth.com/wisdom_teeth/t1_wisdom_tooth.htm

After an Extraction

For the first twenty four hours:

No Smoking
No Alcohol
No Hot or Hard Food or Drink
No Exercise or Exertion

Gauze
Bite on the piece of gauze in your mouth for a good half hour. This helps a blood clot to form. Some bleeding is normal, but if it starts again later bite on another piece of gauze.

Pain
As your anaesthetic wears off (you were anaesthetised, weren't you...?) take some paracetamol or similar. Your dentist will advise you. It is important not to take aspirin as it thins the blood, hindering formation of that blood clot I mentioned.

Salty Water
The following day, start to rinse with salt water. Stir a teaspoonful of salt into a glass of water and rinse the area around the socket regularly. This will help prevent any infection occuring.

What Happens if I Smoke, Drink, Eat Hard Food?
As a smoker, your blood flow is going to be poor to start with, and it will be more likely that your body will have trouble forming a clot over the socket. The blood clot is important because it seals the wound from the bacteria and stuff in your mouth, and allows the wound to heal. If you smoke cigarettes after the extraction, a blood clot may not form at all and that is called dry socket. Dry socket is agonisingly painful and smells dreadful. You don't want it to happen to you.

If you drink alcohol, you may cause inflammation of the wound. Besides, you're not supposed to drink alcohol when you've had anasthetic plus painkillers.

If you eat hard food you may get something stuck in the socket or dislodge the blood clot. If you eat hot food you may burn the wound (or, if you're still numb, the rest of your mouth).

Remember, you have an open wound in your mouth. Would you pour coke in a bullet wound on your leg? No? Well, be careful what you pour on the extraction wound in your mouth.

Why Are You Telling Me This Stuff? (A Disclaimer)
I work as a Dental Assistant in Australia. Giving post-operative care and instructions is part of my daily work. I assist in, on average, one extraction a day and I see perhaps one dry socket per month. These instructions are fairly generic and apply to every extraction we do. However, I am not a dentist nor am I your dental assistant; you should follow the instructions your own dental professionals give you after an extraction. If in doubt or pain, consult your dental professional.

Having your wisdom teeth pulled? Consider this!

After you get your wisdom teeth pulled,

SLEEP SITTING UP!


Why?

It lets the fluids drain out of your head while you sleep, instead of the liquids pooling, which would happen if you lay down. This results in greatly reduces swelling. Greatly reduced swelling means greatly reduced pain on your part. I had only one of the pain pills that was prescribed to me after the surgery. I didnt take any more because I didnt need them.

How?

Sleeping sitting up means, very likely, sitting in a chair when you fall asleep. The first night after the surgery, this should be no problem at all. You should be so drugged up that falling asleep, no matter what position, will be easy. If you aren't fortunate enough to have a comfortable la-z-boy type chair to fall asleep in, I recommend stacking up pillows on your bed and sitting against them. If that doesnt work, sleep against a wall and use pillows to make it comfortable.

When?

The first three or so nights should be all you need to get past the swelling. By the third night, I couldnt really see any swelling, and I was tired of the chair, so I returned to my bed and used the pillow stacking method for the next couple of nights. I was back to sleeping normally by a week after the surgery.

Who?

This was recomended to me by the physical trainer for the sports teams at my high school. He taught my Spanish class and was out for (only) a couple of days due to having his wisdom teeth pulled. He touted sleeping sitting up as a method for speeding up recovery.




DISCLAIMER:

I am not a health proffesional. This is entirely conjecture based on the part of my onetime teacher, and my experiences.

Consult with your doctor or orthodontical surgeon before you do this.

All I can say is that I did it, I am currently 9 days after having had my wisdom teeth pulled, and I was never in any great pain. I recovered wonderfully, and I think that sleeping sitting up helped.

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