My D got her braces off at 14 and they took xrays and it was discovered that she had four bony impacted wisdom teeth, they were sideways and if they tried to erupt they would have damaged her 2nd molars.
We had them taken out the summer after junior year, we had to have the consult months before to be able to schedule in the summer. She had general anesthesia and was not awake during it.
I had to have all of mine out as well, S is next as a recent xray revealed he also has four impacted wisdom teeth.
I think everybody reacts differently. My older D had 3 removed at once and it took her about 5 days to get back to normal (mostly normal). My D’s friend was fine the next day after getting all 4 removed.
It has become routine to extract 3rd molars on teens/college students. 30-40 years ago, orthodontists tended to remove 4 bicuspids so often the wisdom teeth had room to erupt. That led to what we came to call flat face/sunken face syndrome and the pendulum swung back to keep all the bicuspids. Unfortunately, that meant that often there was not enough room for the third molars to fully erupt. Faces and jaws are getting smaller and now I often see patients missing wisdom teeth that never developed. We used to all have 4th molars; now it’s very rare.
Removing wisdom teeth on an adult over 50 is much more difficult that a 20-something. The roots are formed, the bone is dense, healing is prolonged and post-op pain is higher. Often the patient has swelling and is only having the extraction because there are no other options. Hard to get an infected area totally numb and post-op infection rates are higher.
I strongly recommend that my patients have them removed when the roots are not formed and they are not causing trouble. So much easier on the teen! Re the CT scan. Usually the panoramic xray is enough for the surgeon to remove the impacted teeth; however, if there is a question about the proximity of the nerve to the tooth root, the CT scan gives very good information and helps the surgeon to extract safely. The more the root is developed, the closer it is to the mandibular nerve.
A few reminders for those facing extractions soon: IV sedation, if available, helps reduce the stress of the appointment, take it easy for 2 days after (no sports), take pain meds, use bags of frozen peas as your ice bags, keep talking and chewing to a minimum. Post-op swelling usually is gone 7-10 days after the extractions. Biggest tip: don’t overdo, no matter how good you feel, for the first 2 days after. This is a true surgery; treat it as such.
I only had two (bottom) and had them out under local and went to a party that night…I was 17 so everything is easier to recover from at that age! That said, I wish they hadn’t been so grab-happy. I had subsequent problems with a molar that if they’d had the option to pull and let the wisdom tooth move forward, I might have avoided. My impression was that in the bad old days, people lost teeth over time so the wisdom teeth had room to come forward and replace those. Our dentist seems to think that DS16 needs his out because they’re not fully-developed and don’t have enough room. I generally trust her, but I do think that having wisdom teeth out is like braces, now the norm but was not always.
I think it also depends how impacted, soft tissue, partial bony, complete bony impacted they are and how they are angled. I assume the harder they are to remove, the more trauma to the mouth, the more swelling there will be and longer healing time.
I had my bottom two out when I was 19, and the top two out when I was about 35. Both were done in the dentist chair with just a local. I drove myself there and back and after the second set I went home to my two little kids! No down time at all. I wish I could have had a little something to make me sleepy, it was not pleasant being awake and hearing everything and feeling the dentist pry the teeth out!
I always wondered why so many people had molars pulled to do orthodontia. Sounds like an extreme thing to do, but I guess the wisdom teeth then came in and “replaced” the pulled molars.
D is supposed to have a consult. My S had his out and wanted a hamburger that night (I insisted on scrambled eggs) I think post-op pain varies greatly.
@surfcity - pain post-op definitely varies greatly. I had little, but I’m no hero! I had an awful time with pain in my labors and honestly for most dental work or even a headache. So my conclusion is that one’s general pain tolerance is not correlated (?) - which makes sense if it’s more about the impaction etc. per @mommdc.
I am wondering if I should have hers removed on a Monday given she goes back on that Sunday. Is 6 days enough time? She does have a lot of access to medical/dental facilities at school if necessary, but I also would not like to send her back with swelling (if she has any). Part of me wants to wait until May because she will be home for a few months, but the oral surgeon thinks if we wait, the risk of permanent numbness will be higher because the teeth will have more time to grow in.
The oral surgeon thinks it’s fine to have it done on a Monday and return to school on a Sunday.
I had mine out 25 years ago. Xrays showed they were all pointed sideways, and I was going to be spending a year abroad. No one wanted either a dental emergency or orthodontia being undone.
I’m also missing my bicuspids due to orthodontia. DD has better teeth; she has braces but no extractions.
ETA: My mom said I yelled through the entire extraction; I remember none of it due to anesthesia. I was miserable for a solid week after having my wisdom teeth out. No solid food that week, either. I just lay on the couch moping and eating lukewarm mush (ramen noodles broken into crumbs and cooked extra long). But I haven’t bounced back well from any surgery.
If my D was going abroad now I would not hesitate to have it done immediately. I am trying to decide if we can just wait until May, when at least she will be home for awhile. I do not really understand how 4 months can make such a big difference, but maybe it can?
@twogirls - I cannot imagine a scenario where your daughter would have trouble after six days of recuperation, unless God forbid something went very wrong. People can recover from even bigger surgeries in six days, and I’m assuming she is young and healthy on top of the procedure being straightforward.
Two of my three had to have their wisdom teeth removed. It was about 2 days before they were running a pretty normal schedule. Down the day they had the surgery and the next day and then up and going on day 3… probably also depends on whether your d needs pain killers or not and if so, for how long she needs them. I happen to have been born without wisdom teeth and it’s a good thing because i didn’t even have room in my jaw for all the adult teeth and had a couple removed (and then braces to straighten it all out)…big teeth, small mouth structure. My H had a wisdom tooth pulled two years ago - just had the dentist do it and on he went. People are all different how they react and how they recover.
I am a bit cynical about dentists and other oral care providers. You could get a second opinion and see if the second oral surgeon agrees with the current surgeon’s urgent recommendation.
Extraction on Monday should be fine for a return to school the following weekend.
I don’t think the OP is contemplating this, but for anyone reading do not use a general dentist for this, no matter how easy the extraction may sound. I’ve seen a very bad outcome in this scenario. Always use a well-recommended oral surgeon.
I’m getting mine pulled because I have bone loss issues, and the wisdom teeth are affecting my neighboring molars. The dentist has been nagging me about this for a few years. I’m getting it done now,while I still have private dental insurance to cover it.
My two daughters had theirs out over time by our usual dentist - no oral surgeon required. The uppers popped out easily; the lowers took a little more effort. For those, the extractions were done (with novocaine) on Thursday and they were back at school the following Monday. The dentist knew when each should be done and having them out over 2-3 years also spread out the cost to us.
Both of my children had wisdom teeth removed. Their oral surgeon said no physical exertion (no gym or sports) for one week. So we had to schedule extractions after their sport seasons ended. Both had the procedure done on a Friday and were back at school on Monday…and actually liked being excused from gym participation.
First day my D was religious about ice on 20 min, ice off 20 min. She timed it and texted me (no yelling downstairs) when it was time. We got frozen peas and put them in quart ziploc bags. Then I sewed two tube socks together and we put the pea bags in and she tied them around her head. Worked great in keeping them in place.
She did not drink from a straw until OS said it was ok. Just had smoothies and soft foods with a spoon. She did the salt water rinses with the syringe they gave her, no infection.
Just spoke to my BIL who is a dentist, and he seems to have a more laid back approach. He feels if the patient is symptomatic and if there is a chance that the wisdom teeth will damage the surrounding molars, then they should come out. If that is not the case, then it is not necessarily an emergency.
My BIL raised the concern about a dry socket. He said that if that should happen, you do not want her to be away at school. Ugh. I am thinking of doing this in May…