Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

Impacted Wisdom Tooth Extraction

Wisdom teeth, also known as third molars, are the last teeth in the mouth to develop after the second or 12-year molars. They are completely formed at approximately 17 to 19 years of age. As they develop, they attempt to erupt into the oral cavity by the late teens or early twenties. Although many individuals live healthy lives with these molars in place, often times these teeth become trapped beneath the gum line and “trapped” behind the second molars because of the lack of space in the dental arch to allow them to erupt normally. When third molars do not erupt or are “locked” in the bone, they are referred to as “impacted.”

Symptoms of Impacted Wisdom Teeth

Approximately 90 percent of Americans have at least one impacted wisdom tooth, according to the American Association of Oral and Maxillofacial Surgeons, The oral and maxillofacial surgeons at Mount Sinai have vast expertise extracting impacted wisdom teeth.

The lack of eruption or partial eruption can cause these molars to produce various symptoms and issues that may require surgical attention. These include:

  • Infection
  • Surrounding bone and soft tissue
  • Pain and headaches
  • Caries (tooth decay or cavities)
  • Wisdom teeth
  • Second molars
  • Erosion into the second molars
  • Shifting of adjacent teeth
  • Bleeding of the gums
  • Cyst formation surrounding the wisdom tooth
  • Invading bone
  • Encompassing adjacent teeth 

Wisdom Tooth Extraction

Due to the fact that impacted wisdom teeth have the potential to produce so many symptoms and conditions, we often recommend they be surgically removed. For wisdom teeth that are severely impacted, we may recommend to perform the procedure under intravenous sedation or general anesthesia due to the difficulty of the extractions. In some cases wisdom teeth can be removed under local anesthesia, when the degree of impaction is not severe, the position of the impacted tooth is favorable, or the tooth is erupted into the oral cavity.

Intravenous sedation is also known as conscious sedation or “twilight sleep”. This allows the surgeon to perform the procedure with minimal discomfort to the patient. Intravenous Sedation is an anesthetic requiring that the patients not have anything to eat or drink for eight hours prior to treatment and to be accompanied by a responsible adult to safely transport them home.

Postoperative Instructions

Post operatively patients are often asked to take antibiotics and pain medicine as prescribed. Patients are also asked to eat a soft diet and apply ice to the sides of their face to help minimize pain and swelling. Some tips you can do to assist with your recovery also include gargling with warm salt water to aid in discomfort, avoid using straws when drinking as that may agitate the wound and try to get as much rest as possible.

Your Mount Sinai oral and maxillofacial surgeon will be happy to discuss the procedure in great detail with you, give you diet and nutrition recommendations, as well as answer any other questions you may have.