Welcome back everyone!
Wisdom tooth pain can be the cause of much suffering and indicates the potential for danger as well. Infection of a wisdom tooth or the gums around a wisdom tooth can lead to severe swelling of the face, which can mean an urgent trip to the emergency room, or worse.
Fortunately, wisdom teeth problems like this don’t typically make the jump from 0 to 60mph so quickly. With this in mind, even slight discomfort in the wisdom teeth area should warrant a check-up with your dentist; might as well catch a small problem before it blows up in your face (literally).
Your first appointment with the dentist is usually going to consist of a clinical and radiographic assessment. In other words, the doc is going to take a peak at your wisdom tooth, perform some tests, and take an x-ray. Oftentimes, the typical x-rays you’d routinely get at your yearly check-up won’t be adequate to image a wisdom tooth, as these teeth are so far back in the mouth. As a result, the dentist will order either a panoramic x-ray or a CBCT (cone beam computed tomography). Both will allow the dentist to visualize where your wisdom tooth is relative to the important anatomical structures within your head, and will help predict the level of difficulty and risk in removing the offending tooth.
Assuming the difficulty level is such that the dentist himself will be able to remove the tooth for you, further consultation will follow. Timeline, sedation options, cost, and a possible recommendation to remove the other wisdom teeth will be discussed.
Most dental offices offer both Nitrous Oxide (laughing gas) and/or Oral Sedation (i.e. a sedative in the form of a tablet you swallow). The reason I say “and/or” is that both laughing gas and the tablet can be used together to offer an even more profound form of sedation than either offer alone. Some offices also offer IV sedation and even General Anesthesia (being put to sleep) for very advanced cases. The vast majority of people, including very nervous patients, do very well with oral sedation alone, or in combination with laughing gas. Of course, medical conditions, medications and other considerations do come into play when planning a procedure with sedation involved. Make sure to give your dentist a comprehensive report of your medical status when asked for it.
Finally, if the dentist determines you already have an infection, they may prescribe an antibiotic as to reduce the chances of the infection spreading to the face. A word to the wise: a lot of your discomfort may just disappear after taking these meds. This does NOT mean that the infection is gone; it will come back, and often times worse than it was before. Make sure to keep your second appointment to have the tooth removed, despite the apparent resolution of the pain.
Next time we’ll discuss what to expect during the procedure itself. I had my wisdom teeth removed while I was still awake (although somewhat sedated), and I know it’s not fun when you don’t know what to expect.
See you next week!
-Michael the Dentist