Oral Surgery


Wisdom tooth extraction


In Dentistry, the term Oral Surgery entails a wide range of often invasive procedures; however, at Scident, we focus on the most common type of oral surgery which is “tooth extraction”.  Dr. Chehroudi has extensive oral surgery experience from working many years in the rural areas of Persian Gulf and during the era of Iran/Iraq war, as both a military and a private volunteer dentist.  At Scident we offer oral surgical services which include : all types of tooth extraction, treatment of acute and chronic tooth abscesses , soft and hard tissue biopsy, as well as removal of broken roots. One of the most common type of surgical tooth extraction is the Wisdom Tooth removal.

What Are Wisdom Teeth?

Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth; upper, lower, right and left. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12. The third molars usually will try to grow in at around age 18 to 20 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them. Unfortunately, this does not always happen.

What is an impaction?

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her x-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems. Impacted teeth can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor from the follicle, which is the tissue which formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

Erupted wisdom teeth

Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is non-functional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different and only your dentist can determine if there is a reason for you to have a tooth removed.

When should wisdom teeth be removed?

The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted-meaning, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently. Symptoms may include:

• pain

• infection in the mouth

• facial swelling

• swelling of the gum line in the back of the mouth

Many oral health specialists will recommend removal of the wisdom teeth, (when the roots are approximately formed, or three-fourths developed, usually in the adolescent years),as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar. Third molar impaction is the most prevalent medical developmental disorder.

What problems are often associated with impacted third molars?

• bacteria and plaque build-up

• cysts development (a fluid-  filled sac)

• tumor development

• infection

• jaw and gum disease

What is involved in the extraction procedure?

Wisdom tooth extraction involves accessing the tooth through the soft and hard tissue, gently detaching the connective tissue between the tooth and the bone and removing the tooth.

Wisdom Teeth: Is It Wise To Remove Them?

Common misunderstandings surround their name origin, removal reasons and pain sources:

The name 'wisdom teeth' is age related - third molars don't erupt until teenage years and beyond, when people theoretically are more wise to the world. Common reasons for wisdom teeth removal include impaction, pain and crowding of the other teeth, which are typical tooth growth characteristics. If wisdom teeth are not visible, they are impacted or unable to erupt due to space and size limitations. Impacted teeth don't have enough room to grow, and will lay beneath the gums, which may or may not be a problem.

Pain and tooth crowding are also top wisdom teeth problems. Adults have forgotten what normal pain from a growing tooth feels like. Complications also can arise when wisdom teeth partially erupt. The broken gum acts as a breeding ground for bacteria and germs.  When wisdom teeth partially erupt, food gets caught in the gums and may cause an infection, swelling, growth of a tumor or cyst and pain. If this happens, consult a dentist before problems worsen and affect overall oral health.

If wisdom teeth have erupted, the key to preserving them is maintaining good oral health by brushing twice a day and going to see a dentist twice a year.

What is dry socket?

Dry socket, the most common post-operative complication from tooth extractions, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost. The blood clot lays the foundation for new tissue and bone to develop over a two-month healing process. Women who take oral contraceptives are at a higher risk of developing dry socket after wisdom teeth extraction due to high levels of estrogen.

Tips for preventing dry socket

• Schedule extractions during the last week of the menstrual cycle, when estrogen levels are inactive

• Avoid drinking through a straw, the suction will interfere with healthier clotting.

  1. Avoid smoking, it can contaminate the extraction site.

  2. Avoid excessive mouth rinsing, which may interfere with blood clotting.

  3. Avoid spitting, sucking on a straw and drinking carbonated soft drinks for 2-3 days following the procedure.

  4. Gently brush adjacent teeth and swish salt water after meals to keep the mouth free of excess bacteria.

  5. Talk to your dentist about all medications you're taking including oral contraceptives, aspirin and herbal supplements

Check Menstrual Calendar For Tooth Extraction

Dry socket, the most common post-operative complication from tooth extractions, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost. This blood clot lays the foundation for new tissue and bone to develop over a two-month healing process.

Women may have a greater chance than men to develop dry socket, but, for women who take oral contraceptives, their likelihood of developing a dry socket is twice as likely because of their increased estrogen level.  A study published in General Dentistry, the clinical journal of the Academy of General Dentistry, reports that women who take oral contraceptives experienced a 31 percent incidence of dry socket after molar extractions performed in the first 22 days of their menstrual cycle. Within two to three days after estrogen use was discontinued, the extraction site tissue began the healing process. For women whose molar extractions were performed on days 23 through 28 of their cycle, no incidence of dry socket occurred.  Unless there is an emergency, women using birth control should try to schedule their extractions during the last week of their cycle, when estrogen levels are inactive, The healing process can then begin immediately.

Anyone who just had a tooth extracted should avoid drinking through a straw, because the suction will interfere with healthier clotting.  Avoid smoking, which can contaminate the extraction site and excessive mouth rinsing, which may also interfere with blood clotting.