Wisdom tooth words of warning?
October 30, 2012 11:20 AM   Subscribe

I'm 34, and currently have all my wisdom teeth, but one broke over the summer and got an infection a while back. I'm on heavy duty antibiotics now to minimize that and the extraction is scheduled for Friday morning. My regular dentist will be doing the procedure, and it sounds as though I'll just be getting a local anaesthetic. He said I wouldn't even need someone to drive me to the appointment, though I probably will, just to be on the safe side. What else should I know before going into this?
posted by peppermind to Health & Fitness (32 answers total) 3 users marked this as a favorite
Best answer: Follow their instructions regarding post-operative icing to the letter; it will really help to minimize swelling.
posted by infinitywaltz at 11:21 AM on October 30, 2012 [2 favorites]

Best answer: If you get pain medications, take them BEFORE you start feeling pain. I made the mistake of waiting until pain started (thinking I could minimize the amount I'd need to take), and was very sorry.
posted by xingcat at 11:23 AM on October 30, 2012 [3 favorites]

I had all 4 of my wisdom teeth out with only novacaine. It didn't hurt all that much. I went home and slept, then I went to work. (I had an evening job back then.)

If your teeth aren't impacted, it's not that big a deal. Even if they are.

You'll be a bit sore from your dentist crawling around in your mouth. But other than that, no big whoop.

I used wet tea bags to stem the bleeding.

My sister went to the same doctor a week after I did, she had gas and she had a harder recovery.
posted by Ruthless Bunny at 11:25 AM on October 30, 2012

Small bags of frozen peas wrapped in a towel really help with the outside swelling. They're cheaper than ice packs, they conform to the face shape better, and you can eat them afterwards. I got told this by the dentist who did my extractions.
posted by spinifex23 at 11:28 AM on October 30, 2012

Advil was way more help for my wisdom tooth extraction pain than whatever prescription they gave me. Take Advil!
posted by something something at 11:29 AM on October 30, 2012

Best answer: I had my wisdom teeth extracted with local too. I think I had an easier recovery than my boyfriend, who was put under.

A couple of notes:
- I got a TON of anesthetic, and it felt at one point like I couldn't swallow. This was normal. Nothing was going wrong. I wish I'd brought a notepad to communicate with the dentist. It did get hard to talk.
- I brought an iPod and listened to familiar music. It helped me stay calm.
posted by purpleclover at 11:33 AM on October 30, 2012

Do it with local anesthetic if at all possible. I had mine (non impacted) done with novocaine, drove home and was back at work that afternoon. My fiancee (impacted) was put under and it was two days of hell and a fair amount of vomiting before she felt remotely normal again. My dentist prescribed ibuprofen, I guess for the swelling, and it was good enough that I didn't need to break into my strategic Vicodin reserve.

The dentist offered to put me under since I think it's easier on them, but after seeing what my fiancee went through the week before me I turned him down.
posted by mikesch at 11:34 AM on October 30, 2012

See if you can get the pain med prescription filled ahead of time; nothing's worse than sitting around a drugstore while experiencing crippling oral pain.
posted by jenkinsEar at 11:42 AM on October 30, 2012

I had all four wisdoms out at once in the old days when they put you under with sodium pentothal, but I have had lots of major work done since then.

I am a nervous dental patient, due to all the work I've had done by sadistic dentists. I finally found a dentist who does her best to make me comfortable, which makes her job easier.

Before major work she will prescribe me two valium tabs, one for the night before and one for the morning of the procedure. I have to have someone drive me, but I am a relaxed, happy girl who is a pleasure to work on. If you are at all nervous I recommend this highly. You get to go home afterwards, take a pain pill, and sleep for hours.

Yes, bring your iPod and crank it. I find that not having to listen to the noises associated with what's going on in my mouth is key to not being aware of it.

I've never had much trouble with swelling or excessive bleeding; YMMV.

Basically, it's not a big deal getting wisdoms pulled these days. The worst part is the novocain injection, and then make sure you're really really numb before you let them start. You'll be fine.
posted by caryatid at 11:49 AM on October 30, 2012

Best answer: Follow the recommendations to avoid dry sockets. You will be sorry if you don't follow them to the letter.
posted by cooker girl at 11:53 AM on October 30, 2012 [5 favorites]

I had almost the exact same scenario. Ended up getting a scrip for Valium from the dentist (filled across the street and pushed back my appt an hour) bc I was kind of freaked about the only novacaine thing. Recovery was a breeze-back at work next day. Good luck!
posted by atomicstone at 11:56 AM on October 30, 2012

Your recovery will be less dependent on the amount and type of sedation than the degree of impaction that is involved.
posted by Cuspidx at 12:01 PM on October 30, 2012 [1 favorite]

When my wisdom teeth were removed, I was fuzzy by the time they were giving me the care instructions at the end. They told me (I think) to keep the dry gauze in there - but I found that it just kept bleeding, and kept bleeding - so I moistened the gauze, and it helped stop the bleeding. Wet tea bags are likely good (per Ruthless Bunny, above).

I felt fine until I got home and the novocaine wore off, and then I felt like crap, so yes - take the pain medicine before you think you need to!
posted by needlegrrl at 12:10 PM on October 30, 2012

Just as an anecdote, I had one pulled under local, though it was already fairly "out."

I followed the dentist's instructions, took regular aspirin, and was totally fine. He gave me a prescription for painkillers which I didn't even use.
posted by drjimmy11 at 12:12 PM on October 30, 2012

Nthing the other accounts of local anaesthetic straightforward wisdom tooth removal. It is really not a big deal.

But it was a pain trying not to get any food stuck in the hole (and later just indent) for the next month or two.
posted by snorkmaiden at 12:14 PM on October 30, 2012

Best answer: I've had my wisdom teeth removed with no complications. I echo the advice given above to take pain killers before you need them and follow the dentists instructions given.

Keep in mind that a common wisdom tooth extraction procedure involves drilling into the tooth until it is weak enough to break into two pieces. Then, the two broken wisdom tooth pieces are extracted individually. Don't let this surprise you.

I also used having my wisdom teeth removed as an excuse to have ice cream for dinner which I completely recommend.
posted by jazh at 12:28 PM on October 30, 2012

Keep in mind that a common wisdom tooth extraction procedure involves drilling into the tooth until it is weak enough to break into two pieces. Then, the two broken wisdom tooth pieces are extracted individually. Don't let this surprise you.

Oh wow, now mine were done 30 years ago, but they were extracted! No drilling. I was awake so that the surgeon could have me bite down for counter-pressure.

It was over and done in about 15 minutes for all 4.
posted by Ruthless Bunny at 12:38 PM on October 30, 2012

I had a broken wisdom tooth also. My dentist removed all 4 under a local and I was bored and went back to work that afternoon. I had a pain med script but never filled it. I took ibuprofen for the first day.

It wasn't bad at all, but I'm not squeamish. The amount of pressure to remove the teeth was amazing to me. I mean like arm-around-my-head-to-hold-it-in-place pulling and stuff. 3 popped out whole with some tooth puller device. The broken one they had to drill in to and then remove the pieces because the tooth puller device wouldn't hold on to the broken tooth. That one healed more slowly and I had a small tooth piece that worked its way up and came out after a week of me playing with it with my tongue.
posted by cmm at 12:48 PM on October 30, 2012

I had each side taken out separately, both times with novocaine. The first dentist was bad (I knew this going in) so it sucked and I was in pretty bad pain for a day (but felt much better the second day after). The second dentist was great, I needed no prescription meds, I went to work the next day.

Have lots of soft foods, don't use a straw, if you trust this dentist it will probably not be as bad as you are expecting.
posted by shownomercy at 12:55 PM on October 30, 2012

Do not drink any caffeine before you show up at your Dentist's office. An increased heartrate from caffeine plus any anxiety will shorten the effective time of the anesthetic shots. It can get annoying to have to be jabbed every several minutes because the anesthetic keeps cutting out.

Like others have mentioned, if it comes out smoothly it will be easy to recover, but if your tooth is crooked or requires a lot of work it may take a day or two.
posted by Bodrik at 12:56 PM on October 30, 2012

I had all four of mine out under local; they were various degrees of impacted it took longer than expected and at one point the oral surgeon asked me if it would be OK if she only took two out and saved the rest for a second appointment, at which point I was really glad I was awake because I was like "NO WAY LADY, THEY ALL COME OUT RIGHT NOW, GET BACK IN MY MOUTH" (in gestures and muffled grunts). I took a day or two off work because I could (generous sick leave) but I took the subway home from the dentist, I fed myself (OK, mostly I just drank soda and juice), I filled my own prescription for Vicodin (or whatever it was). I did feel kind of spacey afterwards, though, and I'm glad I didn't have to drive myself. I think it was basically just being kind of exhausted by the whole thing, and I'm sure I had been stressing out about it and not sleeping the night before. Presumably only having one out will be less time-consuming.

My main mistake was forgetting to bring my prescription insurance card with me - I had to go home, get the card, then go to the CVS near my home rather than stopping at the CVS near the dentist and downing a couple of pills on the subway (which... would have been awfully classy). But it was fine, really. I could have gone to work the next day, for sure.
posted by mskyle at 1:02 PM on October 30, 2012

Can you pre-load on the ibuprofen? That was recommended to me when I got mine out, and it was a HUGE help. I didn't fall asleep after coming out of the anesthesia, and I didn't even need any of the heavy-duty drugs. Basically, you take like 800 mg of ibuprofen at a time, maybe four times a day, the day before the procedure. IMPORTANT: CHECK WITH YOUR DENTIST AND/OR DOCTOR. DR. MADAMINA ONLY HAS A MASTER'S IN JOURNALISM.

My husband had a very badly impacted wisdom tooth out last year. He went under local and it went pretty well. However, he ended up with a pretty bad infection (through no fault of our wonderful dentist).

--Your mouth will hurt a ton. A TON, even with the good drugs. You will think you can handle driving and do normal things the next day, but you really should plan to have that time unscheduled. My husband was very familiar with pain meds and surgery pain and all that due to some long-ago knee problems, but this tooth pain was getting to be more than he could bear.

--Your pain levels will ratchet up until Day 3 or so, and you'll be like, "Why is it still hurting so horribly?" They should then go down. However, if they do not start getting better after Day 3, particularly if your cheek feels hot in a localized area and the swelling is still apparent, call your doctor/dentist ASAP and make sure you have the correct antibiotics. (Which you may already have because you've already got an infection, but they may switch them up or something. Who knows.)

--If your tooth is crazy like his (nearly horizontal and making life difficult for the neighboring molar) the dentist or oral surgeon may need to cut into the gum in a way that will not easily close up and heal. It may also let the part of the compromised molar be exposed in a way that it normally wouldn't be exposed, which means that it may be more sensitive to things like heat or cold. However, that will likely go away within a few weeks or so as you get used to it.

--You've probably been in frequent contact with your dentist already. I bet they love seeing you every week :) This is another reminder: if you feel like something's wrong, something is most likely wrong.
posted by Madamina at 1:27 PM on October 30, 2012 [1 favorite]

Stock up on pudding and ice cream in advance.
posted by orange swan at 3:10 PM on October 30, 2012

They might poke a hole in your nasal cavity by accident, but it will heal within a few days!
posted by Rinoia at 3:28 PM on October 30, 2012

There is some very good advice upthread. Do what you are told by the dentist since his/her instructions fit your situation. Some people have a bad time; you are probably not one of those people because your problem stems mostly from the broken tooth and infection. Once those are fixed, you will be fine. Ice (for no more than 15 minutes at a time) and soft food, no drinking straws, pain meds before pain hits - all good.
posted by Cranberry at 3:30 PM on October 30, 2012

This question does bring back the memories.

I heartily second zingcats' and others recommendation to take your pain medication before you start hurting.

When I was in college I had all 4 of my wisdom teeth taken out by an oral surgeon I'd never seen before, and it took less than 35 minutes from the moment I walked in the door until I left, even though he took X-rays and two turned out to be impacted, completely horizontal, and deep in my lower jaw, and one of those was infected.

My surgeon was a big redhead, and as he was reaching into my mouth with glittering implements, I remember looking down at his highly freckled forearms and thinking 'my, what big muscles you have, Dr. Steinhauer.'

And he used them, too. Two casual flicks of his wrist and the uppers were gone, then he cut open my lower gums, drilled each tooth into four pieces and removed those, then dealt with the infection by the simple expedient of pulling hunks of the infected tissue out with forceps, which he cheerfully held up for my inspection. They looked like wads of purple chewing gum.

He sewed me up and I was out of there with a prescription for pain medication. Which I did not fill because I was on my bicycle, the sun had already set behind the mountains at 4 PM, the pharmacy was a couple of miles out of my way, and I wanted to get home (up a steep hill) before the roads could ice over again.

Everything was fine at first and I thought I might not need anything, but in about half an hour the pain began, initially only in time with my pulse, though soon unrelenting and so severe I was kind of incapacitated.

I couldn't lie down because that made the pulsing pain much worse, and when my girlfriend got home 4 hours later and called my name into a darkened house, I was sitting gazing out the window in a chair across from our bed completely frozen and unable to respond to let her know I was there. Her scream when she turned the light on and saw me roused me enough that I could tell her what was wrong, she got the prescription filled and I was fine. But I'll never forget that utterly pain-free and comfortable paralysis, though I have no desire to experience it again.
posted by jamjam at 3:33 PM on October 30, 2012 [1 favorite]

I had two wisdom teeth removed (the upper ones, which I'm told are easier) and it was totally straightforward. I asked the dentist to tell me what they were doing beforehand, which made me feel better - cracked ones might be different, but for mine they basically just pushed up and twisted to try and get them loose, then pulled until they came out, which was an odd feeling but not painful when I was full up with novocaine. The dentist recommended I eat beforehand, which was a good plan because I couldn't eat for a few hours till the anathestic wore off, and I laid in some soup for the first day. I took myself there and back on the bus - I probably could have driven myself but I didn't know until it was done how bad it would be, so I wouldn't recommend it. The trickiest bit was trying to tell the bus driver where I wanted to go when three-quarters of my mouth was numb. I took a couple of ibuprofen before the anasthetic wore off, and that was it for pain relief, and they gave me written aftercare instructions so I didn't have to try and remember them.
posted by penguinliz at 3:58 PM on October 30, 2012

Best answer: When you go to bed, set your alarm to wake you up four hours after your last pain med. Take the drug and go back to sleep, but make sure to set the alarm for four hours again. I did this when I had mine out (4 seriously impacted) and I never had any serious discomfort.

You'll stay ahead of the pain that way.

I got the tip from a friend who does pain management.
posted by Pablo MacWilliams at 7:33 PM on October 30, 2012 [3 favorites]

Your mouth will taste bad. Your tongue will tell you that the weird taste is coming from the wound, and it will want to poke around in there. The weird taste will be coming from the wound, but you do not want your tongue to poke around in there. Dry sockets are horrid.
posted by flabdablet at 10:12 PM on October 30, 2012 [2 favorites]

Maybe I have missed this in all the responses, but if not I can't believe no one has mentioned it:

If you're getting someone to drive you and nitrous oxide is an option, do the nitrous!! It's great, you're awake and yet in a distant, hazy, pleasant place and it wears right off once you stop inhaling it through the mask they hook you up to. Also, I repeat for emphasis, nitrous is great!
posted by dahliachewswell at 10:49 PM on October 30, 2012

I, too, had my wisdom teeth removed on just novacaine; they were not impacted, so it was a bit easier.

One thing I don't see mentioned is something I experienced: while novacained up and the teeth areas were numb, I was surprised by a sudden pain on pulling #3 -- it wasn't the tooth, it was in the joint of my jaw, up by my ear; The dentist was pushing pretty hard down on my mandible, and the unexpected pain was a flash of fear before I realized what it was. So, just be aware that your whole head is involved and don't freak out if you feel pain elsewhere, it might happen but it isn't a sign that novacaine is wearing off or anything.
posted by AzraelBrown at 5:08 AM on October 31, 2012

Response by poster: Thanks for the info!
posted by peppermind at 7:33 AM on October 31, 2012

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