Oral & Maxillofacial surgery
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Impacted Teeth

Wisdom teeth, otherwise known as third molars, are the last set of teeth to develop. Sometimes these teeth emerge from the gum line and the jaw is large enough to allow room for them, but most of the time, this is not the case. More often, one or more of these third molars fails to emerge in proper alignment or fails to fully emerge through the gum line and becomes entrapped or “impacted” between the jawbone and the gum tissue. Impacted wisdom teeth can result in swelling, pain, and infection of the cheek & gum tissue surrounding the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage to nearby teeth, gums, and bone and can sometimes lead to the formation of cysts or tumors that can destroy sections of the jaw. Therefore, we recommend to people with impacted wisdom teeth to have them surgically removed.

It’s not just wisdom teeth that sometimes become impacted and need to be removed. Other teeth, such as the cuspids and the bicuspids can become impacted and can cause the same types of problems described with impacted wisdom teeth.

Wisdom tooth should be extracted in following conditions:

  • Repeated history of pain
  • Swelling
  • Pus discharge
  • Cavities in the Wisdom teeth
  • Tooth positioned in a manner, which will likely cause problems in the future
  • X-ray reveals
  • Localized gum infection
  • Damage to adjacent teeth

Wisdom tooth should not be extracted in following conditions:

  • Teeth erupted in healthy position
  • No signs of cavities or gum diseases
  • Teeth are very deeply impacted or in a very risky position and likely not to bother you for rest of your life


Wisdom tooth removal is absolutely painless. It is slightly uncomfortable and tiring due to the length of the procedure. Some patients may experience some pain and discomfort post removal but it depends on:
• Your threshold for pain
• How difficult was your tooth removal?
• How long the operative procedure lasted?

You will be given a prescription post-surgery, and as long as you follow the instructions pain and discomfort is minimal.
Generally, simple and uncomplicated procedures are usually performed under local anesthesia. However, patients with low pain tolerance and requiring complicated procedures can be done under general anesthesia also.
• We advise patients to avoid strenuous physical activity for 24 hrs following surgery, but no restrictions for routine daily activities.
• Smoking before and after surgery can cause dry socket or delayed healing. You should stop smoking completely until the extraction sockets heal, which may take couple of weeks.
• Similar restrictions apply for alcoholic and aerated beverages.
• There will be restriction on certain foods for 24 hrs as well.
• Some difficulty in opening your mouth wide is expected from the 1st post-surgery day of the surgery, but this will gradually return to normal. Mouth opening exercises help open the mouth earlier.
• Some patients experience temporary difficulty or soreness when swallowing.
• You will experience swelling around your jaws at the site of surgery, which generally increases for 48-72 hrs following which it tends to subside. Swelling can vary tremendously among patients and between different procedures.
• Numbness – The roots and jawbone surrounding the lower wisdom teeth can be positioned very close to the nerves that supply sensation to your chin, lip, and tongue. While removing lower wisdom teeth, these nerves can sometimes be stretched or injured so that even after the local anesthetic wears off, you might feel an altered sensation in your chin/lip/tongue. However, permanent numbness is a very rare condition and generally this condition heals by itself over a period of time.

• Oro antral communication – Sometimes the root of a deep seated upper tooth may be in close vicinity or within the maxillary sinus and a communication may occur between the oral cavity and the sinus during the extraction. This may heal by itself or can be managed efficiently by the oral surgeon.