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Dentists insist that wisdom tooth removal is now painless. The perception among the public is very different. What is the truth? Is painless wisdom tooth removal possible?

There is something about a wisdom tooth removal that immediately sets the heart racing. Most people assume that it is a very painful procedure while dentists will insist that is not the case. Where does the truth lie? Well, in this case, the perception of pain has been greatly exaggerated. While some wisdom tooth removal procedures may heal with some amount of pain, the procedure is almost never painful. In fact, it is an infection after wisdom tooth removal that is the cause of pain rather than anything to do with the procedure itself.

Is painless wisdom tooth removal possible?

The short answer to this question is yes. It is possible and in fact the norm. We have four wisdom teeth (in most cases) which are the last teeth to erupt into the mouth. Our jaws have reduced in size as a part of evolution and rendered our wisdom teeth (also called as third molars) superfluous. Since wisdom teeth rarely erupt into the mouth with proper orientation, they are the most often extracted teeth in the mouth [1].

If you are told that you need a wisdom tooth extraction then you should understand that it is a completely routine procedure. Most times, in case of an upper wisdom tooth, the extraction is completely painless and hardly takes a few minutes. Upper or lower wisdom teeth can be removed without too much trouble if they are visible in the mouth [2].

The most difficult wisdom tooth removal procedures are those where the wisdom tooth is infected, has not erupted completely into the mouth or is decayed. Even in such cases, though, the wisdom tooth removal procedure is completely painless. The extraction procedure may be surgical in nature during such cases [3].

Pain during wisdom tooth removal

Each and every patient is given local anesthesia before any kind of extraction. This is true for both non-surgical and surgical wisdom tooth removal. Local anesthesia is enough to numb any sensation of pain, tooth cutting or bone cutting that is required to be done by the dentist [4].

If the patient continues to feel pain during the procedure, then that is an aberration. The reason could be an insufficient amount of local anesthetic agent, severe infection at the site, or an incorrect method of administering anesthesia.

All of these things can easily be dealt with during the procedure itself ensuring that the patient does not have any discomfort.

There are some things that cannot be avoided even after administering sufficient anesthesia. The first is the fatigue on opening the mouth. The wisdom teeth are the furthest back in the mouth and can be difficult to reach. Just the act of opening the mouth during the entire extraction procedure can be tiring [5].

While the anesthesia numbs the pain sensation, patients will feel pressure as the tooth is being removed. The dentist will ask the patients to signal to them if they feel uncomfortable at any time but the feeling of pressure being exerted on the tooth will be felt throughout the procedure.

Pain after wisdom tooth removal

Our body treats the removal of a tooth from its place in the mouth as an injury. Like all injuries, there is some amount of pain, swelling, and general discomfort that can be expected after wisdom tooth removal.

This pain and discomfort after wisdom tooth removal can be managed with pain medication, antibiotics, and rest in most cases. Patients can help their own case by being diligent about the pain medication and making sure that the antibiotics course is completed as directed [6].

In some cases, particularly when the extraction procedure was difficult or the patient is suffering from a systemic condition like diabetes, the healing process after the extraction can be painful. Wisdom tooth removal infection [7] or a dry socket [8] are the common complications that can cause pain and discomfort for patients.

It must be stressed, though, that these complications occur in only a small percentage of the population. Proper planning and following as atraumatic a technique for extraction as possible will help minimize the chances of complications after wisdom tooth removal.

The normal time for healing to take place is around 7 days after a non-surgical extraction. It may take around 10 days for a surgical extraction wound to close up [9]. Patients should take care not to eat spicy food, have too much of aerated drinks, smoke cigarettes, or consume tobacco in any form [10].

All of these things will irritate the extraction site and reduce the pace of healing. Smoking and diabetes is the combination with the highest chance of complications after wisdom tooth removal.  

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