546 Wendel Road
Irwin, PA 15642
Dr. Walter Laverick, D.D.S. DMD PC
801 Portola Drive, Suite 109
Moon Township , PA, 15108
Koren, Larry D.D.S.
3223 N Broad St
Philadelphia, PA, 19140-5007
Gary Henkel, D.D.S. DMD PC
301 horsham Rd
Horsham, PA, 19044
GREG KEWITT DMD, MD, FACS
474 WINDMERE DR SUITE 202
STATE COLLEGE , PA, 16801
When a child's permanent teeth appear, there's usually some push going on, hopefully in the right direction. Although any tooth can jostle its neighbors, the teeth that have the worst reputation are our third molars -- our wisdom teeth. They're the last to come out and often shove other teeth out of their way.
Most mouths can't usually accommodate wisdom teeth, and they end up pressuring the rest of the teeth, disrupting their alignment. They can often cause pain and swelling.
Routine X-rays, done when a person's around age 12, give us early warning of problem molars and tell us whether they need to be extracted. Wisdom teeth, like troublesome neighbors, everyone's a lot happier when they've moved out!
After a wisdom tooth has been extracted, the socket is filled with a blood clot. Slowly, the clot shrinks and fills in. That is, a skin or a covering with tissue similar to the rest of the mouth (mucous membrane) begins to cover the clot and the tissue in the clot area is ingrown by bone cells and tissue cells. Eventually, the area shrinks and the socket is eliminated and replaced by firm tissue, and the depth of the socket fills with bone. The healed area usually is narrower than the site of the original wisdom tooth.
The pain following a wisdom tooth extraction usually lasts no more than a day or two, at the most. If the clot breaks down or is washed away, the protective covering of the exposed bone is lost and the bone can be exposed to the mouth bacteria. This painful condition is known as dry socket. One of the features of its presence is that wisdom tooth post-extraction pain persists longer than a couple of days and can be quite severe.
Though the causes are not known with certainty, some factors seem to predispose individuals towards a dry socket:
Rinsing the mouth within a few hours of a wisdom tooth extraction may flush the clot out of the socket. Using a straw may have a similar effect. That is why post-operative instructions urge the patient not to smoke, rinse or use a straw for at least a day.
Unfortunately, there is no sure way of guaranteeing that a dry socket won't occur, but there is some evidence that placing a small piece (quarter of a square inch) of gel foam (a clotting agent) covered with tetracycline powder (an antibiotic) in the socket after the extraction can reduce the chance of a dry socket. This will be absorbed over a few days and has not been shown to induce allergies or have any other effect on the patient. Fortunately, dry socket is a relatively easy condition to treat.
by Myer Leonard, DDS, MD