Dental Education Lecture: Immediate Extraction of Troublesome Wisdom Tooth

Immediately Before Extraction

Immediately After Extraction





Can we take out an inflamed wisdom tooth?  Yes, and we should if there is no contraindication to it.  When we have wisdom tooth infection, we can feel painful swelling in the back part of the face.  Fig.1 shows facial swelling of a young gentleman on the right side (your left handed side).  He has had severe pain for several days and has difficulty in opening mouth (Fig.2).  He is healthy.  We agree to extract the wisdom tooth immediately.  After sound local anesthesia is achieved, we take out the affected wisdom tooth smoothly and drain a big abscess. The patient suddenly feels that pain and swelling (tension) is gone (Fig.3).  He can open his mouth wider (Fig.4).  You see a piece of gauze in his mouth, which is used to stop post-extraction bleeding.

An infection in our facial region is quite dangerous.  The infection travels thorough valveless veins freely to the brain.  In the other part of our body, veins have valves, a controlling blood flowing mechanism.  Blood travels in one direction and does not flow backward.  In our head, veins have no valves so that infection can spread either way, i.e., any direction it likes to.  Our facial tissue is fairly soft.  Infection can spread quickly and can be out of control easily.  Infection to our brain is usually fatal.  In addition, our mouth is close to our eating and breathing pipes.  When you have infection in the back of our mouth, you have difficult in not only eating, but also swallowing and breathing.  In the most critical situation, you may suffocate to death.

The most effective way to control infection is to take out affected wisdom teeth immediately. Oral infection is usually associated with abscess and tension.  When we take out the bad tooth, the source of infection, and drain the abscess, tension goes down substantially.  The infection is less likely to go to more important structures, such as the brain.  The doctor routine prescribe antibiotic(s) and painkiller after extraction to further control infection.  You will recover pretty quick.  Contraindication to immediate extraction is that you have poor health, such as AIDS and other immune deficiency.  If you are generally healthy and young,  you should be safe for immediate extraction. 

If you have no trouble with your wisdom tooth, do we need to take it out?  Next lecture will address this question.

Xin Wei, DDS, PhD, MS 1st edition 01/17/2009, last revision 03/20/2010