The wisdom tooth is the third molar in the mouth, and is the tooth closest to the throat in the mouth. It is called “wisdom tooth” because the third molar begins to erupt at the age of about 20, when the physical and psychological development of human beings is close to maturity, and is therefore regarded as a symbol of “wisdom coming”. In the growth of wisdom teeth, individual differences are great, some people grow all 4 wisdom teeth, some may only grow 1 to 2 wisdom teeth; some wisdom teeth can be fully erupted, some wisdom teeth are partially erupted or completely buried; some wisdom teeth are orthotropically erupted, some wisdom teeth may be erupted at a certain angle with the adjacent teeth. Due to the special position of wisdom teeth, it is not easy to clean them, and it is easy to induce pericoronitis; wisdom teeth that erupt at an angle with the second molar are also easy to food under plug, which leads to the decay of the second and molar teeth, and even causes pulpitis and apical inflammation; what’s more, if the wisdom teeth press on the distal middle of the second molar, it will lead to the loss of the distal middle bone of the second molar and make it loose. In addition, some patients with unexplained neuralgia can often be examined for the presence of buried wisdom teeth. In all these cases, wisdom teeth are recommended to be removed. 1. Is it time to remove wisdom teeth when they are already pressing on normal teeth and showing damage? When wisdom teeth are already pressing on normal teeth and causing damage or discomfort, they must be extracted. However, this is not the best time to remove them. Regarding the timing of wisdom teeth extraction: preventive extraction of wisdom teeth in the lower jaw is generally recommended before the age of 25, and the more ideal age is 16-22. In this period, the roots are formed 1/3~2/3, rounded and not easy to be extracted; they are farther away from important anatomical structures; the burial depth of the teeth, too, is shallower than after the roots are fully formed; the periodontal gap is looser, and the risk of tooth extraction is less; and the young people recover relatively faster. 2. Is there any limitation on the timing of tooth extraction? Generally speaking, extraction of horizontally blocked teeth is more traumatic and should preferably not be performed in a subnormal state; healthy people should avoid extracting teeth on an empty stomach. There are many contraindications to tooth extraction. For example, in terms of heart disease, such as recent myocardial infarction, frequent attacks of angina, telangiectatic breathing, cyanosis, jugular vein anger, swelling of lower limbs, etc., are contraindications to tooth extraction. The extraction of teeth is also contraindicated during menstruation, the three months before and after pregnancy, and in the case of long-term use of anticoagulant drugs that have not been discontinued recently. Acute leukemia, acute hepatitis, acute kidney disease, and radiotherapy within 3 to 5 years are contraindications to tooth extraction. In patients with hypertension, tooth extraction is allowed only if the blood pressure is lowered to below 180/100 mmHg; in patients with anemia, tooth extraction is allowed when the hemoglobin is higher than 80 g/l. For certain blood diseases such as anemia and leukopenia, tooth extraction should be considered only when the relevant indexes are controlled within a certain range and the relevant specialist considers the situation acceptable. For diabetic patients, extraction can be considered if the blood sugar is below 8 or 88 mmol/L at the time of extraction. 3. Should women not have their teeth extracted when they are near their menstrual period? When you are close to your menstrual period, you can evaluate whether you can have a tooth extracted according to the difficulty of the extraction and the patient’s general health condition. Generally speaking, the wisdom teeth in the upper jaw, which are less difficult to extract, can be extracted two days before menstruation for quicker recovery; if the wisdom teeth in the lower jaw, which are more difficult to extract, it is better to do so after menstruation. Generally, after the menstrual period, you can receive tooth extraction when you feel that your general condition is good. 4. Is a panoramic dental X-ray necessary when the surface cannot be seen? It is very necessary. 1. The panoramic film can clearly present the whole picture of the upper and lower jaws and the whole oral cavity, which can more accurately assess the relationship between the position of the mandibular blocked teeth and the mandibular nerve canal, which helps the surgeon to assess the risk factor of damaging the mandibular nerve canal when extracting teeth and helps to minimize the risk of surgery; 2. It helps to assess whether there are risk factors around the wisdom teeth that contraindicate tooth extraction, such as tumors and hemangiomas, to avoid accidents; 3. The film can present the relationship between the wisdom tooth and the neighboring teeth and the surrounding alveolar bone. It can not only help the doctor to formulate the treatment plan according to the decay of the adjacent teeth, but also judge the influence of the alveolar bone resorption of the adjacent teeth on the prognosis of the adjacent teeth after the wisdom teeth are extracted. (For example, if the alveolar bone resorption on the distal and middle root surfaces of the adjacent teeth is serious, the adjacent teeth will be more loose after the wisdom teeth are removed and cannot be retained in serious cases.) It can also help the doctor to assess the resistance to wisdom tooth extraction so that the wisdom tooth can be removed safely and quickly. 5. How long does the anesthetic last? If I still feel numb after the theoretical time of anesthesia, what could be wrong? What should I do? The numbing effect varies from person to person; it is also related to the potency of the numbing drug and whether it contains vasoconstrictor. It is normal to feel numbness 5~6 hours after the injection of local anesthetic. If you still feel numbness on the next day after wisdom tooth extraction, it is possible that the mandibular nerve is compressed or damaged, and you should seek medical treatment in time. Do not miss the golden opportunity! 6. If the nerve is damaged after tooth extraction, is it a serious problem? About how long does it take to recover on its own? The clinical manifestations of lower alveolar nerve damage are mainly hypoesthesia or absence of sensation in the lower lip, abnormal sensation, numbness, etc. There are usually no abnormalities in appearance or function. If the numbness of the lower lip is caused by nerve dysfunction due to temporary ischemia and mild edema, it will generally recover on its own one week after surgery; if the numbness is caused by local pressure on the mandibular nerve canal, corticosteroid drugs can be used to eliminate edema and reduce the pressure on the mandibular nerve canal, as well as nerve-nourishing drugs to help the injured nerve recover as soon as possible. This type of injury can be completely recovered within six months if the treatment is timely and appropriate; if the lower alveolar nerve is damaged and broken, and the gap is filled by the surrounding soft tissue, which prevents the nerve from regenerating, it will become permanent numbness. 7.Can I eat and drink with confidence after the removal of stitches? Or should I avoid stimulating diet for a period of time? About how long? The stitches are usually removed 7 days after surgery. For patients with a small extraction wound and a good recovery, you can enjoy food with confidence after the removal of the stitches. However, if you still have discomfort on the day of suture removal due to poor body resistance or a large incision, you still need to abstain from eating for a period of time. After tooth extraction and before healing, you should chew sparingly with the tooth on the side of the extraction. Only when there is no discomfort in the tooth extraction wound can you eat more stimulating food.