Wisdom Teeth Removal
My first exposure to wisdom teeth was actually my own. My father, Dr. Clyde F. Hurst, was a dentist and he removed mine for me. His technique was to do one side at a time and just use local anesthetic. I had one side done one week and then a couple of weeks later, the other side. Everything went well with me. I didn’t feel anything going through the procedures and recovered was non eventful. He had developed his technique over the years and was very good at it. At that time sedation and general anesthetic were becoming more popular with tooth extraction so when I came from dental school and started working with him, I added the sedation component to the procedure.
In dental school, along with the regular rotations, I did extra rotations at the LA county hospital to get more experience with wisdom tooth extraction and general oral surgery. That was a good stepping off point when I came to work with my father for my first eleven years of practice. Wisdom teeth extractions were and still are one of my favorite things to do. I took and still take extra courses on all aspects of wisdom teeth extraction and related subjects. Over the years I have developed a system of taking out wisdom teeth that I feel works very well and that the patients have been very satisfied with. For most patients we use local anesthetic and sedate them with oral medications. This has the effect of sedation, relaxation, and forgetting the procedure. The patient is numb for several hours after leaving and by the time everything has worn off the main discomfort has dissipated and they are fairly comfortable. Some people will only need to use one or two of their pain pills. Some have not used any.
Some patients don’t want to be sedated and we just use local anesthetic like when I had mine done and this still works very well also. We can also add nitrous oxide gas to the procedure which helps them “float” as it is described. But the effects of relaxing and forgetting the procedure are not there as with sedation.
I am not in a rush to get done when I do the extractions. It is not a race to see how fast I can do it. I like to take my time and be exact in every aspect. There is not the need do get done quickly as when a person is under a short acting general anesthetic or IV sedation.
Another aspect that I feel is much different than most is the fact that I treat a dry socket before it happens. Some people do not heal quickly and the lower sockets do not line with healing tissue very fast and this is called a dry socket. Dry sockets can be very painful. This is more prominent with smokers and people who do not heal fast. The nationwide figure is that about 20% of all people get this. There is one thing I do that I learned from my father that makes a big difference. I pack the lower sockets after the surgery with a special gauze saturated with a medication that stops the dry socket from occurring or limits it’s occurrence. What I have found is that most patients come back after four to five days and I just remove the packs and they are feeling perfectly fine. There are a few who have a little ache or feeling present. On those I just take out the old pack and put a new one in. Usually they are fine in three to four days. It takes a little more time to do these packs but basically I have eliminated the dry socket problem from my office by doing this.
Since my first exposure to oral surgery I have had a great interest in it. The human body is an amazing creation and it is a great privilege to be able to perform operations such as wisdom teeth removal on individuals. I feel that my techniques of packing the sockets immediately after the extractions, taking my time, and using my method of sedation is an excellent mix that provides the patient with an ideal experience in the removal of their wisdom teeth.
Edwin S. Hurst, D.D.S.