Mary Jo Podgurski

Column Mary Jo Podgurski

Dr. Mary Jo Podgurski is the founder and director of the Washington Health System Teen Outreach. She responds to 68 questions from young people daily and has written 'Ask Mary Jo' since 2005.

Medical information requires context

January 16, 2013

Q. I am totally freaking out. I went to the dentist, and he said I needed my wisdom teeth out. They’re impacted. So I went on YouTube and watched a video about having impacted wisdom teeth removed, and now I do not want to have this done. Plus, the recovery looks horrible. Is there any way to avoid it? My dad said I need to suck it up.

– 18-year-old female

Mary Jo’s response: I actually have two responses for you. First, I’d like to address your anxiety about your wisdom teeth. Second, let’s look at what happens when information is available without easily accessible guidance and processing. In other words, the online universe is amazing and can open doors to knowledge prior generations didn’t even imagine, but a teacher is still necessary to mentor the acquisition of that knowledge.

Impacted wisdom teeth are third molars that haven’t erupted on their own. Third molars are the last adult teeth to come out and are in the back of the mouth. They emerge between the ages of 17 and 25. There are usually two in the mandible (on the bottom of the mouth) and two in the maxilla (on top). If impacted, the teeth are trapped and do not have enough room to emerge and grow properly.

Most dentists and oral surgeons recommend removing impacted wisdom teeth before they cause problems. Symptoms of problems with impacted wisdom teeth that could mean infection are: pain; red or swollen gum; tender or bleeding gum; swelling around the jaw; bad breath; an unpleasant taste and headache.

Even without infection, impacted teeth can cause problems like crowding other teeth or forming cysts. If partially impacted (which means a part of the tooth has emerged) problems like tooth decay and gum disease can result since cleaning is difficult.

An oral surgeon will extract impacted wisdom teeth during an outpatient procedure (you will not be admitted to a hospital). Typically you will be given local anesthesia (that numbs your mouth) as well as either sedation or a general anesthesia. An incision is typically made in the gum around the impacted tooth, the tooth is removed and the wound is closed with stiches and packed with gauze.

Recovery is typically a few days and your dentist or oral surgeon will give you detailed instructions. You’ll be given pain medication and told how to handle any bleeding or swelling. A soft diet is best – gelatin, pudding, light soups – and avoid sucking on a straw for the first few days so a healing blood clot is not loosened. Cold (e.g., an ice pack) helps with swelling the first 24 hours and moist heat (like a washcloth soaked in warm water and wrung out) is useful the following 2-3 days.

As with any medical or surgical procedure, I recommend writing down your questions and asking your health care provider directly. Only your surgeon will know your specific needs. Don’t hesitate to stay in touch after the surgery.

Your anxiety level is normal. I think you’ll feel better after a conversation with your surgeon. Schedule an appointment to ease your fears.

Let’s talk about that YouTube video. As a health educator, I believe in full disclosure. When I was a young nurse, I was taught to avoid sharing details of a person’s care or treatment. That attitude has changed. Maintaining your health is easier if you know what your body needs to stay strong. I’m not opposed to knowledge. I am concerned that online exposure to gory details of procedures like surgical extraction of impacted wisdom teeth can be terrifying if viewed alone and without the benefit of support.

Why not ease your fear (and your curiosity) by discussing the surgery with your dentist or surgeon? If you want to watch a video of the procedure you could do so with the nurse or office staff. They could offer explanations. You could watch with a friend or trusted adult who could help buffer the experience and offer support.

As an 18-year-old person, you can make health care choices. You are right to get informed. Use that information wisely. Good luck with your decision. I hope all goes well.



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