What are wisdom teeth?
Wisdom teeth are the last teeth to come in at the back of your mouth. A flap of your gum commonly stays on top of the tooth which traps food and dirt. Therefore this flap commonly becomes infected and the wisdom tooth below requires extraction to the relieve pain.
This x -ray shows an Impacted Wisdom Tooth. It is unable to erupt as the teeth in front have taken all the space.
This means that your wisdom teeth are unable to erupt into your mouth, they are Impacted !
Common Reasons for removing Wisdom Teeth
When a wisdom tooth is impacted it becomes difficult to clean therefore the flap of gum on top of it can become infected and swollen.
This can be very very sore! You might even feel pain in nearby teeth, or in the ear on that side of your face. This condition can lead to an infection known as ‘pericoronitis’. If left untreated, severe infections may sometimes require a hospital stay and surgery.
Reasons for removal:Because Infection around a partially erupted wisdom tooth
- Decayed or broken down wisdom tooth causing pain
- Decay of the neighbouring tooth caused by food build up
- You may need space for braces (orthodontics).
- Cysts can develop around wisdom teeth.
- Gum disease may develop around wisdom teeth and spread to other teeth
- If you are travelling abroad.
- Members of the armed forces need their wisdom teeth removed to be declared fit for active service over seas.
- While you are having one wisdom tooth removed other wisdom teeth may be removed at the same time for convenience.
WHEN ARE WISDOM TEETH REMOVED ?
Wisdom teeth are normally removed after several episodes of symptoms in your early 20’s.
In some individuals wisdom teeth give no symptoms until later in life however on rare occasions they may be removed in the late teens. The deciding factor is”are your wisdom teeth causing problems?” If the answer is yes, then they probably need removal.
It is normal to control the symptoms of infection before removing wisdom teeth at your convenience. On some occasions the removal of wisdom teeth is the only means available to control pain or infection.
Treatment Options with Wisdom Teeth.
The only treatment possible is to keep your teeth as clean as possible to prevent either infection or decay.
OR
Take out your wisdom teeth.
How are wisdom teeth removed?
There are 2 methods of removing wisdom teeth and we will try to keep this bit simple
1. Elevation Of Wisdom Teeth
If a tooth is not deeply impacted it will often Elevate Out. This means you press down firmly beside the tooth and the tooth will often rise up.
This means there will be minimal post operative pain, almost no swelling and usually no sutures or stitches will be needed.
Elevating a wisdom tooth will usually take less than a minute and you should be able to resume normal activity the next day. While you will be sore and tender it shouldn’t be excessive. Don’t engage in activities that makes you sore as to do so may hinder healing.
2. Surgical Removal Of Wisdom Teeth
If a tooth cannot be elevated, it must be Surgically Removed or cut out. Surgical removal of a wisdom tooth will take between 7 to 8 minutes under normal circumstances. Several dissolving sutures are placed in the gum after and you should expect to have a swollen face for one week as a result. You will probably need several days off work and will most likely need painkillers and antibiotics for several days after.
We find surgical extractions are best carried out under sedation for comfort, while the extraction is possible while you are awake, it involves lifting the gum, cutting bone and tooth and this can be off putting. Several dissolvable sutures are usually placed. If you are awake for the extraction, it will feel like you are having a large filling at the back of your mouth. You should expect an extraction to be uncomfortable as a result of the pressures applied, but painful. Some people are happy to have the procedure carried out while they are awake. However if you’r nervous, sedation is the best option and is available for your comfort.
WHERE ARE WISDOM TEETH REMOVED ?
Its considered best practice today is to remove wisdom teeth in a dental office setting either while you are awake, with your jaw numb or while sedated. (Traditionally wisdom teeth were removed under general anaesthetic in a hospital.)
Many dentists will safely remove easier wisdom teeth and only more the difficult wisdom teeth will be referred to an Oral Surgeon for removal.
Sedation and Wisdom Teeth
In a modern dental practice your wisdom teeth will be extracted under sedation. This allows quick access to treatment. It avoids long and costly hospital visits and the risks involved with general anaesthetic. Recovery times with sedation are much quicker than with general anaesthetic. Sedation facilitates comfortable and safe treatment with a quick recovery for you.
Sedation will be administered through a drip placed in your arm. and we would expect you to be back on your feet and ready to go home in about one hour. There are few if any post operative ill effects from sedation (unlike general anaesthetic).
If you are being offered general anaesthetic for the removal of a tooth you should ask why !! And ask why sedation, the safer alternative is not their first choice and beware !!
Side Effects of Removing Wisdom Teeth
Numb Lip, Chin, Cheek and or Tongue
The nerve to your lower lip and cheek and tongue runs close to your lower wisdom teeth.
All lower wisdom teeth are close to this nerve and some wisdom teeth may actually be touching this nerve. The removal of wisdom teeth from the lower jaw may result in bruising to this nerve. As a consequence of this bruising you may have a numb feeling in your lip, chin, cheek or tongue on that side of your mouth. It’s not going to alter your appearance in any way. This numbness in your mouth usually lasts between 3 to 6 months before resolving, however if altered feeling persists beyond 2 years it will be permanent.
BLEEDING
It is normal to expect some slight oozing after an extraction. Since activity results in bleeding it is sensible to avoid activity that day. You should go straight home and relax. Avoid using your mouth as much as possible as to do so may result in bleeding. However you may drink sips of cool fluid immediately and have liquid food such as soup or a yogurt after about one hour and finally you can eat soft sloppy food once the numb feeling has left your face after about 4 hours.
STOPPING BLEEDING
Should you experience some bleeding after an extraction its probably because you’ve disturbed the blood clot by being too active or chewing on the area. Therefore relax, try to remain calm, some bleeding is normal as a result of any extraction. Sit down and rest, roll a clean tissue or cotton wool into a pad about the size of your finger, place it over the socket and bite on it for ten minutes. If the persistent bleeding do not hesitate to contact us.
PAIN
You will have some pain after any extraction. Dr Murnane will have given you a pain killer before your extraction, therefore you shouldn’t need another until much later that night. In the following days please take whatever painkiller you normally use on a regular basis. This should keep you comfortable. However, if you prefer you may use the painkillers prescribed.
Its important to emphasise you must read the instructions that accompany your painkillers and take your medication on a regular basis to increase its effect.
SWELLING
You will experience some swelling after an extraction, and the more work required to remove your wisdom teeth the more swelling you are likely to experience. Your swelling should be at its maximum the following morning and like any bruise will resolve over 4 to 6 days. Swelling is a consequence of the trauma of the extraction and the more trauma the more swelling. Only an infection will stop your swelling from resolving. So you must make every effort to prevent infection.
DRY SOCKET
Dry Socket is an intense pain that you may experience after your extraction. The pain will not be eased by painkillers, will typically last about 2 weeks but may last even longer. There is no effective treatment. Dry socket tends to run a course and resolve in time. Unfortunately dry socket does tend to run in families.
You cannot predict nor stop a dry socket for happening. Keep your mouth clean with salty water and Corsodyl mouth wash and pour CLOVE OIL into the affected socket. Clove oil will ease, but not eliminate the pain of a dry socket. Dry socket is most common after wisdom teeth extractions.
Ulceration
Ulceration of the skin of your mouth may occur after the removal of wisdom tooth or dental extraction. The ulceration can be quiet painful and will resolve in approximately 10 days. There are many causes of the ulceration in the mouth including biting your self while your numb, trauma from the extraction etc. Difflam Mouth Wash washed around the sore area will be helpful at easing the pain of ulceration.
Fracture of Teeth/ Fillings
Teeth with large fillings and crowns are weaker than healthy teeth and weakened teeth can and do break during extractions as a result of the stresses transmitted through the area.
While this is unfortunate, it is a relatively common side effect and is a result of past decay which has weakened your tooth. When you have recovered you should return to your dentist to have the tooth fixed.
Loose Teeth
Some loosening of teeth which sit beside an extraction is to be expected. In most instances your teeth will firm up in several weeks if left alone and no pressure is applied to them.