Wisdom Teeth Removal
Wisdom teeth are the third set of molars which normally erupt between the ages of 18-21. As human civilisation has developed our diets have become much softer, and as a result our jaws have become smaller. This means that there is often not enough space for wisdom teeth to fully erupt into the mouth and become functional. It is still not known why wisdom teeth sometimes develop at an angle to the other teeth and become impacted.
Unerupted wisdom teeth within the jaw can cause a number of complications:
- Infection of the overlying gum and surrounding soft tissue
- Resorption or decay in adjacent teeth
- Wisdom teeth, even if not fully erupted into the mouth, may still decay
- Occasionally other complications such as cysts may arise.
We generally recommend that wisdom teeth are removed before the age of 19 if there is insufficient space for them. This is because at this stage the roots are not normally full formed. and bone is less dense, making the extraction simpler and complications less likely.
Removal of impacted wisdom teeth
To remove an impacted wisdom tooth usually means that we need to raise a flap of gum back so that we can see the tooth fully. We may also need to remove a small amount of bone from around the tooth. In some cases we also section the tooth and remove it in pieces. The teeth themselves are not “lodged” into the jaw.
The difficulty with their removal is that because they are lying at an angle we cannot simply lift them straight up:- they are larger than the “exit” we have for them.
From a patient's point of view, the procedure is painless as we give you local anaesthetic. Patients will however have a feeling of pressure during the procedure. We can either give you a tablet of Hypnovel ( similar to Valium) or intravenous sedation to relax you.
You have probably heard a lot of stories about discomfort after wisdom teeth are removed. It is normally quite tender on the day of removal. However, after the first day most people feel no more than a dull ache which takes around a week to completely resolve. There may be some swelling, depending on how difficult your teeth are to remove. This normally peaks at 48 hours. It is also normal to experience some stiffness of the jaw which takes 7-10 days to completely disappear.
It is quite normal to have some oozing from the sockets after the extraction of wisdom teeth. As you will have some stitches it is very rare to have more than that, however we will provide you with a gauze pack to apply pressure to the socket should the need arise.
It is quite common to get an infection after having your wisdom teeth removed. We normally prescribe antibiotics to prevent this occurrence- It is also important that you rinse several times a day with warm salty water for at least one week to keep the sockets clean.
There is a nerve which lies within your lower jaw (one on each side), called the inferior dental nerve. This nerve supplies your lower teeth and lower lip. The roots of a lower wisdom tooth may lie close to this nerve. As a result in approximately 4-6% of cases, there may be some bruising of the nerve leading to a numb or tingly lip following the extraction. This normally resolves after several months. Very rarely it may be permanent. We always take an X-ray which shows us the relationship of your tooth to this nerve so we can give you an idea as to whether you are likely to experience any problems.
There is also another nerve which runs along the inside of your lower jaw just below the gum- the lingual nerve. Very rarely this nerve may also be bruised- leading to numbness or tingling of your tongue on the same side. Again this would normally resolve after several months and the risk of this happening at all is about 1%.
It may seem a little daunting to read a list of things that can go wrong”. however, please remember that most treatment is complication free.
Please do not hesitate to ask should you have any further questions or concerns.