Wisdom teeth…not so wise
Wisdom teeth are the large molars that emerge at the very back of your mouth, usually between the ages of 17 and 24. Some people never develop their wisdom teeth, while others have up to four emerge (one in each corner of your mouth). A lot of the time wisdom teeth appear with little trouble, but if there is not enough space for the teeth to grow they can become wedged in or ‘impacted.’
Removal of Wisdom Teeth
Post-Op: Wisdom Teeth
Potential issues when wisdom teeth erupt
Problems usually start when wisdom teeth become impacted. Infection and inflammation can develop in and around the tissue covering the impacted tooth.
You may notice swollen red gums, pain, jaw stiffness, and a general feeling of being unwell. The teeth near the wisdom teeth can also be affected by the inflammation of the gums and surrounding bone, or even decay if food is trapped between the wisdom teeth and surrounding teeth.
In some cases a cyst (sac of fluid) can form around the impacted wisdom tooth, which can destroy surrounding bone, or damage the surrounding teeth and gums. Antibiotics can be prescribed to help with any infections, but in most cases removal of the impacted teeth is the only permanent solution.
General and local anaesthetic
Your dentist or oral surgeon will explain the process of wisdom teeth removal. It is important to tell your doctor your entire medical history, including medicines you are currently taking, any known surgery/anaesthesia related problems, or if you are prone to heavy bleeding. Your dentist may choose to take some X-ray images of your mouth prior to surgery.
Usually the operation is done under local anaesthetic, which completely blocks pain from your teeth and gums while you stay awake. If the teeth are difficult to remove or you feel anxious about the procedure, general anaesthetic may be your preferred option. This allows you to sleep through your surgery.
Your surgeon will advise when to eat and drink before and after surgery. You are usually required to fast between six and 12 hours before your surgery, if done under general anaesthetic. You should have a light meal and some fluids an hour before your surgery if done under local anaesthetic.
How are wisdom teeth removed?
In some cases wisdom teeth extractions are no different to extractions of any other teeth. The dentist will widen the tooth socket by using a straight instrument and a pair of dental forceps, the tooth will be moved from side-to-side until loose enough to be removed completely.
In deeply impacted cases, the surgeon may make an incision in the gums or may remove some bone as well. The incision is closed with stitches, which may be dissolvable after ten days. The whole procedure can take between 30 and 60 minutes.
After-care post surgery
After a wisdom tooth removal, you will need to rest for a while. Do not drive if you have had any sedation or general anaesthesia, and arrange for some help at home for the next day or so. Painkillers will be recommended for up to a week after surgery. Bleeding after surgery is common, but your dentist will inform you on how to best manage this. Swelling of the jaw is also common, and will subside after four to five days (ice can be applied immediately after surgery to manage this).
Your dentist will advise of any possible complications, risks or side effects associated with wisdom teeth removal. If you have any concerns about your treatment, please ask your friendly National Dental Care staff and dentist.
Any surgical or invasive procedure carries risks. Before proceeding with a surgical or invasive procedure, you should seek a second opinion from an appropriately qualified health practitioner.
Do all wisdom teeth need to be removed?
The simple answer is: not necessarily. Due to many factors, impacted and problematic wisdom teeth are becoming more and more frequent. Your dentist will advise whether your wisdom teeth are fine the way they are or if they are likely to be problematic. If so, extraction may be recommended. This can be done in the general dental surgery, under local anaesthetic or under general anaesthetic or under sedation. Occasionally a referral to an oral surgeon (a dental specialist) may be required.
What’s involved in the post-care?
Your dentist or oral surgeon will advise of best care after wisdom teeth removal. Typically, you will be advised to:
- protect the area where the tooth has been removed and avoid touching it with your tongue or hands
- avoid hot drinks or hot food for 24 hours, as this may cause the wound to bleed
- avoid rinsing your mouth and swishing water or mouthwash for 24 hours as this may dislodge the blood clot in the tooth socket and cause further complications
- if you experience bleeding, apply gentle pressure on the site with a clean gauze pack
- do not smoke for 2-3 days after the procedure and avoid drinking alcohol as this can cause serious complications and delay healing
Will I need to go under general anaesthetic?
Not all wisdom teeth extractions are difficult or complicated. Most wisdom teeth can be removed in the dental surgery setting and under local anaesthesia. Other forms of anaesthesia and sedation are available to relieve anxiety about the procedure. If you feel that you are very anxious about the procedure and would prefer not to remember it, you may choose to have your wisdom teeth removed under general anaesthesia either at a hospital day surgery or at an National Dental Care practice offering general anaesthetic services. (Find a National Dental Care practice with general anaesthetic).