Wisdom Teeth Extractions
What are Wisdom Teeth?
Wisdom teeth are the last molar teeth to develop which usually grow at the very back of the upper and lower jaw bones, one at each back 'corner' of the mouth. They usually appear when people are aged 18 to 21 years old, and they are called wisdom teeth because by that age people become 'more mature and wise'. Wisdom teeth can be as good and useful as any other teeth provided that, as they develop, they can penetrate the gums and emerge or erupt into the mouth completely and properly.
Unfortunately, this is not always the case. Frequently wisdom teeth erupt only partly or they don’t erupt at all. They are then called impacted wisdom teeth and they are usually a cause of many problems that makes it necessary for them to be removed.
The wisdom teeth usually need to be removed because of one or more of the following:
- Severe pain and swelling caused by the wisdom teeth themselves
- Recurrent infection of the gum around the tooth
- Serious decay of the wisdom teeth which cannot be repaired
- Helping to reduce crowding of other teeth before straightening with a 'brace' (orthodontic appliance).
- Very rarely, the tissues around the wisdom teeth can develop cysts or tumours and this can be one more reason for removing them.
In some cases a wisdom tooth can be removed under local anaesthetic. In this situation, the area around the tooth is made numb with an injection of local anaesthetic. Sometimes the local anaesthetic is combined with sedation to help you relax and allow you to go through the operation. Having sedation means that you will be conscious during the operation, but will not be aware of what is going on.
Before the operation
Stop smoking. If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check you have a relative or friend who can come with you to the clinic and take you home. Please tell the doctors and nurses of any allergies to tablets or medicines. You will have the operation explained to you and will be asked to fill in an operation consent form.
After - At the clinic
Your mouth will feel bruised and swollen, the jaw will be slightly stiff and usually there is some mild to moderate discomfort. Your cheeks will usually swell a little with slight bruising of the skin. The swelling, bruising and stiffness of the jaw will disappear over a week to 10 days. You will be able to drink two to three hours after the operation but eating may not be possible for a few hours. It may be hard to chew normally for a while so you should eat a softer diet and initially avoid very 'spicy' or 'vinegary' foods. A little extra daily fibre in the form of porridge or bran often helps to prevent constipation whilst your diet is temporarily altered. You may have sutures (stitches), which usually dissolve within 10 days.
After - At Home
You may be given a prescription for an antiseptic mouthwash, painkillers and some antibiotics. It is important to keep your mouth cleaner than normal to prevent infection of your wounds. A warm salt-water mouthwash, three times a day (add a pinch of salt to half a pint of warm water), used for one minute each side of the mouth after tooth brushing often helps soothe the mouth. The antiseptic mouthwash given to you should also be used after the salt water for one minute. You should finish the full course of antibiotics but only take painkillers as directed. Antibiotics can affect function of the contraceptive pill and alternative precautions are advisable whilst taking the antibiotics and for about a week after finishing the antibiotics.
It is generally recommended that you have the operation for wisdom teeth removal sooner rather than later because as you get older the chance of complications after this operation increases.
Bleeding after the operation occurs rarely and usually stops when the surgeon applies some pressure with a sponge on the area of the operation.
If you experience increasing pain at the area of the operation, you feel that it is getting more swollen and you have a temperature, it most probably means that the antibiotics that you were given to prevent an infection were not adequate and that the area of the operation has become infected. This happens relatively rarely and taking antibiotics (most likely different to the ones you were given to prevent the infection) for another week or two usually solves the problem. In a very small number of patients the infection can lead to a collection of infected fluid or pus (abscess) at the area of the operation. In this situation the pus will need to be drained by the oral surgeon.
The lower wisdom teeth are usually very close to a nerve, which supplies the tongue and lip for touch sensation. There is a separate nerve like this on each side. The nerve(s) may be affected by bruising and swelling around the wound(s). This may cause some numbness of the lower lip and tongue on one or both sides. It happens in 1 to 3% of patients. Normal feeling usually returns but in some very rare instances permanent numbness may persist.
In 5 to 10% of cases you can have experience a problem called a “dry socket”. This happens because following the removal of the wisdom tooth a clot was not formed in the area or socket where the tooth used to be or it did form but was then dislodged. This can be painful, and often causes foul bad breath and it is something you usually experience four to five days after the operation. The socket needs to be packed with some medicated gauze for a few days to relieve the symptoms until the healing process progresses and starts to fill the socket. It is believed that patients who smoke or women who use contraceptive pills experience this problem more frequently. Although a “dry socket” can be very annoying, with proper care it settles completely, relatively quickly.
If you have any problems relating to your surgery whilst at home and are not sure what to do, ring the clinic. You may feel quite tired for one to two weeks after your operation.
Things to remember
You must not eat or drink anything for six hours prior to your appointment for your treatment to be carried out under sedation.
After Intravenous sedation a responsible adult must take you home and stay with you for the rest of the day. You must not drive or operate machinery such as vehicles, cookers, washing machines, power tools etc., for at least 24 hours after the treatment has been completed.
Once you are home you may have small sips of water and a small portion of food. Gradually this may be increased to larger portions.
Frequently Asked Questions
Why do I need my wisdom teeth extracted?
If there is not enough room in your jaw, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. Often, part of the wisdom tooth will appear through the gum and part will still be buried under the gum causing soreness and possibly swelling. Food particles and bacteria may collect under the gum and cause an infection in that area. This may be a temporary problem, but in may cases it becomes chronic, when it is best to have the wisdom tooth removed.
Who will operate on me?
If you have been referred to the Chadwell Heath Dental Clinic for the extraction of your wisdom tooth/ teeth, the procedure will be carried out by a dentist with special interest in oral surgery.
Do I have to have I.V. sedation for my wisdom tooth removal?
The procedure can be performed using either local anaesthetic or I.V. sedation. The choice is yours, although the majority of extractions are performed under I.V. sedation.
How painful is wisdom tooth extraction?
The degree of discomfort depends on how easy it is to remove the teeth. There is usually some swelling and discomfort for a few days after extraction. You will be given painkillers, mouthwash and antibiotics (most cases). It may be necessary to use stitches to promote healing and stop the bleeding.
How soon can I go back to work?
You may be off work for a couple of days. Your oral surgeon and recovery nurse will be able to give you more post-operative advice.