Problem wisdom teeth are one of the more common reasons for visiting an Oral & Maxillofacial Surgeon. Often a dentist will send a patient along for an opinion about wisdom teeth before they have become painful. The most common reason for this is that wisdom teeth are generally easier and safer to remove from young mouths or they may have picked up a problem on an x-ray like this impacted tooth below which is a risky to the tooth in front.
Some of the Reasons why wisdom teeth are removed:
- Tooth decay.
- Cystic change.
- To assist orthodontic treatment.
- The likelihood of future problems.
- To avoid increasing difficulty removing teeth when older and poor healing.
How are wisdom teeth removed?
Surgery is performed either under local anaesthesia alone, (dental injections), local anaesthesia with intravenous sedation (IV or twilight sleep), or local anaesthesia with general anaesthesia (GA).
Surgery usually involves raising gum flaps to gain access to the bone which surrounds the tooth. Some of this bone is removed with a drill (similar to the type used for dental fillings). The tooth is usually divided up to allow it to be removed in parts. The socket is washed out and the gum closed with dissolving stitches.
Upper wisdom teeth are often easier to remove than lower wisdom teeth.
There are some risks in removing wisdom teeth:
For this reason it is best to have surgery with someone experienced in the removal of wisdom teeth. You will hear more about these risks at your consultation but they are summarised below.
- Tingling or numbness of the lip, chin or tongue due to the proximity of two nerves occurs in less than 1 percent of patients after removal of lower wisdom teeth. Usually this is temporary lasting days or weeks. Problems that can result from permanent tingling or numbness include lip-biting, reduced ability to feel food on lip, tongue-biting, altered taste and possibly alteration to speech. All patients will experience numbness in the first 24 hours after surgery due to the local anaesthetic injections given at time of surgery.
- Infection is uncommon. Antibiotics and mouthwash are routinely given to try and prevent this outcome.
- Excessive bleeding. Uncommon.
- Dry socket. Occurs after less than 10% of lower wisdom tooth removals. The blood clot falls out early causing the socket to become dry and painful. Occurs a few days after surgery and the socket can become painful. Normally easily treated. Please return to the surgery.
- Jaw joint problems. Uncommon and usually last a few weeks.
What to expect after surgery to remove wisdom teeth:
- Swelling. Maximum at 1-2 days. Lasts 5-7 days.
- Discomfort. Pain-relief medication is effective and will be required for 4-5 days after surgery.
- Limited mouth opening.
- Tiredness after general anaesthesia may occur for a few days. Nausea or vomiting is unusual.
- Weakness of the jaw for several weeks.
Most people return to work or study 4-5 days after surgery. An appointment will be arranged for review if needed call to arrange.