Wisdom Teeth Removal

What are wisdom teeth

Wisdom teeth are the last molars on each side of the jaws. They are the last teeth to emerge, or erupt, usually when a person is aged 16-20.

Since wisdom teeth are the last permanent teeth to come through, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to impacted wisdom teeth: teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.

Wisdom teeth that only partially emerge or come through crooked may also lead to painful crowding and disease. Since teeth removed before age 20 have less developed roots and fewer complications, consult with us during teenage years to have your wisdom teeth evaluated.

Pericoronitis is a dental infection that occurs when there is not enough room in the mouth for a wisdom tooth to erupt. The wisdom tooth is partially erupted and the gum tissue covers a part of the top of the tooth. This allows food or plaque to become lodged under the gum tissue flap. If the area becomes infected, it is called pericoronitis and the gum tissue will become swollen and red.

Symptoms can include a bad smell or taste in the mouth, discharge of pus from the gum near the tooth, swollen lymph lodes under the chin, muscle spasm in the jaw and swelling on the affected side of the face. You can treat it by rinsing with warm salt water in the early stages. An antibiotic may be prescribed if the infection progresses and the wisdom tooth should be extracted.

Preparation for a Tooth Extraction

We will take a panoramic X-ray or a cone beam Xray. This X-ray takes a picture of all of your teeth at once. It can show several things that help to guide an extraction:

The relationship of your wisdom teeth to your other teeth

The upper teeth’s relationship to your sinuses

The lower teeth’s relationship to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.

Any infections, tumours or bone disease that may be present

This will help us plan the best way to remove the tooth.

Be sure to provide your full medical and dental history and a list of all medicines you take. This should include both prescription and over-the-counter drugs, vitamins and supplements.

How are wisdom teeth removed?

A tooth extraction is a relatively routine procedure for us. and removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.

Wisdom teeth are often best removed before the age of twenty years as root formation may not yet be completed.

If the wisdom teeth are erupted, the tooth (or teeth) will normally be removed with local anaesthetic but if the wisdom teeth are impacted and embedded in the bone, we will make an incision into the gums and remove the tooth or teeth in sections in order to minimise the amount of bone being removed. Some pain and swelling may occur, but it will normally go away after a few days; however, you should call us if you have prolonged or severe pain, swelling, bleeding or fever.

Our Dentists are experienced in wisdom teeth removal, we offer 3 options:

1. All done in the surgery under local anaesthetic (with or without laughing gas) – The easiest and most affordable option

2. All done in the surgery under IV sedation – More expensive as it includes costs for an independent anaesthetist

3. All done in the hospital under General anaesthetic – The most expensive as it includes hospital fees, hospital room, nurses and anaesthetist plus our expert dental surgeon usually spends double the time doing the procedure in the hospital than in the chair.

We will provide you with detailed instructions for post-extraction.

After getting your wisdom teeth removed, you may experience some discomfort, bruising or swelling.

While your mouth heals, you have to be careful not to dislodge the blood clot or harm your healing gums. You should not consume hard foods, alcohol, coffee, soft drinks or hot beverages in the first day following your procedure. You shouldn’t even brush your teeth, especially around the extraction area for the first day of recovery.

There are plenty of things you can do to make the recovery time easier. Plan on taking it easy for a few days; you can resume your normal activities after the first day in most cases, but for about a week you don’t want to do anything that could dislodge the blood clot from where your teeth were removed. To help with the swelling, place an ice pack over your jaw. The cold helps to reduce the inflammation and ease any discomfort.

We will instruct you on how to take care of your mouth for the recovery period. You will be told to avoid brushing, spitting, flossing and rinsing for 24 hours. After that, you can gently brush your teeth.

After an extraction, you’ll be asked to bite on a piece of gauze for 20 to 30 minutes. This pressure will allow the blood to clot. You will still have a small amount of blood oozing for the next 24 hours or so. It should taper off after that. Don’t disturb the clot that forms on the wound. If heavy bleeding occurs bite down on a cotton pad for another 20 minutes and if it doesn’t stop contact us or go to hospital.

You can put ice packs on your face to reduce swelling. Typically, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling goes away, try warm compresses.

Eat soft and cool foods for a few days. Then try other food as you feel comfortable.

A gentle rinse with hot salt water, starting 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most bleeding ends within a day or two after the surgery. Swelling can last for a week. Initial healing takes at least two weeks.

If you need stitches, we may use the kind that dissolve on their own. This usually takes one to two weeks. Rinsing with hot salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist.

You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. Do not smoke on the day of surgery. Do not smoke for 24 to 72 hours after having a tooth extracted.

If you notice any unusual symptoms like pus discharge, severe pain or a fever, call us or go to hospital. While complications such as an infection are rare, they are possible.

Common risks and Complications:

1. Dry socket – After a tooth is extracted a blood clot forms in the tooth socket and seals the area so that it can heal. A dry socket occurs during the first five days after extraction, when the blood clot breaks down or is dislodged and it exposes the bone which becomes infected.

A dry socket is very painful! So when it happens we might need to rinse out the empty socket, remove any debris and apply medicated dressings to protect the area and decrease the pain. Painkillers will help to reduce discomfort. With proper care and rest a dry socket should heal in 7 to 10 days.

2.  Bleeding, swelling, discomfort and infection: Following treatment you may experience bleeding, pain, swelling and discomfort, which may be treated with pain medication. You may also experience an infection following treatment, which would be treated with antibiotics.

3. Stiff or sore jaw joint: Holding your mouth open during treatment may temporarily leave your jaw feeling stiff and sore and may make it difficult for you to open your mouth wide for several days afterwards. Treatment may also leave the corners of your mouth red or cracked for several days.

4. Changes to nerve sensations: The nerves that control sensations in your teeth, gums, tongue, lips and chin run through your jaw. Depending on the tooth or teeth to be extracted (particularly lower teeth), in rare instances it may be impossible to avoid touching, moving, stretching, bruising or severing a nerve. This could change the normal sensations in any of these areas, causing itching, tingling or burning (called paraesthesia) or the loss of all sensation (called anaesthesia). These changes could last from several weeks to several months or in some cases, indefinitely.

5. A hole in the sinus during removal of an upper back tooth (molar), the small hole usually will close up by itself in a few weeks. If not, more surgery may be required.

6. Incomplete extraction, in which a tooth root remains in the jaw, occasionally it is less risky to leave a small root tip in place.

Wisdom teeth removal if done by an experienced dental surgeon are relatively straight forward with minimal complications if any, so give us a call to get an expert in the field of dental surgery.

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