Introduction: This information is aimed at patients who may need to have an operation to remove impacted wisdom teeth. It explains why they may need to be removed, what is involved and also potential risks and complications that there may be.
Wisdom teeth: Adults normally have 32 teeth. The wisdom teeth (also known as 3rd molars) are the last to come through and are located at the back of the mouth. Normally there are 4 wisdom teeth, one on each side of the upper and lower jaws.
What are impacted wisdom teeth? If your jaws are too small to accommodate all your teeth, there may not be enough space for your wisdom teeth to come through properly. This may lead to them becoming impacted, in other words, stuck. This often causes associated problems.
Reasons for the removal of wisdom teeth
1. The most common reason is recurrent infection of the gum overlying a tooth that is part way through the gum. This is called pericoronitis.
2. Decay in the wisdom tooth, which your dentist cannot restore.
3. Infection of the tooth (abscess) due to advanced dental decay.
4. When the adjacent molar tooth is affected by gum (periodontal) disease or dental decay due to the impacted wisdom tooth.
5. Progressive cystic (fluid filled sac) formation around the tooth.
6. As part of other surgical procedures involving the jaw.
7. There may be other less common reasons that your dentist will discuss with you.
The removal of wisdom teeth: There is a wide range of difficulty in removing wisdom teeth. The procedure may be carried out under local anaesthetic (injection in the gum to numb the area); with or without intravenous sedation (injection in the arm or hand to reduce anxiety); or under general anaesthetic (completely asleep in a hospital).
Your dentist will discuss with you which method is most appropriate to your case and the degree of difficulty of the surgery, any underlying medical conditions and other personal circumstances will be taken into account choosing the method. Removing wisdom teeth can involve an incision (cut) in the gum close to the tooth. In some cases, some jaw bone around the tooth is removed with a drill. The procedure can also be made easier by sectioning (cutting up) the tooth itself into smaller pieces before removal.
After the operation: As you might expect, there the amount of pain and discomfort suffered by patients varies greatly, depending on a number of factors, including how difficult the surgery was. The average recovery time is between 7 and 10 days. Swelling is common and tends to be at a maximum, on the second and third days after surgery, then reducing over about a week. Your ability to open your mouth is likely to be restricted and a semi- solid diet will be required over the first few days. You should expect some pain from the operation site. This can be controlled by painkillers. Bruising of the face and upper neck also occasionally occurs.
Some possible complications: Removal of wisdom teeth is a very safe and common operation but there is some risk associated with most procedures: Most bleeding should have stopped within about ½ hour of the operation finishing. Blood stained saliva may be noticed for a day or two. However, more persistent bleeding may occur. This should be dealt with by your dentist. Sometimes antibiotics are prescribed after the removal of impacted wisdom teeth. Even so, infection of a tooth socket still occasionally occurs. When an adjacent tooth has a large filling or crown it is possible that this can become dislodged during surgery.
The nerves which give sensation to the lower lip and chin and to the tongue are very close to the lower wisdom teeth and can be prone to bruising. If this happens numbness or a tingling sensation in the lip and chin, or tongue will be experienced. This is temporary in most cases, but in a small number recovery may not be complete. Very rarely continued pain may be felt from damaged nerves.
Your dentist will always discuss with you any complications that are relevant to your case.
Download this page as a fact-sheet for printing – Wisdom Teeth Removal Fact Sheet (PDF file)
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