Wisdom teeth are the molars at the very back. They are removed when they are impacted, decayed, repeatedly infected, or damaging the tooth in front. Upper ones usually come out under local anaesthesia; lower ones can be more involved and occasionally need sedation.
Wisdom Teeth Removal
What Are Wisdom Teeth?
Wisdom teeth are third molar teeth situated at the very back of your mouth. These teeth generally come through (erupt) during adolescence or early adulthood. By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing. The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as “wisdom teeth”.
It is not uncommon for wisdom teeth to only partially come through or get stuck, which often leaves a flap of gum over the tooth. In other instances, the tooth can over-erupt and grow too long.
A wisdom tooth may need to be taken out for a number of reasons: to prevent gum or cheek damage, due to tooth decay, because it is repeatedly causing infection, or to clear space for nearby teeth.
What Are the Alternatives to Surgery?
Painkillers and paracetamol are often prescribed to people suffering from mild pain. Infections can be treated with antibiotics or through using chlorhexidine mouthwash or salty, hot water. However, these solutions provide only temporary relief and are not long-term solutions. A long-term solution would be to surgically remove the wisdom tooth, as this will prevent any symptoms returning. If the flap of gum over the wisdom tooth is causing problems then it is possible to have this removed in a procedure known as an operculectomy.
What Will Happen During the Operation?
Upper wisdom teeth tend to be less problematic and can usually be removed under local anaesthetic. Lower wisdom teeth, however, can sometimes be more difficult to remove and often require general anaesthetic.
The type of surgery you undergo will depend entirely on your individual case, and the severity of your problem. The procedure can take anywhere from 10 minutes to an hour.
Risks and Complications
Any risks or complications will be discussed in advance of your treatment with your expert consultant.
Recovery
The majority of patients are generally able to return home the same day as their surgery. Your consultant may prescribe you antibiotics but this will depend on the severity of your procedure. It is advised that you refrain from bathing in hot water, drinking alcohol or exercising for 1-2 weeks after the operation, as this will help limit any bruising, bleeding or swelling. Most patients will rest for a week before returning to work.
Exercising on a regular basis can help speed up the recovery process; however, you should discuss this with your consultant first.
Jaw Fracture
A broken jaw (or mandibular fracture) is a common facial injury. Only the nose is broken more frequently. A broken jaw is the tenth most common fractured bone in the human body. Fractures (breaks in the bone) are generally the result of a direct force or trauma to the jawbone.
Broken Jaw Symptoms
- The most common symptom is jaw pain.
- You may feel that your teeth do not fit together correctly (this is called a malocclusion). You may be unable to open your jaw all the way, have problems speaking, or notice swelling of the jaw.
- Your chin or lower lip may be numb because of damage to a nerve that runs through the mandible.
- Inside the mouth, you may see bleeding or find a change in the normal lineup of teeth. There might also be bruising under the tongue or even a cut in the ear canal due to movement backward of the broken jawbone.
When to Seek Medical Care
Call your doctor if you have been injured and feel that your teeth don’t fit together correctly, if you have bleeding within the mouth, problems speaking, or swelling. This injury is best evaluated at a hospital. Therefore, your doctor may advise you to go to an emergency department. Remember, if you are the one who is injured, you should not be driving. Have someone take you to the emergency department.
Planning Your Surgery
Before any surgical extraction, the tooth, its roots and the nerve that runs beneath the lower jaw are assessed on an OPG X-ray, and on a CBCT scan where the roots lie close to the nerve. This is what determines how the tooth is sectioned and removed, and it is how the risk of nerve involvement is reduced. Your medical history, any blood thinners you take and any bleeding tendency are reviewed at the same appointment, and the whole plan is explained to you before the day of surgery.
After Wisdom Tooth Removal
Some swelling and stiffness of the jaw for two to three days is normal, and is usually at its worst on the second day. Bite gently on the gauze pack until any bleeding stops, apply a cold pack to the outside of the cheek on the first day, and take the pain relief you have been prescribed. Eat soft, cool food, keep the rest of your mouth clean, and start warm salt-water rinses from the day after surgery, not before. Do not smoke, and do not rinse forcefully or use a straw for the first 24 hours, as this can dislodge the blood clot and delay healing.
Frequently asked questions
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