Wisdom Teeth Extraction
‘Wisdom teeth’ is a common term for the third molars, the back-most teeth in the human mouth. Wisdom teeth are the last teeth to grow, and usually make their presence felt in our late teenage years. Unfortunately most of us have insufficient space in our mouths to allow our wisdom teeth to come through the gums, or ‘erupt’ fully, and they become stuck, or ‘impacted’. Both impacted and non-impacted wisdom teeth can cause a number of problems, for which the extraction of the tooth or teeth is the best solution.
Problems Caused by Wisdom Teeth
The most common problem caused by partially erupted wisdom teeth is infection of the gum around the wisdom tooth. This condition, called pericoronitis, can be enormously painful and can also cause significant swelling of the face. Antibiotics can usually remedy the problem, however once it occurs, the chances of it happening again are very high. The only way to permanently prevent pericoronitis is by extraction of the affected tooth.
Unerupted wisdom teeth are prone to the development of cysts around them. Cysts are fluid-filled sacs which form by corroding the surrounding jaw bone. In extreme situations this can cause a weakness in the jaw bone which may then be susceptible to fracture. If your wisdom tooth has developed a cyst, we will remove both tooth and cyst, and place grafting material in the weakened jaw bone. This will ensure optimal healing.
Damage to Adjacent Teeth
In their attempt to erupt into the mouth, impacted wisdom teeth sometimes exert pressure on adjacent teeth. If the pressure exerted by a wisdom tooth is severe, the roots of the adjacent tooth can erode, sometimes enough to warrant the removal of that adjacent tooth. Early extraction of wisdom teeth in this case can therefore save other teeth in the mouth.
If wisdom teeth do come through the gum into the mouth, they stand a very high risk of decay. This is because of the position of the wisdom teeth – they are so far back that most people find them impossible to clean adequately. When wisdom teeth do become decayed, extraction (as opposed to filling) is commonly recommended because of the risk of problems recurring.
Frequently asked questions
What is the best age at which to remove wisdom teeth?
The problems caused by wisdom teeth can be severe and are best avoided. Therefore, if a wisdom tooth or teeth look like they will cause problems in the future, we recommend their removal. This is because the risk of problems is so high – in fact, the New Zealand Defence Force considers its soldiers unfit for deployment until they have their wisdom teeth removed. At our practice we recommend the removal of ‘at risk’ wisdom teeth ideally between the ages of 18 and 25. As a rule, surgery is more comfortable, less complicated and recovery times are quicker for younger patients.
Only one of my wisdom teeth is causing problems. Why do I need all four removed?
This will depend on whether your other wisdom teeth appear to be at risk of developing problems. If this is not the case there is no reason to remove more than one tooth. However if all of your wisdom teeth are at risk of problems there are a lot of advantages to having them all removed during the one surgical procedure. Having treatment this way is more cost effective and means a lot less time off work or school compared with multiple surgical procedures.
Can I be sedated?
Yes. We offer two different methods of sedation at the practice: oral sedation, using a tablet, or intravenous sedation. Both methods are safe and easily tolerated. Oral sedation is administered by Dr Worthington, and IV sedation is administered by Dr John Foy, our specialist anaesthetist. For very complicated cases we may recommend that you receive a general anaesthetic. In this circumstance your extractions would be performed by Dr Worthington at our partner hospital with Dr Foy performing the anaesthetic.
Will it hurt?
At our practice we pride ourselves on the techniques we use to minimize pain during and after your surgery. It is extremely uncommon for our patients to feel any pain whatsoever during surgery. Post-surgical discomfort, if it occurs, can be managed well with medication that we will prescribe for you.
What can I expect after the surgery?
After the surgery you will probably experience some swelling. The amount of swelling will vary depending on the number of extractions you have had, and their difficulty. Swelling usually peaks at about the 48 hour mark, and generally takes about a week to fully subside. Some patients also experience minor bruising of their facial skin. Use of ice packs after your surgery will minimize both swelling and bruising. Most people also do experience some discomfort in the week after surgery, which can be minimised by pain medication that will be prescribed to you.
How much time off work or school will I require?
This will vary depending on the number of wisdom teeth that are removed and the difficulty of the surgery. For example, you may not feel the need to take any time off after the extraction of one straightforward wisdom tooth. Conversely, extraction of four wisdom teeth under sedation or general anaesthetic may require you to take up to a week off work. We can best advise on this at your consultation.