Oral Surgery

Wisdom Teeth

What are wisdom teeth?

A wisdom tooth is one of the large chewing teeth all the way at the back of your mouth. Not everyone develops wisdom teeth, but if they do develop, it's usually during your late teens or early twenties.

What are "impacted" wisdom teeth?

An "impacted" wisdom tooth is one that has failed to emerge fully into its ideal position. That failure may be because there isn't enough room in your jaw or because the tooth is emerging at an angle and is pushing against your other healthy teeth.

An impacted tooth that is still buried underneath your gums can be left alone as long as it's not causing you any pain or discomfort.

What problems can an impacted wisdom tooth cause?

The term "pericoronitis" refers to an infection that is common with impacted wisdom teeth. It is most common when only part of the wisdom tooth has emerged from underneath your gums, a condition known as "partial eruption".

When your wisdom tooth is only partially erupted, dental plaque can accumulate in the space between your gums and your wisdom tooth and unfortunately there is no way for you to effectively clean it out. The plaque can cause an infection to spread to the tissues surrounding your wisdom tooth, which in turn makes the area feel tender and start to swell. It can also be quite painful and can cause unpleasant mouth odours and taste. In some cases, it can make it difficult for you to open your mouth.

Pericoronitis is usually a temporary problem that can be relieved by your dentist. If pericoronitis is occuring repeatedly, then your dentist may recommend having the wisdom tooth extracted, most likely by an oral surgeon.

What's involved in impacted wisdom tooth removal?

The first step is to take x-rays to better see the entire wisdom tooth and plan the surgery accordingly.

If the wisdom tooth is fully buried then the dental surgeon will need to make an incision in the gums and then remove some bone that lies over the tooth. To minimise the amount of bone that has to be removed in order to get the tooth out, the dental surgeon will often separate the wisdom tooth into smaller pieces. Each piece can then be removed through a smaller opening in the bone.

The entire procedure is carried out under local anesthetic and takes no more than an hour.

Is it difficult to remove a wisdom tooth?

Wisdom teeth in your upper jaw are generally easier to remove than those in your lower jaw. That's because lower wisdom teeth are more likely to be impacted. The exact degree of difficulty depends on the position and shape of the roots.

Very rarely, extremely difficult cases are referred to hospital, where they would be removed under general anesthetic (you would be put to sleep).

Are there any risks involved in wisdom tooth removals?

Minor swelling and some discomfort can occur for a few days after the operation but that usually heals very quickly. It is important to follow the dentist's advice regarding the use of hot salt-water mouth washes. The common pain-killers such as paracetamol or ibuprofen are usually sufficient to deal with pain.

Smoking and drinking can interfere with the healing process and cause post-operative infection. If that happens, you will need to return to your dentist so they can place a soothing dressing and possibly prescribe anti-biotics.