Adults normally have 32 teeth. Wisdom teeth (third molars) are the last to come through at the back of the mouth usually around the age of 18 years. Normally, there are four wisdom teeth, one on each side of the upper and lower jaws. Some jaws are too small to accommodate all the teeth. There may not be enough space for the wisdom teeth to come through completely. They are said to have become impacted.
Reasons for the removal of wisdom teeth:
- the most common reason is repeated infections (pericoronitis) of the gum overlying a wisdom tooth
- decay in the wisdom tooth, which your dentist cannot fill.
- decay in the tooth in front of the wisdom tooth. The dentist cannot fill this tooth properly until the wisdom tooth is removed.
- infection (abscess) at the bottom of the wisdom tooth root.
- when the molar tooth next to the wisdom tooth is affected by gum (periodontal) disease.
- a cyst (fluid filled sac) forming around the wisdom tooth.
- as part of other operations on the jaw where the wisdom tooth is “in the way”.
- there may be other less common reasons that your surgeon will discuss with you which are too unusual to go into detail about here.
What happen during the procedure?
The procedure will usually be performed under local anaesthetic, with/without intravenous sedation, so patients will not feel pain while having the procedure.
It involves a cut in the gum close to the tooth. Sometimes some bone around the tooth is taken away with a drill and the tooth may be cut into smaller pieces. This makes removing the tooth and root easier. Stitches will be placed in the area and these dissolve usually by themselves in one to two weeks.
What can be expected after the operation?
- Pain which may necessitate several days of recuperation. Painkiller e.g. ibuprofen and paracetamol to be used as advised.
- Swelling which may necessitate several days of recuperation.
- Bleeding which may necessitate suturing.
- Postoperative infection requiring additional treatment.
- Damage to adjacent structure/teeth/fillings.
- Restricted mouth opening for several days or weeks, with possible dislocation of the temporomandibular (jaw) joint.
- For upper tooth: Oroantral (Mouth-nose) communication. Opening of the sinus (a normal cavity situated above the upper teeth) might require additional surgery if lasted for >2weeks.
- For upper tooth: Fracture of the upper back rounded bone (Tuberosity) which might need suture.
- For lower tooth: Injury to a nerve resulting in numbness or tingling of the chin, lip, cheek, gums and/or tongue on the operated side; this may persist for several weeks/months (~2%), or in remote instances, permanently (~0.5%).
- Decision to leave a small piece of root in the jaw when its removal would require extensive surgery.
- In certain circumstances, the need to repeat the procedure again.
