Wisdom Teeth Extraction

Wisdom teeth extraction removes third molars to prevent issues, using local anesthesia, with a recovery period of a few days.

Wisdom teeth are back molars (or “third molars”) that grow in each corner of the mouth during adulthood.Contrary to the name, these late bloomers don’t make us wiser. 

They usually emerge from the gums between the ages of 17 and 25 – when we’re meant to be a little more enlightened.

Most people have four wisdom teeth – but some have fewer or more (‘supernumerary teeth’!There are even people who have none at all – which comes down to evolution and genetics.Although our ancestors needed more teeth to grind raw foods, our eating habits have changed, and our jaws are often no longer big enough to comfortably accommodate all 32 adult teeth.Research suggests that around 35 per cent of people will stop developing wisdom teeth, for this reason!

Why are wisdom teeth removed?

In many cases, there’s not enough room in the mouth to comfortably accommodate third molars. By the time this last set of adult teeth emerges, the first and second molars have already hogged all the space at the back of the jaw bone.

This prevents the third molar from sprouting correctly, causing it to be trapped under the gums (“impacted”) or positioned at a wrong angle. 

Problems caused by impacted or poorly positioned teeth: 

  • food and bacteria is easily trapped (plaque builds up)
  • It’s difficult to clean around the tooth (limited space)
  • Tooth decay or infection 
  • losing bone around the roots
  • pericoronitis (tissue inflammation)
  • abscess
  • cysts and benign growths
  • damage to surrounding teeth

Signs that you may require wisdom tooth extraction:

  • Your mouth feels sore and tender, but you’re unsure where the pain originates.
  • Swelling, inflammation and pain in the gums at the back of your mouth.
  • Consistent headaches or earaches, but you don’t know why.
  • Bad breath caused by infection and inflammation. 
  • Other teeth start to shift due to overcrowding.    
  • Surrounding teeth show signs of fractures, pain and discomfort. 
  • Dislodgement or cracks in fillings and crowns on nearby teeth.

At what age should you get your wisdom teeth removed?

Typically, third molars are removed around the time they emerge – between the ages of 18 and 25. 

During your consultation, x-rays determine whether or not extraction is required and what the best approach is. 

Please note that extraction isn’t always necessary—especially if you’re not experiencing any problems. When symptoms are mild, dentists may decide on alternative solutions (such as antibiotics or putting a small incision into the gums to encourage proper growth). However, if your dentist believes that third molar removal can help you – try not to delay as this may cause complications in the future. If you have any doubts, get a second opinion from another dentist.

Should you get your wisdom teeth removed before braces or Invisalign?

Yes, this is preferred in many cases. We usually recommend that people with impacted wisdom teeth delay their orthodontic treatment until after extraction – in case the positioning of these teeth causes more misalignment problems. The same advice applies when these late bloomers haven’t yet erupted but are likely to grow in a problematic way (X-rays help us determine if this could happen). 

Wisdom teeth and pregnancy

If possible, women who have problems with their third molars should consider getting them removed before planning to fall pregnant. Pregnancy makes women more susceptible to tooth decay and inflammation so that early removal may lower the risk of further dental complications. 

However, any procedure carries some risk – so it’s best to avoid wisdom tooth extraction while pregnant (unless this can’t be delayed due to severe pain and inflammation). 

How are wisdom teeth removed? (local vs general anaesthetic)

There are two approaches, depending on the severity of the case and the number of wisdom teeth being extracted. Extraction generally takes anywhere between ten to about 90 mins.

  1. Extraction under local anaesthetic (your dentist does this at the clinic) 
  2. Surgery with a general anaesthetic (performed by a specialist oral surgeon at the hospital)

Extraction under local anaesthetic:

This procedure is for simple extractions at the dental clinic. It’s suitable when the tooth has emerged from the gums with no significant issues.

A local anesthetic is used to numb the area while the patient remains awake, though they may choose to be mildly sedated if this is an option. Forceps are used to loosen and remove the tooth, much like a regular tooth extraction.

For patients who need to remove all four wisdom teeth – it’s common to remove the upper and lower molar on the same side during a single session, and come back at a later date for the other side.

Wisdom teeth surgery using general anaesthetic:

Dental surgery occurs at the hospital under general anaesthetic, which means the patient isn’t conscious during the procedure. This is a day procedure, so it’s essential to organise for someone to drive you home. This is the only option for complex cases where the tooth is trapped beneath the gums (impacted) or other obstacles (such as the roots getting in the way). 

The procedure involves cutting the gum to extract all tooth fragments and traces of infection, before disinfecting the area and sealing the wound with stitches. 

Your dentist will discuss the best option and refer you to a specialist oral surgeon if surgery is recommended. Surgery may also be considered by patients who want to extract all four teeth at the same time to get it over and done with, even if their case isn’t complicated.

What to expect after wisdom tooth removal?

We recommend taking a week off school, work, and other activities to focus on recovery. For a few days after the procedure, your body will work hard to heal damaged tissue, causing discomfort, bleeding, and swelling.

Thankfully, the puffy “chipmunk cheeks” and other symptoms will soon subside, and you can confidently go out into the world again. Most people are back to normal within a week. However, complex cases can take longer to heal (mainly if stitches have been used to seal the gums).

Even if you’re well enough to resume normal activities straight away. Remember it can take months for your wounds to heal completely. In the meantime, avoid doing anything that could loosen your stitches. Although it’s normal to experience some pain, swelling and bleeding, please call your dentist if this is excessive or lasts longer than a week.

Most patients have no problems. However, if the wound becomes infected, some may require urgent treatment.

Wisdom Teeth Removal Complications

Infection: 

After the extraction, a blood clot usually forms over the empty socket to protect the bone and nerve endings. This is a good thing.

Problems arise if the clot becomes dislodged or fails to develop. Food particles can get trapped in the exposed area (called a “dry socket) and cause infection. This can lead to painful nerve damage if left untreated.

What to do for wisdom tooth infection after removal:

Book an emergency consultation with your dentist or oral surgeon. Antibiotics may be enough to treat it, but the area usually needs to be numbed with local anaesthetic and thoroughly cleaned (this occurs at the dental clinic; hospitalisation isn’t required). 

Signs that you may have an infection or dry socket

  • Significant pain in your mouth, jaw, neck or face
  • Excessive bleeding that doesn’t stop when pressure is applied
  • Difficulty swallowing or breathing
  • Medication doesn’t ease comfort
  • Fever
  • Numb in the mouth, jaw, neck or face
  • Blood, pus or discharge from the nose

How to avoid these complications…

  • Gently rinse your mouth with saline water. Your dentist will give you detailed instructions for keeping the wound clean.
  • Take the painkillers your dentist prescribed, and apply an ice pack to reduce the swelling.
  • Avoid smoking, alcohol consumption, drinking out of a straw, slurping, spitting and exercising while recovering – as these activities make you more susceptible to infection. For women, some oral contraceptives also heighten the risk of developing a dry socket due to the estrogen levels.Your dentist will tell you if you should avoid taking any medications during this time.
  • Best foods to eat after getting wisdom teeth removed (for the first few days to a week): Eat only soft foods, such as soup, mashed potato, yoghurt, scrambled eggs, porridge, pudding, avocado and smoothies. Don’t consume scalding hot foods and beverages that could burn your mouth, and please avoid anything that requires a lot of chewing, as this could dislodge stitches or even create a dry socket. Spicy foods are a no-go, as they can irritate the wound. 
  • How to brush teeth after wisdom tooth extraction: You must be very gentle when brushing your teeth and rinsing your mouth. For the first 24 hours, focus on carefully rinsing with tepid salt water, and letting the water fall out by angling your head over the sink (don’t swish and spit). Avoid brushing, flossing, swishing or spitting during the first 24 hours after the procedure. 

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