Wisdom teeth removal

Wisdom teeth is the commonly used term for ‘third molars’ – the large teeth right at the back of the mouth that come through last, usually between the ages of 17 and 25, though they can also erupt much later or not at all.

Why are they called “wisdom teeth”?
Back in the 17th century, these teeth were called the ‘teeth of wisdom’ as they appeared when you were no longer a child and theoretically wiser. In the 19th century, the term ‘teeth of wisdom’ transformed into ‘wisdom teeth’.

Why are they extracted?
While a person has 32 teeth, the jaw can sometimes be too small to accommodate them all. In fact, many people only have enough room for 28. If there’s not enough space for a wisdom tooth (or teeth) to come through properly, it may come through at an angle. Before too long, it’s likely to push against an adjacent tooth, causing pain and irritating the cheek and gums. This is known as an impaction and can lead to gum infection, tooth decay, damage to other teeth, and even jaw cysts. Sometimes lymph glands under the jaw become swollen and sore as a result of recurring infections. Extraction of the wisdom tooth or teeth is the only solution. Generally, upper wisdom teeth tend to be easier to remove than lower ones, and they are more likely to be impacted.

How does the dentist know if an extraction is needed?
All through your teens and twenties, your dentist will be observing and monitoring the situation with your wisdom teeth. If there’s no pain and no crowding, the wisdom teeth may settle in happily.

However, if there’s considerable pain or if you find it difficult to open your mouth, it’s likely that a wisdom tooth is impacted under the gums. The dentist will take an x-ray to find out if the impacted wisdom tooth needs to be extracted. Sometimes, all that’s needed is a small cut in the gums to help the wisdom tooth come through.

In the dental chair or at hospital?
If your dentist decides that a wisdom tooth needs to be extracted, a local or general anaesthetic will be used. Either way, it’s a relatively pain-free experience during the procedure. Your dentist may be able to remove the wisdom tooth with the aid of a local anaesthetic while you’re sitting in the dental chair.

However, if it’s a complex case due to the position and shape of the roots, your dentist will refer you to a specialist oral surgeon. The operation will likely be performed while you are asleep under general anaesthetic in the hospital.

What other problems can wisdom teeth cause?
A wisdom tooth may appear through the gum with part of it still covered. This causes swelling and can be very painful. This condition called pericoronitis can usually be easily fixed and cleared quickly by using correct brushing technique, mouthwash and sometimes an antibiotic if there are signs of infection. However, if the problem keeps recurring regularly, it may be time to have the tooth removed.

If a wisdom tooth is decayed due to the fact that it’s virtually impossible to clean, it may also be time for an extraction.

Recovery time
Wisdom teeth are often large compared to other teeth, so stitches may be required following their removal. Removal may cause swelling and some bleeding for the first few days, but over-the-counter painkillers, such as paracetamol or ibuprofen, can help alleviate the pain.

Eating and drinking
In the first 24 hours post removal, it’s best to avoid applying pressure or suction to the wound and only rinse your mouth very gently if necessary for comfort.

It’s best to stick to a soft diet such as soup or mashed potato which don’t require chewing. Over the next few days you can reintroduce other foods into your diet.

Warm salt water
Because the extraction will have left a deep socket, you will need to take extra care to keep the area clean to avoid infection.

Stir a level teaspoon of salt into a glass of warm water and let it gently wash over the area. Carry out a rinse after meals and before bed for seven days.

Brushing
You can resume brushing your teeth gently, as per your normal routine, after the surgery.