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Wisdom teeth are usually the last teeth to come through at the back of your mouth. They don’t usually erupt through the gums until people are in the late teens, early to mid-twenties or rarely in older adults. Most people will get four wisdom teeth, one on each side of the upper and lower jaw, but some people don’t get them at all. Wisdom teeth are variable in number and in the position they develop in the jaws. Most people need their wisdom teeth removed for various reasons.
Impacted wisdom teeth
Often there’s not enough space for wisdom teeth to emerge through the gums easily. In these cases, the tooth may become wedged or ‘impacted’. This can be an issue if the tooth remains buried in the gum, as it can cause a variety of problems, especially if it’s close to an important nerve.
Possible problems caused by impacted wisdom teeth
- Infection – This can start when the impacted wisdom tooth starts to erupt through the gum. It can cause pain and inflammation and may also cause bad breath and a nasty taste in your mouth. You may also have trouble swallowing. Infection, in rare cases, can be severe and life threatening.
- Crowding – Impacted wisdom teeth may push neighbouring teeth out of position, which can cause further pain and aesthetic concerns.
- Cysts – A common problem that can occur around a wisdom tooth is the formation of a cyst or sac of fluid. The cyst may enlarge significantly with time and cause problems such as infection or even a broken jaw (pathological fracture) due to weakening of the jaw.
- Ulcers – upper wisdom teeth may erupt at a sideways angle. These may then cause painful ulcers on the inside of the cheek from rubbing.
- Food traps – Food can become trapped between the wisdom tooth and the adjacent tooth, possibly leading to decay in the adjacent tooth.
- Resorption cavity – Occasionally a resorption cavity is caused by a wisdom tooth pushing against the adjacent tooth (external root resorption). This can lead to serious damage to both teeth.
- Decay in adjacent teeth – Because it’s impossible to keep the adjacent tooth clean, it may decay and sometimes even requires removal along with the wisdom teeth.
Mesially impacted wisdom tooth
Distally impacted wisdom tooth
Deeply impacted wisdom tooth
Infected wisdom tooth
Deciding when to remove wisdom teeth
Even though wisdom teeth can cause problems such as infections, the more minor issues may subside when the tooth has pushed through the gum and settled in.
Some wisdom teeth never need to be removed.
Your surgeon will be able to advise you if they think wisdom tooth removal is necessary based on a history, full oral examination and X-rays.
Wisdom tooth surgery tends to be easier when you are younger as the jawbone is softer and the tooth roots are not fully-formed. The ideal time to have your wisdom teeth removed is in the mid-late teens or early 20’s.
Here are some reasons why your surgeon may recommend removal of wisdom teeth:
- The wisdom teeth do not have enough room to erupt.
- The wisdom teeth may adversely affect the position of your other teeth during or after orthodontic treatment.
- The wisdom teeth are causing problems such as infections, cysts, dental decay or ulcers.
- The wisdom teeth are impacted and affecting adjacent teeth.
Proceeding with wisdom tooth removal
Your surgeon will have a consultation with you prior to surgery to discuss your dental and medical history to ascertain the best way forward. Aspects of your health such as existing medical conditions, medication you may be taking, allergies you may have to antibiotics or anaesthetics, or whether you may be pregnant may affect your treatment. Your surgeon will advise whether you will need to have your wisdom teeth removed in our rooms or in a private hospital.
Your surgeon will advise what kind of anaesthesia they recommend for your procedure and it will usually be one of these three types:
- Local anaesthesia – administered into the mouth to numb the area. Usually used for straight forward wisdom tooth removal.
- Local anaesthesia with conscious intravenous sedation – in addition to the local anaesthetic, you may benefit from having a sedative drug administered intravenously. Adelaide MaxFax uses a specialist anaesthetist from Adelaide Anaesthetic Services (AAS) to administer the anaesthetic. This will help relieve anxiety and is great for nervous patients.
- General anaesthesia – for more complicated wisdom teeth you may be “put to sleep” in hospital for the duration of the procedure with an injection administered by a specialist anaesthetist from AAS.
Wisdom tooth surgery procedure
During wisdom tooth surgery a small incision is made in the mouth to allow the wisdom tooth to be removed. It may be necessary to carefully remove a small amount of bone, or divide the wisdom tooth into sections to facilitate removal. The incision will be closed with resorbable sutures that do not require removal.
After wisdom tooth surgery
After you have recovered from the anaesthetic and returned home, rest is important and you should avoid driving, operating machinery, and heavy exercise for several days. You may need several days off work and should avoid alcohol while you are taking pain medication or antibiotics. Any pain, swelling and bleeding should start to subside a few days after your procedure. You may need a follow-up appointment so your surgeon can check on how you are healing. Your surgeon or his/her staff will arrange this if required.
Possible risks and complications of wisdom tooth surgery
Any surgical procedure can have complications despite the highest possible standards of practice and the many steps taken to minimise risk. The vast majority of patients will not experience complications, but your surgeon will be happy to discuss any concerns you may have. You will be required to sign a surgical consent form prior to surgery.