10:00pm Wednesday 20 November 2019

A Wise Decision: Your Guide to Wisdom Tooth Extraction

Evolution is a funny old business. Whilst it selects those features that give an advantage, it sometimes leaves behind other features that can be inconvenient or dangerous. In humans, one such drawback is retaining a full set of 32 teeth while our jaws have got smaller through the millennia. The biggest teeth, and the ones most likely to cause a problem are the four wisdom teeth at the very back. Often the best thing to do is to get rid of the trouble-makers.


The Problem

The four wisdom teeth are the biggest molars and erupt last, usually in the late teens or early twenties. Whilst all the other teeth emerge when the jaws are still growing, the wisdom teeth usually have to find their places in jaws that have already reached their full size. Since they are such big teeth, they can have difficulty getting properly located.

They may be impacted, which means that they do not successfully break through the gum. This can give rise to infection, or damage the roots of other teeth or to the jawbone itself.

They may erupt partially, leaving a flap of gum tissue over them, which can trap food particles and bacteria, causing infection and pain.

They may grow at an unnatural angle, sometimes exerting pressure on other teeth or on mouth tissues.


The Procedures

Your dentist will take x-rays of your mouth and advise you on the best way forward. The appropriate procedure will be affected by the nature of the problem and the number of teeth affected, but also by your age since younger jaws have less developed structures and generally fewer complications.

In most cases, your dentist will perform the procedure in her own office with a local anesthetic. In some cases, for instance, if all four teeth are to be removed at the same time, or if there is a higher risk of complications, she may recommend that your operation takes place in a hospital under general anesthetic.

The dentist will make an incision in the gum and remove the whole tooth with its roots. In many cases, it will also be necessary to remove a small amount of bone over the tooth. The tooth may need to be cut into smaller pieces to remove it effectively.

You may need stitches, which can dissolve or be removed later.


The Prognosis

In the vast majority of cases, patients make a rapid recovery from surgery and are back to normal within a couple of weeks. However, your dentist is obliged to point out to you the things that can happen, so that you can make an informed decision.


Common short-term aftereffects include:

  • Pain or inflammation of the region of your mouth affected.
  • Stiffness of the jaw.
  • Prolonged bleeding.

Less common effects include:

  • Damage to existing crowns or bridges, or to the roots of neighboring teeth.
  • Infections spreading to other parts of the body.
  • A condition called “dry socket” caused by the blood clot coming out of the healing socket too soon and exposing the tissue and bone underneath.

Serious problems are very rare and can usually respond to treatment.


The Protocol

The risk of complications is minimized by proper molar removal aftercare procedures, which will help your mouth to recover quickly. Follow your dentist’s advice and use the following practices to allow the blood to clot cleanly and do its job:

  • Take painkillers and use a cold pack on the outside of your face for the first day or so.
  • Bite gently on the gauze pad that you will be given and change it if it becomes saturated with blood.
  • Do not exert yourself physically at first.
  • Eat soft foods for a few days.
  • Do not rub the wound with your tongue.
  • Do not suck on a straw, spit energetically, or smoke for a few days.
  • After the first day, start to rinse the mouth very gently with salt water.
  • Continue to brush your teeth carefully, avoiding contact with the wound until it has healed.


A Routine Procedure

Many thousands of people have one or more wisdom teeth removed every year. For the vast majority, it is a straightforward and uncomplicated procedure that will have a very positive effect on their quality of life. The visit to the dentist and the inconvenience of the next few days are a price well worth paying.

Patrick Foster works at a dental practice and in recent months has found he enjoys writing articles to help patients understand in more detail what to expect and what will happen. These are appearing on health as well as lifestyle blogs.

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