I was driving the other day and heard a radio announcer say the expression, this is like pulling teeth, and being a dentist, I thought maybe I should write something about tooth removal, in particular wisdom teeth removal. Some of my patients were joking saying I don’t want to remove my wisdom teeth because I want to stay wise.
WHAT ARE WISDOM TEETH?
Wisdom teeth are also known as third molars. In most cases, they are the last set of adult teeth to grow through the gum. Wisdom teeth usually push through the gum in the late teens, twenties or even older. They appear later than the other teeth, at the age where people are presumably “wiser” than when a child, hence the name wisdom teeth.
There are so many questions and concerns regarding wisdom teeth removal, so, here we will try to answers some frequently asked questions such as:
- Should I remove my wisdom teeth?
- When should I remove my wisdom teeth?
- What problems are caused from wisdom teeth?
- What are the risks of extracting wisdom teeth?
- Where should I have my wisdom teeth removed?
- How much will it cost?
REMOVE OR NOT TO REMOVE WISDOM TEETH?
Not all wisdom teeth are required to be extracted or removed. The decision of tooth extraction is determined after clinical and x-ray examination. Your dentist may recommend removal of one or more wisdom teeth if the area around the tooth is infected, if there is a lack of space resulting in pushing of an adjacent tooth, food trap, or pain.
It may be advisable to keep the wisdom teeth if they are well-aligned and never cause problem. However, ultimately the decision of removal of the wisdom teeth is always yours.
WHEN TO REMOVE OF WISDOM TEETH?
It is more beneficial to remove wisdom teeth while the patients are young as the roots are not fully formed and the surrounding bone is softer. This allows the process of the tooth removal to be less complicated and have a lower risk of being damaging to nerves, adjacent teeth and surrounding structures.
Your dentist may recommend for the removal of one or more wisdom teeth at young age if there is not enough room for the tooth to erupt into the correct position, poor angulation of the wisdom tooth or if the adjacent tooth may cause problems such as pain or infection.
COMPLICATIONS OF IMPACTED WISDOM TEETH
There are multiple issues that are caused by impacted wisdom teeth. Most of the problems result in pain:
Infection
This occurs when the impacted wisdom tooth pushes through the gum which can cause an infection to start on top of the tooth. The infection and inflammation can cause pain and swelling around the tooth on the jaw or the side of the face. The infection of wisdom teeth may result in fever, swollen lymph glands, bad breath, an unpleasant taste and possibly pain when swallowing. Generally, the person may feel unwell.
Pushing on adjacent teeth
A wisdom tooth may push nearby teeth out of their position and may cause dental crowding.
Food trap
Food may be trapped between the wisdom tooth and the adjacent tooth. This can cause gum irritation and decay on both teeth, which then lead to pain.
Cyst
Cyst is a sac of fluid that can commonly form around an un-erupted wisdom tooth. The cyst can destroy and damage the surrounding gum and bone. In this case, it is advisable to remove the wisdom tooth.
Resorption cavity
Resorption is an inflammatory reaction that causes a progressive degrading of parts of a tooth. The impacted wisdom tooth is pushed against the adjacent molar and can cause a resorption cavity on the molar. If the damage is severe enough, both teeth will need to be removed.
Ulcer
When a wisdom tooth is erupted in an incorrect position, it can rub against the tongue or cheek, causing ulcers.
Supra-eruption
Supra-eruption is when a tooth grows further than adjacent teeth. It commonly happens when there is a missing opposing tooth. Sometimes, a person may have upper wisdom tooth, but no lower wisdom tooth and the upper tooth may be over-grown, causing interference during chewing.
POSSIBLE COMPLICATIONS OF WISDOM TEETH EXTRACTION
All dental extractions and surgeries carry some degree of risk. Most people will not experience complications, but, if you have concerns, please discuss them with your dentist. Serious complications in dental extractions are rare, however, it is advisable to weigh up the benefits and risks when considering extraction of wisdom teeth.
The following are the possible complications of wisdom teeth removal:
Numbness or altered sensation
A lower impacted wisdom tooth may be close to nerves such as the inferior alveolar nerve or the lingual nerve. These nerves supply the sensation of the lower teeth, gum, cheeks, lips, chin and tongue. If the nerve is injured during tooth extraction, then it may cause numbness or tingling on the damaged side of the mouth. The injured nerve will usually heal in 4 to 8 weeks or sometimes, it can take up to 18 months. However, in rare cases, the nerve may not heal completely and the damage is permanent. In very rare cases, an injured nerve may heal poorly and the pain may persist permanently.
Infection
An infection may occur in the gum and bone of the tooth extraction site. It is usually treated with an antibiotic and disinfectant mouthwash. Please contact your dentist if you have any concerns.
Dry Socket
Normally, after a tooth is removed, a blood clot will form over the bone to allow proper healing and relieve pain. However, if the blood clot is washed away, the bone will then be exposed which is known as “dry socket”. A dry socket usually occurs 2 to 4 days after tooth extraction and results in throbbing pain. If you experience this problem, please contact your dentist for treatment. Please note that antibiotics do not help with a dry socket as it is not an infection.
To minimise a dry socket, the following instructions should be followed:
– Rinse your mouth gently with salty water 3-4 times a day to retain the blood clot and encourage healing.
– Do not smoke or drink alcohol, as this may interfere with healing.
– For the first day after the surgery, do not brush teeth around the area as you may loosen the blood clot, and after the first day, take care and gently brush your teeth.
Haemorrhage or bleeding
Bleeding may occur, and if so, make sure to bite down firmly on the gauze that is supplied for at least 30 minutes. Biting down on the gauze should provide pressure on the tooth socket which will help to stop the bleeding. If bleeding persists, you need to contact your dentist.
Limited mouth opening
After wisdom teeth removal, it is common to experience difficulty in opening your mouth, due to pain and discomfort from the swelling. This should improve in a few days once the swelling has subsided.
Sore lips
The lips may be bruised or sore when a tooth is removed, as the lips may be stretched or pressure may be applied from surgical instruments.
There are also other complications such as fever, vomiting, sinus exposure or damage to nearby teeth or fillings.
WHERE TO HAVE WISDOM TEETH REMOVED?
Your dentist will advise you whether your wisdom teeth should be removed and will discuss with you your options of where to get your wisdom teeth removed. Generally, you have different options of anaesthesia:
- Local anaesthesia – Your dentist will give you local anaesthetic through a needle to numb a tooth and the simple process of surgical extraction can be done in a dental clinic.
- Intravenous Sedation – An anti-anxiety drug is administered directly into blood stream which gives a calming effect, as well as drowsiness and minor amnesia. This is commonly done at the dental surgery.
- General anaesthesia – It is given to patients by specialist anaesthetists in the hospital. This is indicated for wisdom teeth that are more complex to remove or patients who simply want to be completely asleep during surgery.
COST OF WISDOM TEETH REMOVAL
At AL Dental Surgery in Inglewood, the cost of wisdom teeth removal ranges from $250 to $500 per tooth depending on the complexity of the removal. For an assessment or quote please contact us on 9271 9911.