What is a wisdom tooth?
Wisdom teeth are also commonly referred to as the third molars, and they can be found at the back of your mouth. In most cases, these teeth are the last to develop. Wisdom teeth were once used by our ancestors to hunt and eat prey. However, nowadays, our jaw structure has evolved and no longer has enough room for the wisdom teeth. Today, wisdom teeth can result in severe oral problems.
What is Impacted Wisdom Tooth?
Impacted wisdom teeth are the molars at the back of your mouth that do not have sufficient space to erupt or develop properly. As a result, these teeth grow in the wrong direction, emerging at a wrong angle, sideways or only partially thereby affecting the nearby teeth. Additionally, there may be severe pain and damage to the other teeth. However, even if there is no apparent damage, your teeth can become more prone to diseases. If your tooth partially erupts and is stuck under the gums, bacteria can collect, thus lead to infections. Read the Impacted Wisdom Tooth blog for more details.
Do We Need Wisdom Tooth Extraction?
Not everyone will require their wisdom teeth removed. In some very rare cases, the wisdom teeth can erupt like any other teeth and never be a cause of concern. While everyone is advised to have a routine dental x-ray around the time when the wisdom teeth are erupting, only patients with signs of impaction, abnormalities or pain need the extraction. For those that have their wisdom teeth come in properly, your dentist may still suggest a period of observation since it may be too early to tell if your teeth will become impacted and need extraction.
If your dentist does recommend extraction, the right time to extract your teeth will depend on a combination of factors such as the risks involved, convenience and symptoms. Extracting your tooth too early can be quite challenging since it is still deeply rooted in the jaw bone. While removing it too late increases risks of complications because of the negative impacts of ageing on the gums, teeth and bone.
Why is Wisdom Tooth Removal Necessary?
Wisdom teeth are usually problematic to dental health when they emerge and retained. Most dentists recommend wisdom teeth extraction due to their problematic nature. Removing your wisdom teeth early on can save you from many oral complications and improve your quality of life. The extraction includes removal of all the tooth’s parts together with its roots. Here are some of the reasons that explain why wisdom tooth extraction is necessary.
Pericoronitis
Pericoronitis is an inflammation of the tissues surrounding a partially emerged wisdom tooth. Usually, this symptom is a common problem that affects young adults. It develops when bacteria get trapped between the partially emerged teeth and the gum. Almost 95% of pericoronitis cases appear on the impacted wisdom teeth found in the lower jaw.
Common symptoms of acute pericoronitis include a bad taste in the mouth and swollen gum tissues that surround the wisdom tooth. Severe symptoms of pericoronitis that need urgent medical attention include wisdom teeth-related abscess, difficulty opening your mouth due to swelling and fever. By extracting wisdom teeth as soon as they start appearing will prevent pericoronitis from occurring.
Less Orofacial Pain
Wisdom teeth can cause significant facial and oral discomfort more, especially if the eruption of the teeth have already caused tooth decay and gum disease. Oral and facial pain can greatly affect a person’s quality of life and by extracting the wisdom teeth will help to reduce that discomfort linked to wisdom teeth retention.
Tooth Root Infection, Caries and Pulpitis
Tooth decay and dental caries are common problems associated with wisdom teeth. If these symptoms are not treated, and the wisdom tooth is not removed, caries can cause pulpitis, the inflammation of the dental pulp. Pulp inflammation can lead to severe pain in the tooth. If the pulpitis is left untreated, it can reach the dental pulp resulting in tooth root infection, also known as the apical periodontitis.
Reduces Headaches
Usually, when the wisdom teeth start emerging, the other teeth are already well-established in the gums and jaw. So, since the other teeth are well- developed and grown, having extra teeth emerge later in life can result in unwanted tooth movement. As a result, this leads to overcrowding of the teeth due to limited space. Not only does crowding affect the position of the teeth but also affects a person’s comfort. Additionally, it can lead to throbbing headaches which are a common problem that patients with impacted wisdom teeth experience. Wisdom teeth removal can reduce the frequency of headaches since your teeth are no longer exerting excess pressure.
Reduces the Risk of Gum Disease
Keeping your wisdom teeth increase the risks for developing gum disease; this condition can lead to oral infections, discomfort and loss of vital oral tissues. Severe gum disease can cause damage to the tissues and bone that offer to your teeth and cause the teeth to become loose. Extracting your wisdom teeth can help you enjoy reduced risks of these serious oral issues.
Classification of Wisdom Tooth Extraction
There is two main types of wisdom teeth extraction which include simple extraction and surgical extraction.
Simple Extraction
A simple extraction involves the removal of the tooth that can be seen and are easily accessible. In other words, the wisdom tooth has already emerged from the gum line. Mostly this procedure is carried out in dental offices using local anaesthesia to numb the area and minimise the pain during the procedure. These simple tooth extractions require simple dental instruments which in most cases are forceps and elevator to grasp and loosen the visible part of the tooth. The tooth is then gently moved back and forth until the gum ligaments break and the alveolar bone which supports the tooth is opened enough to allow the loosened tooth to fall out. During the procedure, the dentist will apply a gentle, steady and controlled force to remove the tooth. Luckily, with the use of local anaesthesia and advanced dental techniques, the patient will only experience little to no pain or discomfort during the procedure.
Surgical Tooth Extractions
Surgical tooth extraction is a more complicated procedure, and it involves the removal of wisdom teeth that are hard to reach using forceps. Usually, this is because the teeth have not emerged through the gums completely or they are broken and fractured under the gums. During this procedure, the dentist will cut into the connective tissues that surround the tooth to gain access to it for extraction. For instance, the soft tissues covering the tooth may be elevated, or a drill may be needed to remove some of gum tissues and bone during the removal process. In most cases, the tooth may need to be broken into smaller pieces to allow it to be removed.
Therefore, due to the complexity and the pain associated with this procedure, it is usually carried out under some form of anaesthesia or sedation by a dentist in a dental clinic setting. The time required to perform this procedure is based on several factors such as the position of the tooth, the thickness of the bone surrounding the tooth, length and curvatures of the roots and physical health of the patient.
How does OPG X-RAY Help in Identifying the Type of Treatment required?
An OPG (Orthopantomogram) is a special type of dental x-ray that shows all of your upper and lower teeth on a single image. The image shows the position, growth rate and a number of your teeth, including those that are not yet emerged. An OPG x-ray is commonly performed by dentists in everyday practice and may be used to plan treatments for extractions, implants, braces and dentures. OPGS can be used to monitor and identify treatments for:
- Dental Cavities- Jaw Dislocation
- Wisdom Teeth Impaction
- Fractures
- Infections
- Sinuses
- Tumours
Wisdom Teeth Removal procedure
Before the Procedure
In most cases, wisdom tooth extraction is done as an outpatient procedure. Therefore, it means that you will need to go home the same day after the extraction. Before the procedure, you will have to meet the dentist and talk about the treatment process. You will receive instructions from the dental expert on what to do before the surgery and the day of your scheduled surgery. At this appointment, ensure that you have discussed some of the following details: - List of any drugs your doctor may prescribe you.- Any health problems you have
- Discuss what type of anaesthesia you will receive, you can either be numbed on the area or asleep during the whole procedure.
- Ask any questions that you may have about the surgery.
During the Procedure
Usually, this procedure takes about 45 minutes or less and can be simply performed by your local dentist in the dental office. Here are the basic steps your dentist will follow during the procedure.
Selection and Administration of Sedation
Your dentist will apply one of the available sedation options to keep you comfortable during the procedure. The sedation will also reduce pain and ease your anxiety. Your dentist will use one of the three options depending on your comfort level, the expected anxiety as well as the complexity of the procedure.
Local Anaesthesia
Local anaesthesia is administered through an injection near the area of the extraction. Before you receive the injection, the dentist will apply a substance that will help numb your gums. So if you are afraid of injection pain, you don’t have to worry since the gums will be numb. Local anaesthesia will prevent you from feeling any pain during the procedure. However, you might feel some movement and pressure while the dentist is working on you.
Anxiety Suppressant
Medication can be prescribed to reduce anxiety. This type of medication is taken an hour before the treatment. Apart from this medication, local anaesthesia will also be used to numb the gum area and bring pain to zero.
Imaging
After the sedation has taken effect and the area is numb, the dentist will go ahead and take some x-rays. Most probably, the dentist already has some images through x-rays, but it might be necessary to take more during the procedure.
Tissue Removal
The surgical part of the procedure will begin by removing the tissue covering the part where the wisdom tooth is located. In the event that the wisdom tooth is impacted, the dentist will be forced to make inclusion in order to access the tooth. Surgical instruments will then be used to push the tissue out of the way until it can be visible.
Bone Removal
The chances are always high that an impacted wisdom tooth is partially or fully impacted in the jaw bone. If that is the case, the dentist will use a high-speed hand-piece to drill the bone and uncover the tooth. The dentist will loosen the connecting tissue from the wisdom tooth if the tooth has already erupted in your mouth.
Sectioning the Tooth
Once the tooth is clearly visible to the dentist, he will use some dental instruments to loosen the tooth from the surrounding connective tissues. The dentist will use high-speed hand-piece to cut through the extraction. They might also divide the tooth into different sections to avoid breaking it before it can be removed from the socket.
Tooth Removal
Once the dentist has sectioned the tooth, and it is loose from the connective tissues, it is now ready for removal. The dentist will use some dental instruments to remove it from the socket fully.
Stitches
At this point, the wisdom tooth is now out of the socket, but now the area where it was located has been left open. The dentist may be forced to add some stitches if they feel that the patient will better heal with stitches.
After the Procedure
If your dentist used sedation or general anaesthesia during the procedure, you will be taken to a recovery room after the procedure is completed. If local anaesthesia was used, recovery is likely to be done on a dental chair since it will not take long. As you heal, here are some instructions you should follow for fast recovery.
Bleeding
After the surgery, there is a certain amount of bleeding to be expected. Oozing, slight bleeding or redness in the saliva is a common symptom. You can control excessive bleeding by gently wiping and rinsing off clots from the area of surgery then firmly biting on a gauze. You should bite on the gauze for approximately 30 minutes. You can repeat the process if the bleeding does not stop after the thirty minutes. If the bleeding still continues, bite on a moistened tea bag for the same amount of time. A tea bag has an acid known as tannic. It helps in contracting the blood vessels to form a clot and thus stop bleeding. Also, avoid any form of exercise, sit upright and avoid becoming very excited to avoid further bleeding. However, if all these methods are not working, make sure you seek immediate attention from your dentist.
Pain Management
Normal pain can be managed by some of the over-the-counter drugs such as acetaminophen (Tylenol and others). Take the pain management tablets at least two to three hour after the procedure since sedation will have started wearing off. Your dentist will recommend some pain management medication for severe pain. In most cases, you will feel postoperative pain if the dentist had to remove some bone structure. Avoid alcoholic drink. Pain is expected to reduce every day. However, if this is not the case, seek attention from your dentist.
Swelling
Use an ice pack for swelling as directed by your dentist. Any swelling usually reduces after two to three days. Swelling may be expected on eyes, cheeks, mouth and side of the face. This is a very normal reaction after dental surgery. Use ice packs when you are awake, though they will not have any beneficial effects after 36 hours.
Diet
After the procedure, limit yourself to taking only liquids. Make sure not to use straws but take the beverages straight from the glass. The pressure from the straw can remove the blood clot resulting in bleeding. Also, you might eat some soft foods but make sure that you chew away from the surgical site. Foods with high proteins and calorie are recommended. Also, avoid dehydration by taking fluids regularly.
Keep Your Mouth Clean
You should keep your mouth clean after the surgery to avoid any form of infection. Within the first 24 hours after the procedure, don’t brush your teeth. You can only gently rinse your mouth or use mouthwash. Your dentist will tell you to resume brushing after 24 hours. Be very gentle after you resume brushing. Also, rinse your mouth with warm salt water every two hours after a meal. Do this for the entire week after surgery.
Stitches
There are different type of stitches your dentist may choose to use. Some stitches automatically dissolve after a week while others need to be physically removed. If you have stitches that need to be removed, schedule an appointment with your dentist for the removal.
Potential Side Effects of Wisdom Tooth Removal
Wisdom tooth removal is a common dental procedure that is performed by dental experts. And just like any other dental procedure, it does carry some potential risks. However, fortunately, they are quite small. Here are some of the potential side effects of wisdom tooth removal.
Dry Socket
Dry socket is one of the most common side effects of wisdom tooth removal. One may be at a higher risk of developing a dry socket if:
• You are a smoker
• You fail at following your dentist aftercare instructions
• You are 25 years and above
• You have suffered a dry socket before
• The extraction procedure was complicated
Dry socket occurs when the blood clot fails to form on the operated area, thus becoming dislodged or break downs. Usually, it is less painful immediately after the procedure, however, the pain increases between three to five days after the surgery.
Nerve Injury
Although the damage is far less common to occur than partially erupts dry socket, it is a potential side effect of wisdom tooth removal. Usually, this complication is temporary and it lasts for several weeks. Nonetheless, it can be permanent if the nerve is seriously damaged.
General Anaesthesia
Usually, general anaesthesia is needed to perform the surgery. It comes with additional risks. However, the side effects are very uncommon, occurring in less than 1 in every 10,000 procedures. The anaesthesia is applied under a very controlled environment, and the dental team will monitor your body during the entire process.
Bottom Line
Though wisdom tooth removal may seem nerve-racking, the procedure is very common and complications are very rare. However, if you are nervous about the procedure, your dentist is the best resource. You can call or make an appointment to take about any concerns you might have about the treatment. Your dentist will be sure to give you some advice to help you walk through the treatment. Additionally, you need to consider several factors while looking for a wisdom tooth removal clinic. Make sure that the dentist is well trained, experienced and have the necessary academic qualifications. Also, make sure that the clinic is clean and well equipped to handle a wisdom tooth removal procedure. At Springvale Dental Clinic and Carrum Downs Dental Group, we have met all these qualifications. Schedule an appointment with us today for wisdom tooth removal procedure, and we will be sure to offer quality services.