Wisdom tooth removal

wisdom teeth

 Wisdom teeth removal is very common in young people. They are often impacted.

Wisdom teeth removal is the removal of the third molars in the upper and lower jaws.

They are the last teeth to appear in the mouth in an early adult.

There are total of 32 teeth if all four are present.

However, one or more wisdom teeth may be  congenitally missing. They may or may not be impacted in the jaws.

 

We advise removal of wisdom teeth when:

1 Partially erupted wisdom teeth that causes food trap and resultant decay of the second molar in front of it.

2 Inflammation of the gums covering part of the wisdom tooth

 ulceration of soft tissues trapped between upper and lower wisdom teeth

4 Decayed wisdom tooth that is not accessible to cleaning.

5 A wisdom tooth may push on other teeth and cause poor alignment (though this is debatable)

6 Presence of related pathology such as a cyst may develop and the latter can destroy bone and damage other teeth and gums.

We assess the following before minor surgery:

1 Medical and dental history

2 Access to tooth on jaw opening

3 Any pain and swelling related to the wisdom teeth.

4 We treat it with a course of antibiotics, painkillers and antibacterial rinse so as to control the infection and allow better post op healing.

5 Take Xray to show the anatomy of the tooth, its angle and depth of impaction and proximity to vital structures such as the sinus or major nerve.

Most wisdom tooth surgery are easily removed under local anaesthesia by raising a flap, removing some bone , sectioning the tooth to facilitate its removal followed by closure of the incision.

Post op instructions:

1 Bite firmly on the gauze and be gentle when rinsing.

2 Rest and no vigorous activities

3 No alcoholic drinks and smoking

4 Complete the antibiotic course

5 Soft diet for the first two days on the non operated site.

6 Drink lots of fluids

7 Ice pack to reduce swelling.

 

Possible problems: 

1 Incidence of dry socket 

2 Numbness may occur especially if the wisdom tooth is close to the nerve. It may take up to weeks or months to heal.

3 Pain, swelling and difficulty in opening the mouth (trismus) is common. Medication should be taken religiously.

4 Excessive bleeding my be due to repeated or vigorous rinsing. Biting down on a gauze would help. Contact the clinic if persist.

5 Lip sores can happen from stretching of the lip during removal.

* Most wisdom teeth removal have uneventful healing.

 

What makes extraction difficult;

1 Grossly Carious tooth that easily fractures

2 patient has dense Bone

3 An extra root not visible on xray's perspective can add to resistance

A minor surgery with sectioning of the roots and bone guttering usually resolves the problem.