ALL THINGS ABOUT WISDOM TEETH

Do wisdom teeth always cause problems?

No. If there is enough room they will usually come through into a useful position and cause no more problems than any other tooth.

Often there will be some slight discomfort as they come through, but this will disappear once the tooth is fully in position.

What is an impacted wisdom tooth?

If there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as 'impacted'.

What problems should I be prepared for?

If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. This is called ‘pericoronitis'. Bacteria and bits of food can collect under the gum edge, and it will be difficult to clean the area properly.

This is a temporary problem that can be dealt with by using mouthwashes, special cleaning methods and possibly antibiotics. If the problem keeps coming back, it may be better to have the tooth removed.

What can I do to

help relieve the discomfort of wisdom teeth?

A mouthwash of medium-hot water with a teaspoonful of salt will help to reduce gum soreness and inflammation (check that it is not too hot before using it). Swish the salt water around the tooth, trying to get into the areas your toothbrush cannot reach. Do this several times a day.

An antibacterial mouthwash containing chlorhexidine can also reduce the inflammation. Pain-relieving tablets such as paracetamol or ibuprofen can also be useful in the short term, but talk to your dental team if the pain continues. The tablets should always be swallowed and not placed on the area.

What if this does not help?

If the pain does not go away or if you find it difficult to open your mouth, you should see your dentist. They will be able to see the cause of the problem, and give you the right advice. They may clean around the tooth very thoroughly, and may prescribe an antibiotic.

Are x-rays needed for wisdom teeth?

The dental team will usually take x-rays to see the position of the root, and to decide whether there is room for the tooth to come through into a useful position.

What are the main reasons for taking wisdom teeth out?

Far fewer wisdom teeth are now taken out than in the past. If the tooth is not causing problems, your dentist will not want to remove it. They will only remove wisdom teeth:

• When it is clear that they will not be able to come through into a useful position because there is not enough room, and they are also causing some pain or discomfort.

• If they have only partly come through and are decayed - these teeth will often decay as it will be difficult to clean them as thoroughly as your other teeth.

• If they are painful.

Are wisdom teeth difficult to take out?

It all depends on the position and the shape of the roots. Your dentist will tell you how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often easier to remove than lower ones, which are more likely to be impacted. Your dentist will say whether the tooth should be taken out at the dental practice, or whether you should be referred to a specialist oral surgeon at a hospital. Very occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth. Your dentist will tell you if it is possible in your case.

Either a local anaesthetic - like you would have for a filling - or sedation will probably be recommended. A general anaesthetic - where you would be asleep - can also be used, but this will only be given in a hospital.

Will it make any difference to my face or mouth?

Removing wisdom teeth may cause some swelling for a few days. But as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the wisdom teeth were impacted.

What should I expect after a wisdom tooth is taken out?

The amount of discomfort will depend on how easy it was to remove the tooth. There is usually some swelling and discomfort for a few days afterwards, and it is important to follow any advice you get about mouthwashes and so on, to help with the healing. Normal painkillers such as paracetamol or ibuprofen will usually deal with any pain. It is best to stay fairly quiet and relaxed and avoid smoking and drinking alcohol for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over. Your dentist will probably want to see you again about a week later to check how your mouth is healing, and to remove any stitches.

What does it cost to remove wisdom teeth?

The cost of having wisdom teeth removed will vary according to the difficulty of the procedure and whether it is being carried out in a dental practice or hospital. It is always recommended that you get a written estimate before starting treatment.

Removing impacted wisdom teeth 

Where the wisdom tooth is below the gum entirely or there is only a small portion of the tooth exposed, the extraction process is a little more complex.

Some of these can be carried out in your normal dentists surgery, they just tend to take a little longer to complete.  It is common for your dentist to refer you to a specialist oral surgeon to have these teeth removed.

For particularly nervous patients or the most complex of extractions, general anaesthetic may be used.  You would be put to sleep, so you will not know what is going on during the extraction. This sort of surgery will be completed in a hospital.

For those that do not need hospital treatment, a local anaesthetic will be given to numb the area.  Once a few minutes have passed the numbing agent will have taken effect and the extraction can begin.

Because little or none of the tooth is exposed, the dentist will have to make a small cut in the gum, that will allow for the gum tissue to be lifted back and reveal more of the tooth.

It is quite common here that the dentist will make use of specialist drills to actually break the tooth up into a number of smaller pieces to make the extraction simpler.

By removing smaller pieces, it makes the job easier for the dentist.

All the pieces will be removed during the extraction process.

Once the tooth is out, the gap is now closed with the use of a couple of stitches.  More often than not these stitches are designed to dissolve and do so within 7-10 days.

The following video from Bupa is an animation of the extraction process, that helps give a visual representation of what a dentist would do.