Wisdom teeth start its development during adolescence and erupts into the oral cavity during early adulthood. Most of us unfortunately do not have enough jaw space to accommodate these teeth. As a result, these teeth are unable to erupt fully and starts to jam itself against the tooth in front of it. Dentists often refer to this condition as an “impacted wisdom tooth”.

Benefits of removing a poorly erupted wisdom tooth.

This include the ability to eliminate areas of food trap that often leads to recurrent gum infections (which manifest as episodes of pain or discomfort), prevent decay of the adjacent tooth that lies in front of it, and prevent premature loss of gum or alveolar bone due to chronic gum infection.

What will the surgeon do?

The surgeon will start by administering local anaesthetic to numb the affected wisdom tooth and its immediate surroundings. Patients who are especially anxious may also choose to do the surgery under sedation or general anaesthesia. The surgeon will thereafter proceed to make an incision along the gum line and expose the impacted wisdom tooth by removing some bone around it. Delivery of the tooth is often accomplished by dividing the tooth into 2 or more pieces to minimize the risk of nerve injury during removal. Finally, the surgeon will proceed to clean the socket and close the incision using stitches.

How long will it take?

The average procedure time is 15 minutes.

When is the best time to remove your wisdom tooth?

The recommended age to remove wisdom teeth that are impacted is during early adulthood when healing is often swift and uneventful. The experience will also be more predictable as the roots of the wisdom teeth may not have fully formed yet and the jaw bone still relatively elastic.

What is the experience like?

The surgery itself is fairly painless as this will be managed using fast acting local anaesthetic agents. Patients often find the noise and vibration associated with bone removal and sectioning of the tooth to be slightly uncomfortable (as sound conduction through bone is more efficient than air). You will also be able to sense some pressure during the delivery of the tooth.

What to expect after surgery?

You should expect mild bleeding, swelling and discomfort over the surgery site for two to three days after the surgery. A small percentage of patients may experience bruising along the jawline and neck.

You are encouraged to rest at home during the first 24 hours after the surgery. This will allow for the formation of a proper blood clot and minimise the risk of prolonged bleeding. Avoid smoking, exercising and using a straw for the first 48 hours. It is recommended that you do not consume alcoholic beverages whenever you are on prescribed medication.

A soft or liquid diet is recommended for the first 3 days before slowly resuming to your normal diet thereafter. Your surgeon may advise the use ice packs and prescribe analgesics to help relieve the swelling and discomfort. You can keep the wound site clean by rinsing with an antiseptic mouthwash. You can brush the other teeth as per usual.

A follow-up visit with the surgeon is often scheduled about 1 week after the surgery to ensure that you are making good progress towards a full recovery.

Are there any risks involved?

A potentially, serious complication associated with wisdom tooth surgery is nerve injury. This is due to the close proximity of the wisdom tooth to the Inferior Dental nerve. Injury to the nerve will result in a persistent feeling of numbness or a tingling sensation affecting the lower lip, gums, chin or tongue after the surgery. Fortunately, these symptoms will often resolve over time in most cases of mild nerve injury. Only on rare occasions does the injury become permanent. The experience of the surgeon and the patient’s ability to cooperate during the surgery may play a significant role in risk reduction.

A more common complication is the occurrence of a painful condition, three to five days after the surgery, known as a “dry socket”. It occurs when there is an inexplicable failure to form a proper blood clot within the tooth socket. Your surgeon may suggest for you to abstain from using a straw, smoking and spitting (or do any other type of sucking action) immediately after the surgery to mitigate this risk. The complication will usually resolve by itself and immediate emergency management is directed at pain control for patient comfort.