Impacted-Wisdom-TeethModern dentistry and oral health practitioners aim to preserve natural teeth. However, damaged or badly decayed teeth may need to be removed (extracted). The dentist may also recommend extraction to deal with wisdom teeth that are causing problems.

These teeth can cause various dental problems, including:

  • overcrowding of the existing teeth
  • impaction (the wisdom tooth grows at an angle and butts into the next-door molar or the gum).

A tooth may be removed using local anaesthetic. Sedation or general anaesthesia may also be offered depending on the difficulty of the procedure.

What Are Wisdom Teeth?

Wisdom teeth are the rear molars that erupt sometime around the late teens or early 20s. These teeth can sometimes cause overcrowding, or can impact into the gum or neighbouring teeth. Wisdom teeth that cause problems are best removed.

There are normally two wisdom teeth in the upper jaw and two in the lower jaw, but some people have fewer than four or even none at all. Wisdom teeth can cause various oral health or dental problems, including overcrowding and impaction.

Common problems associated with impacted wisdom teeth include gum infections and tooth decay. Impaction is where the wisdom tooth erupts at an angle which causes it to butt against the next-door tooth (hard impaction) or the gum (soft impaction). A wisdom tooth that grows on an angle can’t contribute to chewing, which makes it useless and at times painful. It is sometimes recommended that problem wisdom teeth be removed. X-rays taken while the teeth are still erupting can show whether or not they will cause difficulties.

Symptoms of infection

The symptoms of an infection caused by a wisdom tooth include:

  • Reddened, inflamed gum alongside the wisdom tooth
  • Swelling
  • Pain
  • Pus coming from the gum line
  • The lymph glands under the jaw become enlarged and sore
  • It may become difficult to open the mouth and to swallow
  • Fever.

ExtractionsCommon complications of wisdom teeth

In some cases, there may not be enough room in the jaw for the erupting wisdom teeth. This may stall their eruption (soft impaction), and make brushing and flossing these teeth difficult. Food and bacteria often become trapped between the wisdom tooth and its neighbouring molar tooth, which may cause tooth decay and gum infections.

Crowded wisdom teeth in the upper jaw have a tendency to lean sideways and grate against the cheek. This may cause ulcers on the cheek and chewing problems. The pressure from wisdom teeth may also force the other teeth closer together and interfere with a person’s bite. Cysts are other complications of impacted wisdom teeth. Very rarely, a tumour may develop at the site.

Antibiotics are a short-term solution

Infections caused by wisdom teeth can be treated with antibiotics, however the infection may keep coming back unless the problem teeth are removed. People with pre-existing health problems and compromised immunity may suffer complications from these infections.

Extraction (removal) of wisdom teeth is best done early

Wisdom teeth don’t usually cause any pain until the damage has already been done. Therefore extractions are best performed sooner rather than later. The roots of wisdom teeth in a teenager are still forming which makes extraction easier. The procedure may be more complicated if a person waits until later in life, when the roots of these molars are completely formed. X-rays taken while the teeth are still erupting can show whether or not they will cause problems.

Extraction of wisdom teeth

Using x-rays, your dentist or other oral health professional can determine which wisdom teeth will be functional and which ones need to be removed. Sometimes, a person may need all of the wisdom teeth extracted. This procedure can be performed using local or general anaesthetic, depending on the complexity of the problem.

If a wisdom tooth has potential to be a functioning tooth and has impacted into the gum, your dentist may only need to snip away the soft tissue to allow the tooth to completely erupt. If the whole tooth needs to be removed, it may be necessary to cut into the surrounding bone. Since a wisdom tooth is comparatively large, after an extraction the socket may need to be stitched to aid healing. It is normal for your jaw and gum to be sore, swollen and prone to bleeding for a few days after the procedure.

One possible post-surgery complication is a dry socket (alveolar osteitis), where the site doesn’t heal as well as it should. Symptoms consist of pain and a bad odour and pain from the socket. This can be successfully treated by your dentist or other oral health professional.

Self-care suggestions

Your dentist or other oral health professional will offer instructions on caring for your mouth after surgery, but general suggestions for self-care after an extraction include:

  • Take painkillers if required and upon advice from your dentist or other oral health professional
  • Regularly hold a mouthful of warm salty water and upon instruction. Be sure to wait 24 hours after the procedure before doing this.
  • Eat soft, easy-to-chew foods for the next few days.
  • Avoid smoking for at least 48 hours after the extraction
  • Avoid drinking alcohol.

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