Wisdom teeth

What we dread to hear each time we visit a dentist?

"You have cavities." and "Your wisdom tooth needs to be removed."

What are wisdom teeth?

These are not extra teeth like most of us think. They are part of our normal set of teeth. Each one of us has 32 teeth. 28 would have erupted into the mouth by the time we are 13 years of age. The last four, one in each end of the upper and lower jaws are the wisdom teeth. There is a sequence of eruption and it just so happens that the wisdom teeth are the last ones to erupt at the age of 18 to 24 years of age. By then there is usually a lack of space for them to erupt properly and so most are always stuck(IMPACTED). So we always have this idea that they are extras!

Do we need to remove them?

There criteria most Dental Surgeons will have to determine whether that wisdom tooth of yours need to be removed.

These are:

• They have given you gum pains before. These pains will usually subside after some medications and then will recur at a later date. No one can predict the frequency and severity of these recurring pains. They may or may not be accompanied by swelling and pustulent products.

• They have caused cavities in the teeth in front of them due to food trapping or they themselves have cavities from food trappings. These are usually determined by the dental surgeons after a check up or through x-rays results.

• They interfere with the treatment you are having. Usually this will happen in those who seek braces treatment. The orthodontist doing the treatment will be the best person to determine this.

• They are constant causes of food trapping and irritation.

How are they removed?

There are two methods of removing wisdom teeth. They can be by simple extraction or they are removed by simple minor surgical procedures. These are determined by their degree of impaction.
Removing wisdom teeth either by extraction or surgery can be performed under local anaesthesia or under general anaesthesia.
Local anaesthesia means that they can be done in the clinic when you are fully awake or sedated.
General anaesthesia will mean removing them while you are asleep and is usually done in a hospital environment under Day Surgery.ie. you go home about four hours after the procedure is performed. These can be carried out either in the private hospitals or restructured hospitals. The surgeons can be private practitioners or from government service.

What do we need to know when wisdom teeth are removed?

Medical Leave

If you have having an extraction done, you will only need one day's rest at home. The most is two days.
If you are having them removed under minor surgery, then you need to rest for at least five days.
For those who have them removed under general anaesthsia eight days of rest will be given commonly.
Whatever the number of days of medical leave given, it only means that you are not allowed strenuous activity for that duration. It does not mean you have to lay in the bed throughout. You can still carry on with light activities, though speaking is abit difficult.

Pains

There will be certain degrees of pain experience post surgery or extraction. These can usually be controlled with pain killers. Period of pains is variable in most of us. Usually it can last from one day to five days. On average most patients say they are fine after the third day. If extraction is done. The pain is usually only one day.
Sick your dental surgeon's help if the pain cannot be controlled with painkillers.

Bleeding

Bleeding post treatment for both extraction and surgery can be controlled with biting hard on gauze provided and swallowing the saliva. Maintaining the pressure and dryness for 30 minutes to one hour can stop the bleeding. Change the gauze for one to two times if necessary.

Swelling

Swelling post extraction is rare. Seek help if it happens. Swelling after surgery is common and the maximum size will be seen the following day. They will subside after three days. The swelling can be reduced with medication at times. Bruising may be evident in some of us. The swelling also will restrict the opening of the mouth.

Infection

Since there is a wound in the mouth, keeping food out of the wound is important to reduce infection. Brushing may be painful over the area of surgery. So the use of cotton buds to clean the area is necessary. Follow the instructions for medication, especially the antibiotics. No smoking is allowed. One sign of infection is severe pain and foul discharge from the area after two days.

Complications

There are known complications for any type of surgery. And wisdom teeth extraction or surgery are no different.
In the upper wisdom teeth, perforation into the sinus is possible. This can be repaired. One sign is water getting into the nose when you drink after an extraction or surgery. Long term complication is pus discharge from the nose. Seek help from your dental surgeon if this happens.
In the lower wisdom teeth, the most common complication is numbness of half the lower lip and half the tongue on the side of the surgery. This is usually temporary. It can last from three months to six months before the sensation comes back.
Even if it happens, your looks, movement of the affected side, speech are not affected. It usually involves the loss of sensation for pain, pressure, touch and the feeling is of a swelling in the area of concern.
Let the dental surgeon know if it happens and he will help you.

And Lastly
Please see the dental surgeon for removal of stitches if you have a minor surgery done. This is usually one week post operation. Even if the stitches are resorbable, it is important to see the dental surgeon to ensure that no infection or complication is brewing!