Wisdom teeth are the last molar teeth to develop which usually grow at the very back of the upper and lower jaw bones, one at each back ‘corner’ of the mouth. They usually appear when people are aged 18 to 21 years old, and they are called wisdom teeth because by that age people become ‘more mature and wise’. Wisdom teeth can be as good and useful as any other teeth provided that, as they develop, they can penetrate the gums and emerge or erupt into the mouth completely and properly.
Unfortunately, this is not always the case. Frequently wisdom teeth erupt only partly or they don’t erupt at all. They are then called impacted wisdom teeth and they are usually a cause of many problems that makes it necessary for them to be removed.
The wisdom teeth usually need to be removed because of one or more of the following:
In some cases a wisdom tooth can be removed under local anaesthetic. In this situation, the area around the tooth is made numb with an injection of local anaesthetic. Sometimes the local anaesthetic is combined with sedation to help you relax and allow you to go through the operation. Having sedation means that you will be conscious during the operation, but will not be aware of what is going on.
Your mouth will feel bruised and swollen, the jaw will be slightly stiff and usually there is some mild to moderate discomfort. Your cheeks will usually swell a little with slight bruising of the skin. The swelling, bruising and stiffness of the jaw will disappear over a week to 10 days. You will be able to drink two to three hours after the operation but eating may not be possible for a few hours. It may be hard to chew normally for a while so you should eat a softer diet and initially avoid very ‘spicy’ or ‘vinegary’ foods.
You may be given a prescription for an antiseptic mouthwash, painkillers and some antibiotics. It is important to keep your mouth cleaner than normal to prevent infection of your wounds. A warm salt-water mouthwash, three times a day (add a pinch of salt to half a pint of warm water), used for one minute each side of the mouth after tooth brushing often helps soothe the mouth. The antiseptic mouthwash given to you should also be used after the salt water for one minute. You should finish the full course of antibiotics but only take painkillers as directed. Antibiotics can affect function of the contraceptive pill and alternative precautions are advisable whilst taking the antibiotics and for about a week after finishing the antibiotics.
You must not eat or drink anything for six hours prior to your appointment for your treatment to be carried out under sedation.
After Intravenous sedation a responsible adult must take you home and stay with you for the rest of the day. You must not drive or operate machinery such as vehicles, cookers, washing machines, power tools etc., for at least 24 hours after the treatment has been completed.
Once you are home you may have small sips of water and a small portion of food. Gradually this may be increased to larger portions.
If there is not enough room in your jaw, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. Often, part of the wisdom tooth will appear through the gum and part will still be buried under the gum causing soreness and possibly swelling. Food particles and bacteria may collect under the gum and cause an infection in that area. This may be a temporary problem, but in may cases it becomes chronic, when it is best to have the wisdom tooth removed.
The procedure can be performed using either local anaesthetic or I.V. sedation. The choice is yours, although the majority of extractions are performed under I.V. sedation.
The degree of discomfort depends on how easy it is to remove the teeth. There is usually some swelling and discomfort for a few days after extraction. You will be given painkillers, mouthwash and antibiotics (most cases). It may be necessary to use stitches to promote healing and stop the bleeding.
You may be off work for a couple of days. Your oral surgeon and recovery nurse will be able to give you more post-operative advice.