This webpage has been designed to improve understanding of Wisdom Teeth Removal and contains answers to the most commonly asked questions about this treatment. If you have any other questions that the website does not answer or would like further explanation please ask a member of our medical staff.

The problem
The wisdom tooth (or third molar) is usually the last tooth to erupt into the mouth anytime after about 16 years of age. Frequently there is not enough room to accommodate wisdom teeth and as such they do not come into the mouth normally. When this happens, the wisdom teeth are said to be “impacted”. Wisdom teeth are usually either impacted forwards into the tooth in front or backwards into the jaw bone.

Why is treatment needed?
An impacted wisdom tooth can cause a number of problems that mean the tooth is best removed. Most commonly these are:

		Repeated attacks of infection in the gum surrounding the tooth. This leads to pain and swelling.
		Food packing which causes decay in either the wisdom tooth or the tooth in front.
		Cysts can form around the wisdom tooth if it does not come into the mouth properly. A cyst occurs when fluid fills the sack that normally surrounds a developing wisdom tooth.

What does the treatment involve?
Because the wisdom tooth has not fully erupted into the mouth it is often necessary to make a cut in the gum over the tooth. Sometimes it is also necessary to remove some bone surrounding the crown of the wisdom tooth. Rarely the tooth needs to be cut into 2 or 3 pieces to remove it. Once the wisdom tooth has been removed the gum is put back into place with stitches. In the majority of cases these stitches are dissolvable and take around two weeks to disappear.

What type of anaesthetic is used?
A number of options are available and depend on how difficult the wisdom tooth is to remove:

Local anaesthetic - this is an injection into gum surrounding the wisdom tooth, rather similar to what a Dentist might use for a filling. The injection takes a couple of minutes to numb the area and means that there is no pain while the wisdom tooth is removed. This is the best option for wisdom teeth that are simple to remove.

Local anaesthetic and intravenous sedation – in addition to a local anaesthetic injection, an injection can be given into the arm. This helps patients to feel relaxed and less aware of the procedure.

General anaesthetic – it is usually possible to remove wisdom teeth under a “day case” general anaesthetic, i.e. although patients are put to sleep completely, they will be able to go home on the same day as surgery.

How long does it take to remove a wisdom tooth?
This is a variable. Some wisdom teeth may take only a few minutes to remove. More difficult wisdom teeth that need to be cut into pieces to remove can take around 20 minutes to extract

Is there much pain or swelling after the removal of wisdom teeth?
It is likely that there will be some discomfort and swelling both on the inside and outside of the mouth after surgery. This is usually worse for the first three days but it may take up to two weeks before all the soreness goes. The jaw may also become stiff and require a diet of soft food for a week or so. If it is likely to be sore your Surgeon will arrange painkillers. It may also be necessary to have a course of antibiotics after the extraction. There may be some bruising of the skin of the face that can take up to a fortnight to fade away.

Is there any post operative care?
It is important to keep the extraction sites as clean as possible for the first few weeks after surgery. It may be difficult to clean teeth around the sites of the extraction because it is sore and if this is the case it is best to keep the area free from food debris by gently rinsing with a mouthwash or warm salt water (dissolve a flat teaspoon of kitchen salt in a cup of warm water) commencing on the day after surgery.

Does this procedure require any time off work?
Usually it will be necessary to take 5-7 days off work and avoid strenuous exercise for this time. Depending on the type of anaesthetic used, it is important to remember not to drive or operate machinery for 24 hours after Intravenous Sedation and for 48 hours after General Anaesthesia.

What are the possible problems?

		Although there may be a little bleeding at the time of surgery this usually stops very quickly and is unlikely to be a problem. Should the area bleed again, this can usually be stopped by applying pressure for at least 10 minutes with a rolled up handkerchief or swab. If the bleeding does not stop, please contact Pacific Oral and Maxillofacial Surgery.
		Infection is uncommon particularly if antibiotics are used.
		When Implants are placed into the lower jaw it is important to be aware that some nerves may lie close to the site of surgery. One of these runs through the centre of the jawbone and supplies feeling to the lower lip, chin and lower teeth. The other runs on the inside of the lower jaw and supplies feeling to the tongue and helps with taste. Sometimes these nerves may be bruised when an Implant is placed. This can cause tingling or numbness in the lip, chin or tongue, and more rarely altered taste. The chances of these nerves being bruised depends on exactly where the Implant is going to be placed and how much bone there is around the nerves. Your Surgeon will discuss these risks during consultation.

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