If the jaw does not have enough room for the wisdom tooth to come through, the tooth will become wedged in or "impacted". Some impacted wisdom teeth remain buried and cause no trouble. However, other impacted wisdom teeth may cause severe problems. Often one or more wisdom teeth will cause problems and must be removed. If one or more of your wisdom teeth becomes troublesome, your oral surgeon may recommend that it be removed. Removal of a wisdom tooth is a very common procedure. Removal of troublesome wisdom teeth should usually be done as soon as possible before the problems get worse.
Treatment of a wisdom tooth infection
Your surgeon may gently clean the infected area around the tooth. You may be advised to rinse your mouth often with a warm saltwater mouthwash. Use one teaspoon of salt in a glass of warm water. The water should be as warm as possible, but not too hot. Your surgeon may also suggest a disinfectant mouthwash and a pain killer for you to use. Your surgeon may prescribe antibiotics. Tell your surgeon if you have ever had an allergic reaction to any antibiotics or other drugs. Take the complete course of antibiotics.
The decision to remove teeth
After inspecting your mouth, jaws and x-ray films, your surgeon can discuss the diagnosis with you. Your surgeon may recommend removal of the wisdom teeth or other options. If the area around the tooth has been infected, your surgeon may decide to delay surgery while the infection is being treated. Even though a wisdom tooth has caused problems, it may "settle down" after it pushes through the gum. Your surgeon may delay surgery to see if the tooth stops causing problems. While impacted wisdom teeth may cause problems, some never cause trouble and may not need to be removed. The decision to have wisdom teeth removed is always yours. If you decide to have wisdom teeth removed, your surgeon may ask you to sign a consent form. Read it carefully. If you have any questions about the form, the surgery or anything else, ask your surgeon. If you are uncertain about your surgeon’s advice or diagnosis, you may wish to seek the opinion of another surgeon.
Early removal of wisdom teeth
Your surgeon may recommend early removal of one or more wisdom teeth due to the following reasons:
• There is not enough room for the tooth to push through.
• You need orthodontic work, and the remaining teeth must not be crowded by wisdom teeth.
• The tooth has started to cause trouble. It should be removed soon so that pain, infection or other problems do not get worse.
• It is best to have troublesome wisdom teeth removed while the person is young. In young people, a tooth’s roots have not formed totally, and the bone surrounding the tooth is softer. This allows easier removal of the tooth, and there is less risk of damage to nerves, bone or other teeth.
X-ray examination
Your surgeon needs to take x-ray films of your jaw. The films will help your surgeon plan the best way to remove troublesome wisdom teeth.
Where to have the surgery
Your surgeon will advise you whether your wisdom teeth should be removed in the surgery, hospital or in a day-surgery hospital.
If you go into hospital
As part of routine procedure, your surgeon may want you to have some tests. You may be given a sedative to help you relax.
Stopping pain during surgery
After discussion with your surgeon, a decision will be made whether the wisdom tooth will be removed under a local anaesthetic or a general anaesthetic. Discuss the options with your surgeon.
Local anaesthesia
If a wisdom tooth removal is fairly simple, your surgeon may give you a local anaesthetic with a needle. The local anaesthetic will numb the gums and lower parts of the face. The surgeon can then remove the tooth. Your surgeon may give you a tablet to help you relax during the surgery.
General anaesthesia
For some people, the surgeon may recommend "general anaesthesia", that is, putting them to sleep with an injection. General anaesthesia is given by a specialist anaesthetist. General anaesthesia may be used in people who:
• have wisdom teeth that will be difficult to remove
• do not want to remain awake during the surgery
• have other problems with their wisdom teeth, gums or jaws.
Note
For six hours before surgery under a general anaesthetic, do not eat or drink anything. If your surgery will be done in the morning, do not eat or drink after midnight the night before. Your surgeon will give you full instructions. Modern anaesthesia is safe with few risks. However, a few people may have serious reactions to them. If you have ever had a reaction to an anaesthetic drug, tell your surgeon.
Removal of wisdom teeth
Your surgeon will have to make an incision to open your gums to remove the wisdom tooth. A small portion of the bone may have to be removed so your surgeon can get to the tooth. The tooth may have to be divided into segments so it can be removed easily and safely. The incision in your gums may have to be closed with stitches. Some stitches dissolve after a few days. Other stitches will be removed by your surgeon.
After the surgery
After the tooth has been removed, you will have to rest for a while before you go home. Your surgeon will check on you as you recover. When your surgeon is satisfied with your recovery, you can go home. A family member or friend should take you home after the surgery. Arrange this well in advance. You should not drive after surgery. If you have been staying in hospital, you will return to your room when you recover from the anaesthetic.
Taking care of yourself after surgery
• Rest at home after the surgery.
• Do not drive, engage in active exercise, or operate machinery.
• Take several days off from work, school or other duties.
• Do not drink beer, wine, spirits or other alcoholic drinks while you are taking pain killers or antibiotics.
• Eat soft foods such as soups, blended (purred) vegetables and meats and gelatine for the first two days.
• Drink lots of fluids.
• Ice packs may reduce swelling and pain.
Pain relief after surgery
Pain may be minor in some people and greater in others. Your surgeon will prescribe a pain reliever for you. If you are uncertain about the best pain relief medicine for you, ask your surgeon. Pain usually starts to decrease after the second day. However, some people may still need pain relief after one week. If your pain does not seem to get less as the days go by, tell your surgeon.
Control of bleeding
You can apply pressure over the area of bleeding by biting gently but firmly on a piece of cotton gauze. The pressure helps stop bleeding, and a blood clot forms. It is important not to disturb the area or bleeding may start again. The gums may ooze blood slightly after surgery. Any bleeding should stop by the second day. If bleeding does not stop, contact your surgeon.
Swelling
Swelling almost always occurs after surgery and can vary from a little to sever. Most swelling takes four to five days to go down completely. Swelling can be reduced by applying ice packs on the cheeks.
Follow-up
A follow-up visit is important. Your surgeon will want to check on healing. Stitches may be taken out. |
