The Problem

The wisdom tooth (or third molar) is usually the last tooth to erupt into the mouth any time 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 do I need treatment?

An impacted wisdom tooth can cause a number of problems, hence the need for removal. 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 mouth. Sometimes, it also necessary to remove some bone surrounding the crown on the wisdom tooth. Usually, the tooth also needs to be cut into several pieces in order to remove it. Once the wisdom tooth has been removed, the gum is put back into place with stitches. In majority of the cases, these stitches are dissolvable and take around four weeks to disappear.

What type of anaesthetic is used?

A number of options are available:

  • Local anaesthetic – This is an injection into gum surrounding the wisdom tooth. The injection takes a couple of minutes to numb the area and means that you will feel no pain while the wisdom tooth is removed. This is the best option for wisdom tooth that are simple to remove.
  • Local anaesthetic and intravenous sedation – In addition to a local anaesthetic injection, you can be given an injection into your arm. This makes you feel relaxed and less aware of the procedure. However, it needs an anesthetist attending to you.
  • General anaesthetic – It is usually possible to remove wisdom teeth under a “day care” general anaesthetic, i.e. although you are put to sleep completely, you will be able to go home on the same day as surgery. This is commonly done at a hospital.

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 30 to 40 minutes to extract.

What to expect after the operation?

A number of options are available:

  • Discomfort and swelling on the face and inside the mouth – mainly for the first three days after surgery but it may take up to two weeks before all the soreness goes away.
  • Occasionally there will be a temporary discoloration of the skin over the swelling and soreness at the corner of your lips.
  • Your cheek may feel tight and your mouth opening may be restricted. This will make chewing difficult and we therefore recommend a soft diet for about a week or so.
  • There may be oozing of blood from the site of the surgery (which will have some stitches) when you get home. This can be stopped by biting for 20 minutes on a piece of rolled up gauze placed exactly over the area. Avoid hot drinks and vigorous rinsing of the mouth as these promote bleeding. If bleeding persists, please refer back to respective Artius clinic.

Is there anything else I need to do after the surgery?

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 your 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) beginning on the day after surgery.

Do I need to take any time off work?

Usually it will be necessary to take 2 to 5 days off work and avoid strenuous exercise during this time. Depending on the type of anaesthetic used, you may not be able to drive (24 hours after intravenous sedation and for 48 hours after a general anaesthetic).