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Wisdom tooth surgery and impacted wisdom tooth are common occurences but what do you mean by them?
When someone tells you he has an impacted wisdom tooth or if your dentist tells you that you have an impacted wisdom tooth, it generally means that your wisdom tooth is erupted in an unnatural position. An impacted wisdom tooth more often than not requires wisdom tooth surgery to remove it and x-rays may be necessary to determine the degree of impaction before removal.
When someone tells you he has an impacted wisdom tooth or if your dentist tells you that you have an impacted wisdom tooth, it generally means that your wisdom tooth is erupted in an unnatural position. An impacted wisdom tooth more often than not requires wisdom tooth surgery to remove it and x-rays may be necessary to determine the degree of impaction before removal.
What is the wisdom tooth?
The wisdom tooth actually refers to your third molars. Everyone has a natural complement of 32 adult teeth in their lifetime. Some has more, a condition called hyperdontia whereas those who has less than the natural complement of 32 teeth has a condition called hypodontia. The third molar will be the last adult tooth to erupt and it normally surfaces around 18-21 years of age.
Why does the wisdom tooth give problems?
Due to its late eruption and the lack of space that the jaw may have, to accommodate it, the wisdom tooth may not be able to erupt properly or may even remain buried. Hence if it is not erupted properly, it is called an impacted wisdom tooth. An impacted wisdom tooth can cause food to be easily trapped and cause gum inflammation and swelling leading to pain and infection. Even if an impacted wisdom tooth is buried and can't be seen, it may just be under soft tissue e.g your gums which makes it easy for the bacteria and food to track under the gums via the pockets and cause swelling, infection and pain.
When do I have to remove the wisdom tooth? If I have an impacted wisdom tooth is it a must to remove it?
Removal of the wisdom tooth depends on a case to case basis. If the wisdom tooth is erupted properly and there is no problems associated with it then it can be and is normally left alone. If however there is difficulty in keeping it clean and there is a high chance that it might give problems in the future then it becomes an option for removal.
In an impacted wisdom tooth where there is pain or infection associated with it, it is normally indicated for removal via wisdom tooth surgery.
Sometimes the orthodontist (specialist dealing with braces) may also recommend removal of an impacted wisdom tooth or teeth early.
How is the wisdom tooth removed?
The wisdom tooth can be removed either via simple wisdom tooth extraction or in the case of an impacted wisdom tooth it can be removed via a wisdom tooth surgery. In the first instance, the wisdom tooth is extracted without any need for surgery and the procedure is normally done under local anaesthesia.
In an impacted wisdom tooth or in a difficult wisdom tooth extraction, wisdom tooth surgery needs to be performed in order to remove the wisdom tooth.
Wisdom tooth surgery can be done under local anaesthesia or general anaesthesia. In local anaesthesia, the surgeon will administer local anaesthetic and proceed with the surgery once the surgical site is numb. An incision will be made at the surgical site and bone and tooth exposed. Bone may need to be removed in some cases to enable the wisdom tooth to be elevated and the wisdom tooth may also need to be sectioned or cut to facilitate the removal.
Once the impacted wisdom tooth is successfully delivered, the surgical site will be irrigated and cleansed. A resorbable or non-resorbable suture will be used to close up the surgical site. In some cases, closure with sutures may not be necessary.
Wisdom tooth surgery can be done under local anaesthesia or general anaesthesia. In local anaesthesia, the surgeon will administer local anaesthetic and proceed with the surgery once the surgical site is numb. An incision will be made at the surgical site and bone and tooth exposed. Bone may need to be removed in some cases to enable the wisdom tooth to be elevated and the wisdom tooth may also need to be sectioned or cut to facilitate the removal.
Once the impacted wisdom tooth is successfully delivered, the surgical site will be irrigated and cleansed. A resorbable or non-resorbable suture will be used to close up the surgical site. In some cases, closure with sutures may not be necessary.
In general anaesthesia, the wisdom tooth surgical procedure still remains the same. However, the additional step will be the administration of general anaesthesia by a trained anaesthesiologist before the surgical procedure is initiated.
What are the risks and complications of wisdom tooth surgery?
Wisdom tooth surgery as with all other surgical procedures does not come without its own set of risks and complications. The most important risk of wisdom tooth surgery that must be noted is the risk of paraesthesia ( altered sensation ) or even anaesthesia ( total numbness) of the lips,chin and tongue on the damaged side. Tooth sensation on damaged side may also be affected. The incidence of nerve injury as cited in the literatures ranges from roughly 1- 5 %. It is not a hard and fast figure and the chances of a nerve injury might go higher depending on the anatomy of the patient involved. The degree of impaction of the impacted wisdom tooth also contributes to this as a more severely impacted wisdom tooth will increase the difficulty of the wisdom tooth surgery.
Other complications are dislodgement of the tooth or part of it into body spaces such as the lingual pouch for the lower wisdom tooth and the maxillary sinus or the infratemporal space for the upper wisdom tooth.
Fractured roots or part of the wisdom tooth may also be left in situ either on purpose or accidentally but if the pieces are small they normally cause minimal problems. In fact some surgeons leave behind small pieces of the wisdom tooth behind if its too risky to go after them as it is basically a risk to benefit surgical call.
Post operative bleeding, TMJ ( jaw joint) pain and damage to adjacent tooth are other complications that might occur.
Due to the increasing number of patients taking bisphosphonate drugs for osteoporosis, it may be prudent to include osteonecrosis related to bisphosphonate use as a complication of wisdom tooth surgery and in such cases the impacted wisdom tooth can just be symptomatically treated.
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| Surgery Done to Enable Broken Tooth Removal | ||
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| Tooth Removed and Wound Sutured. Nampak menakutkan kan??hehehe... | ||
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- Make sure you make your appointment on a day that gives you a couple of days to recuperate after the surgery.
- 2Stock up the night beforehand. Make sure you buy lots of soft foods. (apple sauce, chicken soup, yogurt, canned peaches, pears, pudding, cottage cheese, etc.) You won't be able to have hard, cold/hot foods for at least 48 hours after surgery.
- 3Right after your teeth are pulled, depending on the circumstances, your doctor will have certain things he/she wants you to follow. Make sure you read the material he/she gives you about how to take care of your teeth.
- 4Leave the gauze on for at least 30 minutes. Do not attempt to change the gauze as it will disrupt the clotting process. Think of it as a band-aid; you wouldn't want to have one stuck to the wound and be pulled off every time it clotted. Once the first gauze pad has been taken off, keep the area clean and leave it be. Do not attempt to spit the blood out as the pressure change in your mouth will affect clotting. You can bite on a teabag which helps form a clot and stop bleeding.
- 5Use a teaspoon of sea salt with about 8 ounces of warm water to rinse your mouth out after food and before bed, it helps the healing process.
- 6Have someone with you the first day you get them removed; you might want some extra help since you may be drugged.
- 7Ice may be applied to your cheek(s) to help prevent swelling for the first 24 hours. After 24 hours ice may continue to help ease the pain, but will be useless in prevention of swelling. If the operation was just a simple extraction of erupted teeth swelling may be very minor or not present in which case ice is not necessary.After the first 24 hours, apply a heat pad to your cheek(s). The body's natural response will cause additional swelling if the ice pack is reapplied.
- 8When lying down or sleeping have your head elevated with a couple of pillows. This will help with the swelling as well.
- 9Always have some water, your pain killers, and antibiotics (if prescribed any) near you. You'll want them near you when you need to take them again.
- 10Have lots of movies, games, books, and other things around you. You may be in a lot of pain, so you want to make sure you have a lot of resources around to keep your mind busy.
- 11Within a couple of weeks the gum tissue should be mostly healed and discomfort should be minimal. If a dry socket has developed, healing will take longer.
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