Ouch! Wisdom teeth

We often hear about wisdom teeth being extracted, most of the time with a minor surgery. A lot of the times, it is assumed that these ‘additional’ back molar teeth need to be removed regardless of how they come through. In Singapore, the normal practice is elective removal of these wisdom teeth as soon as they push through the gum tissue.

But WHY?

Why do wisdom teeth cause pain? Why do they need to be removed? And why is it a lot of the times a surgery? Let us explore!

WISDOM TEETH ARE ALMOST ALWAYS IMPACTED

As they erupt at an angle, we end up with a tooth that is partly below gum and partly above. See picture below as reference

As food gets packed between tooth and gum, it gives rise to an inflammation of the gum commonly known as pericoronitis. This may cause an infection which causes pain and swelling. Patients may complain of a bad taste / bad smell.

---

According to NICE guidelines and AAOMS, prophylactic surgical removal of these teeth is not required if they are disease free.

In general, dental and medical professional agree that they should be removed in one or more of the following instances:

1. Infection or periodontal disease

2. Unrestorable cavities

3. Pathologies such as cysts or tumours

4. Damage to neighboring teeth

Wisdom teeth that are completely erupted and functional, painless, cavity-free, in a hygienic environment with healthy gum tissue, and are disease-free may not require extraction. They do, however, require regular, professional cleaning, annual check-ups and periodic radiographs to monitor for any changes.

---

Impacted wisdom teeth more often than not require a minor surgery for removal. Since these teeth are not well aligned with neighboring teeth and are located further inside the thicker jawbone, their removal may be more complicated.

What can you expect during surgery?

You will be given local anaesthesia, oral sedation, intravenous sedation or general anaesthesia. Speak to your surgeon regarding type of anaesthesia that is most suitable for you. Wisdom tooth removal should be a pain free procedure. Usually stitches are placed to help healing.

What happens after surgery?

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

Wisdom teeth do not always require removal. Get them checked by your dentist on your check up appointments to assess your risk.