Wisdom Tooth Extraction
 The
Wisdom tooth, or Wisdom teeth (also called Third Molars) usually
do not push through the gums until the late teens or twenties.
Wisdom teeth are usually the last teeth to come through the
gums.
Complications
In the majority of cases, there will not
be enough room in the jaw for a wisdom tooth or all wisdom
teeth to fully emerge. This can lead to several complications.
If the exit of the wisdom tooth is stalled at the halfway
point (soft impaction), this can make brushing and flossing
the wisdom tooth extremely difficult. Food and bacteria builds
up between the wisdom tooth and its neighbouring molar, and
decay and gum infection are very likely to occur. Crowded
wisdom teeth in the upper jaw have a tendency to lean sideways
and grate against the cheek. This wisdom tooth usually causes
ulceration and chewing problems. A further problem is wisdom
teeth crowding- the pressure from wisdom teeth may also force
the other teeth closer together, and interfere with the bite.
Gum disease and cyst formations are also complications of
impacted wisdom teeth. Very rarely, tumours may also form
from a wisdom tooth. Pressure from the wisdom tooth can also
cause toothache on the tooth next to it. Ulceration can also
be caused by wisdom teeth. An upper wisdom tooth may push
sideways out of the gum and cause ulcers inside of the cheek.
Antibiotics are a short term solution for impacted
wisdom teeth
Mouth infections such as pericoronitis caused by wisdom teeth
can be treated with antibiotics, but the infection will reocurr
unless the wisdom teeth are removed. People with pre-existing
health problems can suffer serious complications from these
wisdom teeth infections.
Wisdom teeth surgery is best done early
Toothache prompts patients to come to the
dentist. However, wisdom teeth do not usually cause pain until
damage has already been done! Getting wisdom teeth out, wisdom
teeth surgery or as some say wisdom removal is best performed
sooner rather than later. Age is one of the most important
aspects when it comes to risks and post-operatory recovery
from surgeries involving impacted wisdom teeth. The roots
of wisdom teeth in a teenager are still forming, making the
wisdom teeth removal easier and safer. Later in life the roots
of wisdom teeth are completely formed and embedded firmly
in the jaw. X-rays taken earlier can indicate whether or not
wisdom teeth will cause problems. The dental surgeon or oral
surgeon will tell you when is the best time for getting wisdom
teeth out.
Procedure, pre surgical consultation and review of
wisdom teeth removal
During a consultation involving x-rays and examination, the
dental surgeon or the oral surgeon can determine which wisdom
teeth or wisdom tooth will be, or are, functional, and which
ones need to be removed. In many cases all four wisdom teeth
will need to be extracted. The wisdom teeth pre-surgical consultation
is very important, and at Wisdom Dental Emergency, this consultation
is most of the time performed by Dr Pinho. Aside from the
examination and the decision on whether to operate or not,
the consultation also allows the patient to establish a comfort
level with the dental surgeon and some of the other members
of the team. The wisdom teeth removal commonly involves an
incision to open the gum, and sometimes a small portion of
the bone may need to be removed to provide access for the
wisdom extraction. The wisdom tooth may also need to be divided
into segments so it can be removed safely and easily. Perfect
wisdom teeth technique and a lot of experience is a must for
these surgical procedures. The incision in the gum may then
need to be closed with stiches (these are dissolvable in our
practice). The patient is always well monitored during the
wisdom teeth surgery, and a set of instructions are given
and discussed for the post-operation recovery period. Dr Pinho
always phones every patient a couple of days after every wisdom
teeth surgery and also reviews the patient around 1 week after
the procedure totally free of charge.
General or Local Anaesthesia
The option of which anaesthesia to use during the wisdom
teeth surgery will be discussed during the pre-consultation.
The level of surgical difficulty, tooth impaction and the
patient's anxiety level are all taken into consideration.
All general anaesthesia operations are performed at The Royal
Dental Hospital in Melbourne, a state of the art dental facility
perfectly equipped for wisdom teeth removal and difficult
teeth extraction.
The decision to have wisdom teeth removal is always the patients
decision. If you have any questions regarding the treatment
please ask one of our professionals.
Wisdom teeth removal for prosthetic reasons
Wisdom teeth surgery or impacted teeth extraction may need
to be considered before construction of dentures. Sometimes
a wisdom tooth erupts beneath the denture and that can cause
severe irritation and infection
Wisdom teeth surgery when acute infection is present
Generally speaking, wisdom teeth removal should be delayed
in the presence of infection. Most of the time is preferable
to control the infection with antibiotics and oral higiene
first. The tooth extraction of the opposing wisdom tooth is
also sometimes adviced but that needs to be decided during
the consultation with the dental surgeon or the oral surgeon.
Asymptomatic impacted wisdom teeth
There is always a risk that impacted wisdom teeth may cause
problems. it may occur at inconvenient and unpredictable times.
If the wisdom teeth appear to have a high chance of causing
problems in the future, the dental surgeon and the oral surgeon
may advice removal of wisdom teeth
Wisdom teeth X-ray
The most used radiograph to assess wisdom teeth is called
OPG. This x-ray is most often required to show the end of
the roots of wisdom teeth and its location in relation to
important nerves and the sinus. Its advisable to have this
x-ray prior to any wisdom teeth consultation
Impacted wisdom teeth categories
Impacted wisdom teeth fall into several categories. Mesioangular
impaction is the most common and means the wisdom tooth is
angled forward, towards the front of the mouth. Vertical impaction
means the tooth is angled backwards, towards the rear of the
mouth. Horizontal impaction means fully 90 degrees forward.
Most of the time wisdom teeth with distoangulation are the
easiest to extract in the maxilla and the most difficult in
the mandibule. The wisdom teeth with mesioangulation are easier
to remove in the mandibule and more difficult in the maxilla
General comment
Wisdom teeth surgery is not something people look forward
to, but modern surgical and anaesthetic techniques as used
at Wisdom Dental Emergency have now combined to make wisdom
teeth surgery a much more acceptable procedure than in the
past.
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