Wisdom Teeth & Extractions
Adults have up to 32 teeth, of which four are wisdom teeth and these are the last to come through the gum. They are the one's right at the back of the mouth and usually appear between the ages of 17 and 25 although sometimes they can appear in later years.
If there is enough room in the mouth the wisdom teeth will come through (erupt) in a useful position and there will only be minor discomfort as they erupt. However, wisdom teeth can cause problems if there is not enough room in the mouth, as the wisdom tooth erupts at an angle and gets stuck against the tooth in front; the dentist will describe this as 'Impacted'.
The dentist will be able to assess whether there is sufficient room for the teeth to come through by taking an x- ray which will show the position of the root. Once the x-rays have been taken, the dentist will be able to tell how easy or difficult it will be to remove the tooth. The dentist will then determine whether the tooth should be taken out at the Dental Practice or by a Specialist Oral Surgeon.
The dentist will only recommend taking out wisdom teeth if
- The teeth are not able to fully erupt through the gum and are causing an infection in the surrounding tissue; this is known as Pericoronitis.
- There is decay present - wisdom teeth will often decay as it is very difficult to clean them as thoroughly as your other teeth.
Following the removal of wisdom teeth, there is likely to be some discomfort. However, this will vary depending on how difficult it was to remove the tooth; it is not uncommon to experience some swelling for a few days. The dentist will advise on how best to reduce this discomfort and may recommend pain killers such as Paracetamol or Ibuprofen. A further dental appointment will be necessary for the dentist to check the healing process and remove any stitches.
Dental Extraction is a removal of a tooth from the mouth. It is performed for a wide variety of reasons.
- Tooth decay – If the decay is severely advanced and the nerves and blood vessels in the tooth have been infected, and are unsuitable for root canal treatment.
- Impacted wisdom teeth – Sometimes our mouths are simply not big enough to accommodate these teeth. The teeth become impacted (stuck), this can cause infection and pain.
- Orthodontics (braces) – Teeth can erupt in many different positions, if this happens you may have to have teeth extracted so your other teeth can be brought into line.
- Periodontal disease - Bacterial infection under the gum damages the tissue which connects the tooth to the gum; as the disease progresses, the bone anchoring the tooth to the jaw begins to dissolve, resulting in the tooth becoming loose.
- Teeth that have been damaged by trauma.
- Certain medical conditions may require teeth to be extracted.
Your dentist will examine your tooth and explain the reasons why your tooth needs to be extracted, an x-ray will be taken to help plan the best way to remove the tooth and to see if an abscess is present.
If an abscess is present your dentist will give you a course of antibiotics before your tooth is extracted.
Your dentist will ask you about your medical history. You must list every medication you are taking even if you have purchased it from over the counter, as some medications can complicate an extraction
Tell your dentist if you are anxious about the procedure as sedation is available. If your dentist does not carry out sedation he will refer you to a practice that does.
How the extraction is carried out
There are two types of extraction
- A simple extraction is performed when the tooth can easily be seen in the mouth. The dentist will give you a local anaesthetic to numb the area around the tooth. When the anaesthetic has taken affect and the area around the tooth is numb the dentist will grasp the tooth using a pair of forceps, you will feel pressure but NO pain. The dentist will move the forceps back and forth to loosen the tooth in order to extract the tooth.
- Surgical Extractions – This is carried out on teeth which -
- Cannot be seen in the mouth but are present below the gum.
- Partially showing through the gum
- Broken off at gum level.
A local anaesthetic will be administered to numb the area before a small incision is made in the gum. The gum is pulled back to expose the whole of the tooth or the root. The dentist then uses the same procedure as a simple extraction to remove the tooth, in some cases the tooth or root may have to be cut into pieces to be removed.
When the tooth has been removed a swab will be placed at the extraction site and you will be asked to bite on this until the bleeding has stopped and a blood clot has formed.
Extraction After care
After the extraction a blood clot will form in the socket were the tooth used to be, this is NOT to be disturbed by vigorous rinsing or poking the site with your tongue or finger as it is a very important part of the healing process.
If the socket does start to bleed after you have left the dental practice, place a clean tissue or handkerchief over the extraction site and apply pressure by biting down, the bleeding will normally stop within a few minutes. Again do NOT disturb the blood clot. If the bleeding does persist please contact your dentist for further advice.
Your mouth will still be numb for an hour or so after the local anaesthetic, please take care not to bite your cheek or tongue or burn your mouth when drinking hot liquids.
Avoid Smoking and Alcohol for 24 hours as these can have an effect on the healing process
You may be in discomfort after the anaesthetic has worn off, take a household painkiller (headache tablet) following the manufacture's instructions. Do NOT take Aspirin as this may cause the socket to bleed.