Guide to Impacted Wisdom Teeth

The painful emergence of wisdom teeth has become a rite of passage for young adults. Research suggests that somewhere between 60% and 90% of us will develop impacted wisdom teeth – usually between the ages of 16 and 25. Impacted wisdom teeth are a part of growing up. They are something that most of us look forward to with real trepidation. There are plenty of adults who will tell you how painful wisdom teeth can be and how much they make your jawbone ache as they try to push their way to the surface.

Provided you visit your dentist regularly, emergency treatment for impacted wisdom teeth should not be required. Your dentist will take regular x-rays to identify what stage the development of your wisdom teeth has reached. Your dentist will then be able to refer you to a specialist if necessary, plenty of time before your impacted teeth begin causing you any pain. As some occasions, however, if a person misses check-up appointments with their dentist, the first sign of their wisdom teeth emerging may be the pain caused by them becoming impacted.

In this article, we will look at wisdom teeth and explain what they are, why they are a problem and why you need to have them removed. There are quite a few myths and misconceptions about wisdom teeth – so hopefully we will dispel a few of those as well.

What are wisdom teeth?

Most adults grow 32 teeth. The first 28 come through earlier than the last four, which are known as wisdom teeth. The wisdom teeth erupt at the back of the mouth and they tend to appear after the age of about 16. Because they emerge later in life when you are a little but older (and wiser!), they are known as wisdom teeth.

However, this later emergence is also the reason why they can cause problems. The wisdom teeth push against the existing teeth as they try to force their way up through the gums. When the existing teeth stop the wisdom teeth from emerging, they can grow crookedly are become called impacted wisdom teeth. When the wisdom teeth become impacted, your dentist will usually refer you to an oral surgeon and recommend that you have your wisdom teeth extracted.

What does impacted mean?

Why is it so important to have your impacted wisdom teeth extracted? Many people assume that they have to have their wisdom teeth extracted because of the crowding that they would cause in their mouth. There is simply no room for them. This is partly true, but there is a much more important reason for having the wisdom teeth extracted.

Impacted wisdom teeth can be horizontal, angled inwards, outwards, backwards or forwards. This unusual growth causes problems because pockets form around the wisdom teeth and the adjacent teeth that trap debris and encourage decay.

This debris and decay attracts bacteria and creates the right sort of environment for bacteria. Wisdom teeth cannot be reach through conventional brushing and flossing as they usually have more of the tooth below the gumline.

Not every has to have their wisdom teeth removed and it is rare that you need to have all four removed at the same time. The more teeth you have removed, the more painful the post-operative recovery usually is.

What is the procedure like?

The type of treatment you require will depend on where exactly your wisdom teeth are. If they have managed to emerge into the gum, then your dentist may simply be able to give you a local anaesthetic, slice open the gum and then extract the tooth. It could be that straightforward and you may wonder what all the fuss was about.

However, for some people, the impacted wisdom teeth remain partially trapped in bone. This makes it a much more complicated piece of oral surgery. Ideally, your oral surgeon will be able to remove your wisdom teeth before they start to cause you pain or problems.

Normally, once your dentist has referred you to an oral surgeon, you will need to arrange an appointment for a pre-operative consultation. Your surgeon will be able to evaluate your x-rays, discuss the procedure with you and alleviate any fears or concerns you may have.

When the time for your procedure approaches, you will not be able to eat or drink for 24 hours before your operation. You will also be required to have a friend or relative with you, as you will not be able to drive after the procedure.

Your wisdom teeth will be removed while you are under general anaesthetic. The procedure normally takes around 60 minutes with another 30 minutes allowed for you to come round and regain your composure. You will still be groggy for around 24 hours after the surgery, so you will probably need somebody to accompany you home and stay with you.

Your oral surgeon will expose the wisdom tooth that requires extraction by slicing through the gum and lifting it away. If the wisdom tooth is encased in bone, then the surgeon may be required to cut some of the bone aways before cutting up the tooth and removing it piece by piece. Once the tooth has been fully removed, the surgeon will replace the gum and hold it into position with dissolvable sutures.

What happens after the operation?

Wisdom teeth removal is usually performed as an Outpatient service and patients rarely remain in hospital overnight. After the operation, you may find that you experience some swelling and tenderness around your jaw and gums. During the first 24 hours after the operation, you may notice some of the following side effects:

  1. The empty tooth socket from which the wisdom tooth has been removed may continue to bleed sporadically for a day or so after the operation. This is entirely normal. To stop the bleeding, press a cotton pad over the bleeding socket and bite down hard on it.
  2. Depending on how complex the surgery is to remove your wisdom tooth, you may experience some bruising to your jaw and cheek. If you have a number of wisdom teeth out at the same time, you may find that you jaw is particularly sore and stiff for a period of time after the operation. The only thing to do is to wait until the bruising and swelling go down. Try to eat softer foods and liquids for the first few days after the operation. An ice pack on the affected area may also help to soothe the pain.

Can things go wrong in surgery?

As with any type of surgery, there are always possible complications. On the whole, however, wisdom teeth removal is a straightforward and safe procedure which is performed regularly.

Sometimes, wisdom tooth removal can be highly intricate work. Even the very best oral surgeons can sometimes cause damage to the teeth, gums or jaw bone around the wisdom tooth.

Some patients experience temporary numbness in their tongue, lips or mouth after wisdom tooth removal. This is because the wisdom teeth are often close to the nerves that link to these areas. If the nerves are accidentally damaged, this can cause temporary numbness. If the numbness does not gradually disappear, you should contact your dentist.

Some patients develop a condition called dry socket when they have had a wisdom tooth removed. Dry Socket occurs when a blood clot does not form properly in the socket from which the wisdom tooth has been removed. Therefore, the socket does not heal quickly enough and can also become inflamed and painful. Dry Socket is easily treated with a dressing.

Infection is also a possibility after wisdom tooth removal. However, we must add that it is fairly unlikely. The most obvious symptom of a gathering infection is a high temperature. If you do contract a temperature, your dentist or doctor should prescribe a course of anti-biotics to dispel it.

There are a variety of other complications that are possible after a wisdom tooth removal. Your surgeon may accidentally leave a particular of tooth behind, which is therefore in danger of becoming infected. On very rare occasions, patients can experience complications to do with their sinuses, jaw bone or jaw joint alignment.

On the whole, complications arising from wisdom tooth removal are uncommon and also fairly straightforward to remedy.

How do I look after my teeth after an operation?

You should continue brushing your teeth after you have had a wisdom tooth removed. However, you should ensure that you brush them gently, especially around the affected area.

Just as important as what you do after your operation, of course, is what you do before it. It is very important that you visit your dentist regularly so that they can evaluate how your wisdom teeth are growing and what steps need to be taken. If you do not have regular check-ups, it could be that you only discover you need your wisdom teeth removing after they have begun causing your pain.


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