If you have been referred to see Wayne about your wisdom teeth then it's likely one or more wisdom teeth will need to be removed. This page will give you information on what wisdom teeth are, why they are removed, how they are removed and your recovery. If you'd rather not read then click here to view a very American but accurate video on Wisdom Teeth.
By the age of 18, the average adult has all their teeth. The last teeth to appear are your wisdom teeth, also known as third molars or "eights" as they are the 8th tooth from the front.
The basic problem is a lack of space. We have too many teeth to fit into our small jaws. Problematic wisdom teeth may emerge into the mouth but part of them remain covered under the gum or jaw bone. They can cause a number of problems:
Decay. Wisdom teeth can be very difficult to clean, and therefore often get decayed. It is usually not possible to repair such teeth – simply because they are so inaccessible and will continue to decay around the repair.
Infection. Impacted wisdom teeth very often have a flap of gum over the back called an "operculum". This area is always chronically infected and will undergo occasional acute flare-ups every 2-3 months which last 3-5 days. People often refer to this as their wisdom teeth "coming through" when in fact they are stuck and as "through" as they will ever be. When there is an acute flare-up, the gum around the tooth can get quite swollen and tender to bite on. There is often a discharge of pus, a foul taste and bad breath. Swelling can spread to the cheek and to the area and glands under the jaw. Before the days of antibiotics, infections in this area were considered life-threatening, because swelling could block your airway.
Damage to neighbouring teeth. Another common way that impacted wisdom teeth can be a problem is the risk they pose to adjacent teeth. It is common for an impacted lower wisdom tooth to affect the second molar immediately in front (see the green arrow in the X-ray above). Impacted wisdom teeth can damage this second molar and result in the loss of the second molar tooth in addition to the wisdom tooth. Very often the wisdom tooth has been present for many years with minimal symptoms and the first symptom is toothache from death of the second molar.
Tooth crowding. Some authorities believe third molars can cause crowding and malallignment of the front teeth. This effect is minimal if at all significant but if orthodontics is planned, your orthodontist will usually request the wisdom teeth removed to speed up your orthodontic treatment.
Cysts. Impacted third molars can form cysts, and this can produce significant deformity and require extensive surgery. Patients are usually totally unaware of cysts growing, it is recommended you obtain an X-ray to check your wisdom teeth once you have reached your 20's. One in fifty people will have a cyst associated with an impacted wisdom tooth. See X-ray below.
Tumours. Tumour formation around impacted third molars is uncommon, but does occur in 1% of impacted wisdom teeth.
Jaw fracture. Individuals who play contact sports have a greater risk of jaw fracture if they have impacted wisdom teeth. Or as with the photo above jaw fracture can occur from cyst formation and the loss strength of the jaw bone.
Notice that of all these problems only "infection" gives you any forewarning with mild discomfort once or twice a year, all the others develop silently and by the time symptoms occur the problem is more complex with more difficult surgery. Patients will often wonder why their dentist is getting concerned about their wisdom teeth and reffering them to me, especially if they haven't been any bother for years. It is definately worthwhile having them checked early.
Wayne will give you written information and explain the risks of your particular surgery. The most important risk people want to know about is damage to nerves that run close to the lower wisdom teeth. There are two sensory nerves, one providing feeling and taste to the side of the tongue and another providing feeling to one side of the lower lip and chin.
2% of people who have a wisdom tooth removed may experience temporary altered feeling or loss of feeling (numbness) to the lip, chin or tongue. Approximately 1 in 2000 people have a high risk of permanent sensory loss or altered feeling which could be painful or unpleasant. Usually these high risk people can be identified and alternative surgery performed to eliminate this risk, this is why a thorough examination and X-ray and/or CT scan is necessary in all cases of Wisdom teeth removal. The function of the lip and your appearance will not be affected, only the sensation to the affected area, therefore your smile and appearance is unchanged.
Click on the patient information tab at the top left for more detail. With an oral examination and x-rays of the mouth, Wayne can evaluate the position and health of your wisdom teeth. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an Oral and Maxillofacial surgeon.
As a general guideline, if you are in your 20's or younger and have impacted or partially erupted wisdom teeth then you are usually better off having them removed. Often if one side causes trouble then the other side will too. Not what you want to hear! but removal when you are young is a much simpler procedure with a lower complication rate and fast recovery.
If you are 30 or above then things change, consideration of long term future of the teeth vs risks of surgery and other factors will be discussed with you. Cases are individual and having a comprehensive discussion during your consultation with Wayne is invaluable.
In most cases, the removal of wisdom teeth is performed under Local Anesthesia, intravenous Sedation or general anesthesia (click this link to find out more about these options). Once the teeth are removed, the gum is sutured with dissolving sutures which disintegrate after 5-7 days. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, Chlorhexidine antibacterial mouthrinse, a prescription for pain medication and antibiotics, and a follow-up appointment in one week. If you have any questions, please do not hesitate to call us at 04 9746866.
Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.
Q. What do I have to do to prepare for surgery?
A. No. With IV Sedation or General Anaesthetic you will fell nothing apart from the iniital "drip" or canula in the arm, like having a blood test. With just local anaesthetic you will feel the injections just as you do for dental treatment.
Q. How long will it take?
A. You should plan on being at the surgery about an hour, sometimes a little longer. Please instruct your escort/driver to arrive 45 minutes after your appointment begins, so that we can go over your care instructions with them and answer any questions they may have.
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Poriura NZ • Wairarapa NZ • Lower Hutt NZ • Upper Hutt NZ
Address: 97-99 Courtenay Place • Wellington, NZ 6011 • Phone: 04 974 6866
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