Most adults have along the way experienced wisdom teeth problems. They usually emerge in our late teens or early twenties. However, unlike our normal teeth wisdom teeth can have an abnormal shape, root formation and eruption position.
Quite commonly these teeth can become “impacted” which is the technical term for stuck behind the teeth in front. If they erupt and cause pain, it is usually the soft tissue gum around the tooth which becomes inflamed and becomes a trap for food. This causes a cycle of recurrent inflammation and infection.
Most of the time this can be treated with good oral hygiene, cleaning the area well either with an electric toothbrush or professionally with a hygienist / dentist.
Persistent Wisdom Teeth Issues
When should I have my wisdom teeth removed?
They should only be removed when necessary. Situations where there is decay in the wisdom tooth, decay in the tooth adjacent, several infections requiring 3 or more courses of antibiotics, or one severe infection are just some of the indications for removal of wisdom teeth. Ultimately, removing them must provide some benefit to you, but this should be weighed up against the risks
What are the risks of getting my wisdom teeth removed?
Whenever we treat patients, there must be a benefit, which must outweigh the risks. The main risks are pain, swelling, bleeding, infection, stitches, damage to adjacent teeth and retained roots. There is also a nerve in very close proximity to lower wisdom teeth which can be susceptible to damage. This risk can vary from person to person and often depends on how close the nerve actually is to the wisdom tooth. This must be assessed beforehand with a special form of imaging known as OPG (orthopantomogram) / DPT (dental panoramic tomogram) and nowadays 3D scanning with a CBCT (cone beam computerised tomography) is also common practice.
While the risk of nerve damage is quite low in general, if nerve damage does occur, there can be persistent numbness, pain or altered sensation of the lip, chin and tongue which may or may not recover. This is why it is important to be seen and treated by a suitably trained clinician to assess, diagnose and treat you accordingly.
Will the procedure hurt ?
With good local anaesthetic, removal of wisdom teeth is uncomfortable at worst. However, wisdom teeth that are deeply embedded within the bone may require a surgical approach with bone removal. If this is the case it is generally the post operative swelling which causes pain afterwards. If this is controlled with local measures such as ice packs and regular anti-inflammatory drugs, the pain can be well tolerated. Occasionally a patient can be unlucky and get an infection, this can cause pain which can be helped by seeing your dentist.
Do I have to have wisdom teeth removed?
No, if there are no symptoms associated.
However we will only advise an extraction after all alternative treatments have been explored.
Best pain relief
Rinsing with warm salty mouth rinses are good in addition to chlorhexidine based mouthwashes which are routinely available from your local pharmacy. Anti inflammatories like ibuprofen if you are not allergic to them are good at reducing pain however always follow guided dosage.