WISDOM TEETH OR THIRD MOLARS

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What are wisdom teeth?

Wisdom teeth, also known as third molars are the last teeth to erupt into the mouth and are more than often non-functioning  teeth. There are many theories as to why we have these teeth but none of these are proven.

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Why remove wisdom teeth?

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Problems can arise if third molars are left alone. Often these teeth

are impacted against the adjacent tooth leading to difficulty with cleaning. Gum disease, decay and infection can arise from this. In rare circumstances, these infections can be life threatening.

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How do we remove  wisdom  teeth?

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More than often, removal of third molars requires a “minor” surgical procedure.  Under a local anaesthetic (you are awake but the area is numb) with or without IV sedation or general anaesthetic(near sleep or completely asleep) your surgeon will raise a “flap” to access the underlying bone and tooth. Often, bone removal is needed and the tooth divided for safe extraction. Once the tooth is removed, stitches are placed to maintain integrity of the soft tissues inside your mouth. These are often self-resorbing stitches which eventually fall out several weeks later once the incision is healed. You surgeon will discuss your procedure in detail with you at the time of your consultation.

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WHAT ARE THE MAIN RISKS OF THE PROCEDURE?

 

Post-Operative   Pain
 

All patients will invariably have a degree of pain after the procedure. However, with good anaesthetic techniques and medications, post operative pain can be minimized and you can achieve excellent comfort levels after your surgery.

 

Standard medications will include a combination of Paracetamol and Ibuprofen in most instances with substitution of these when necessary. Further analgesia can be achieved with opioid analgesics such as Codeine only if required. The side effects of these medications must always be considered when prescribing. You surgeon will discuss this with you at the consultation and on the day of surgery.

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Pre-operative analgesics are often prescribed for surgical procedures for added benefit.

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Nerve Injury

A small number of patients will have injury to the dental nerves leading to numbness of the tongue, chin or lip during lower wisdom teeth extraction. These numbers range from 1% to 5% depending on many factors. Some of these include the tooth location, degree of difficulty and surgeons skill level.  Most injuries are transient and are due to slight “bruising” of the nerve. In very rare circumstances these injuries can be permanent. However, these injuries will not affect anything functional such as your speaking , chewing or smiling. Your surgeon will discuss this at your consultation.

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Bleeding

Post-operative bleeding can occur and in most instances, only a trickle of fresh blood will be seen. This is rarely life threatening. Potential causes of post-operative bleeding can be due to poor surgical technique, an increase in blood pressure or an undiagnosed bleeding disorder. Significant post-operative bleeding in large volumes is a rare event. However, if this occurs, seek immediate advice from your surgeon or present to your  nearest  hospital  emergency department.

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Swelling

Swelling is a normal reaction of trauma to the body. This often occurs in the cheeks after wisdom teeth removal. We can minimize this with cold packs and anti-inflammatory medications. Swelling will last for 2 to 5 days in most instances and will naturally resolve with time. During this period you may have a “chipmunk look”. In most instances, this is normal and does not imply an infection is present. If you are concerned, please discuss this with your surgeon during the post-operative period.

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Infection

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Unfortunately, a low rate of infection does occur with wisdom teeth removal . This is in the realms of less than 5% of cases. Treatment is with antibiotics, a further surgical procedure or a combination of both depending on severity. Some signs can be fever, extreme pain, significant swelling - particularly only on one side and severe limitation of mouth opening. If there are any issues, please discuss this with your surgeon before and after your procedure. Other rare  complications can include:

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• osteomyelitis  (bone infection),

• jaw fracture,

• damage to  adjacent teeth

 

 

We will endeavour to do our best to avoid all these complications with meticulous attention to detail before, during and after your surgery.