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Smart ways to handle impacted wisdom teeth

When any of your third molars are unable to take their proper place, they are at great risk of becoming an impacted tooth. The experienced dentists at City Dentists in Wellington can help with wisdom tooth removal both before or after you are experiencing jaw pain resulting from the impacted wisdom tooth.

We know dental surgery is nobody’s idea of a good time, but we urge all of our patients to get regular X-rays so we can identify a potential problem early to plan for removal that will avoid complications like gum infection or bad breath. Wisdom tooth removal is an everyday part of our work as dental professionals, and we will be happy to make you as comfortable with the procedure as possible.

The life cycle of a wisdom tooth

The teeth we refer to as our wisdom teeth are our third molars. They’re typically the final four adult teeth to come through the gums, usually erupting in our late teens or early 20s. Where there is space for them to descend normally into the mouth, they are the teeth closest to the very back of our mouths. And as molars, they are among our strongest teeth. Together with our tongue, they do the work of mashing and grinding food for us to swallow.

All too often, though, surrounding teeth crowd out space where a wisdom tooth should exist — leading to an impacted tooth. A wisdom tooth can be painfully problematic when it becomes impacted. This means the tooth is not able to erupt through the gums because it is growing sideways, blocked by another tooth or stymied by a cyst. When the tooth is stuck underneath the gums or partially emerges, it can cause pain, gum infection and tooth decay. A neighbouring tooth may be affected, too.

Regular dental X-rays will help dentists identify impacted wisdom teeth early. Wisdom teeth are easier to remove before they are two-thirds formed, so this is an important metric. When their roots have grown longer, there is a greater risk of nerve damage when extracting a wisdom tooth.

The tooth may be seen on X-rays stuck in the jawbone, coming in sideways or lying at a right angle below other teeth. Having this information before symptoms become present — or even just to confirm the reason for symptoms like jaw pain — will help the dentist to decide if extraction is warranted. Dentists typically consider:

  • Existing infection, tooth decay, pain, cysts or tumors
  • Other health conditions which might result in the patient struggling to recover from surgery
  • Age of the patient, as younger patients typically recover more quickly without complications like dry socket
  • Current and future likelihood of being able to clean the tooth properly, preventing decay or infection
  • Allowing for related orthodontic work to help resolve issues like crowding

What to expect from wisdom tooth surgery

Most of the time a dentist will perform wisdom tooth extraction. If the wisdom tooth is being extracted early, only local anesthesia will be used. This means a numbing agent will be injected to the area surrounding the impacted wisdom tooth. For more complicated cases, general anesthesia can be used but this must be done at a hospital. General anesthesia means a patient will be in a controlled state of unconsciousness during the extraction.

Once the patient is sedated, dentists will make a small incision in the soft tissue of the gum. If the tooth has not come through the gums yet, the incision may be slightly larger. But if the wisdom tooth has already erupted, the incision can be smaller. The dentist may also remove a small piece of bone just under the gums.

Patients who are conscious may feel pressure and wiggling as the dentist eases the pesky wisdom tooth out of place and removes it. Lower wisdom teeth are usually more difficult to remove. When a patient’s wisdom tooth has grown long roots, especially in the lower part of the mouth, it may require a coronectomy. This involves removing the top part of the tooth and leaving the roots behind to avoid damaging other nerves. Surgical removal of only the crown of a wisdom tooth is a rare occurrence.

Once wisdom tooth removal is complete, stitches are made so the soft tissue of the gums will heal.

Planning for life after surgery

Particularly if all four were surgically removed at once, the hours and days after wisdom tooth removal are a great excuse to eat ice cream and other cold foods — provided you clean your mouth afterward.

We will advise you about pain management strategies after the procedure, which usually includes eating only soft foods for up to a week. We’ll also discuss medication and cleaning your mouth with warm salt water after about a day. Along with normal oral hygiene, a saltwater rinse helps prevent gum infection around the site of your stitches.

Additionally, avoid smoking of any sort after surgery and limit alcohol.

Our patients will want to be aware of typical complications. Sometimes the incisions may be bloody for a day or so after surgery; it’s easy to swallow some of this blood and then feel nauseous or even vomit. It’s also typical to feel jaw pain and headaches. We recommend applying ice to the face to help reduce throbbing and swelling.

The most common complication is dry socket, when blood clots fail to form at the incision site, leaving a hole where the tooth used to be. When this hole fills with food particles or bacteria, the resulting nerve pain can be excruciating. Patients usually experience this 1-3 days after the surgery and should call us any time they suspect it.

We know it can be scary and annoying to take time away from life’s routines to have one or all four wisdom teeth extracted. But the pain resulting from an impacted wisdom tooth is nothing to suffer silently, particularly because tooth decay, dental caries and damage to a neighbouring tooth are potential outcomes.

At City Dentists, we know no two cases of impacted wisdom are the same. We know to give each the careful consideration it deserves. Ours is a modern dental office with a state-of-the-art practice that can make this process as easy as possible. Contact the dental experts at City Dentists to learn more.

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