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In total, adults can expect to get four wisdom teeth: one on each side of the top and the bottom jaw. Occasionally known as ‘third molars’, wisdom teeth are the last to come through and their arrival, which can sometimes be late into your twenties, is not always welcome. In some cases there is not enough room in the jawbone for these extra teeth to come through and, unfortunately, this can cause a range of painful problems. Often the discomfort and pain will go away on its own, but sometimes wisdom teeth will need to be removed. The procedure is usually a quick procedure carried out using local anaesthetic, with a recovery time of a couple of days.

This article was originally written for Patient.co.uk -http://www.patient.co.uk/health/wisdom-teeth


In total, adults can expect to get four wisdom teeth: one on each side of the top and the bottom jaw. Occasionally known as ‘third molars’, wisdom teeth are the last to come through and their arrival, which can sometimes be late into your twenties, is not always welcome. In some cases there is not enough room in the jawbone for these extra teeth to come through and, unfortunately, this can cause a range of painful problems. Often the discomfort and pain will go away on its own, but sometimes wisdom teeth will need to be removed. The procedure is usually a quick procedure carried out using local anaesthetic, with a recovery time of a couple of days.


When are wisdom teeth a problem?


Wisdom teeth (or third molars) do not normally start to emerge until between the ages of 17 and 25, although some people don’t actually ever get them. In most cases, wisdom teeth will ache when they emerge through the gums, but otherwise cause you very little discomfort.


However, if the space in your mouth is limited, you may suffer from what are known as impacted wisdom teeth. This is when a tooth tries to come through the gum but gets stuck against the tooth next to it and emerges at an angle. This can cause toothache, earache pain, swelling and even infection, cysts and abscesses. If this is the case, then it could be necessary to have the wisdom teeth removed from your mouth.


Having wisdom teeth removed


Before the procedure, your dentist will talk you through how to prepare. Smokers will need to stop their habit several weeks before the operation to avoid the chances of complications and everyone having the treatment will need to sign a consent that shows you understand any risks associated with the treatment. If there are any alternatives to extraction, your dentist will explain them to you. For example, if a wisdom tooth is impacted but otherwise healthy and not causing discomfort or tooth pain then it may not need to be removed at all.


When it comes to the procedure itself, a local anaesthetic will be used to block the pain from your nerves but you will remain awake throughout. If you are nervous about going in the chair, you may be given a sedative treatment to help you relax whilst the procedure takes place.


If your case is particularly challenging then you may need to go to a hospital to see an oral surgeon specialist to plan and complete the treatment. The fear most people have is pain during the treatment, however the procedure itself is actually pain free. The pain after the procedure is typical of any surgical procedure and advise will be given on how to manage the healing socket after the procedure.


Having a wisdom tooth removed is generally straightforward and the extraction can take as little as a minute. The same method is used as would be for any other extraction, in that specialised instruments are used to widen the socket. The tooth is then rocked back and forth in order to loosen the fine ligament that holds it in place, and then removing it.


If the tooth is highly impacted, it could be necessary for the dentist to make a small incision in your gum to gain access to the tooth. Once removed, the dentist will use stitches (usually dissolvable) to help your gums to heal. In this scenario, the procedure can take around 20 minutes to complete.


After the removal


If you were given a general anaesthetic (which is rare these days) you will need a friend or family member to take you home and look after you for the next 24 hours, as the lingering effects of the anaesthetic can effect your behaviour and judgement.


Although local anaesthetics have less impact immediately after the procedure, you will likely have numbness in your mouth for a few hours, so be careful not to inadvertently scold yourself with hot food or drink.


You may also be prescribed anti-inflammatory medicine or antibiotics to take while you recover. If not, and you need over-the-counter painkillers, avoid aspirin. Blood clots help with the healing process and aspirin can complicate this by thinning the blood.


When brushing, avoid the affected area for a couple of days. You may also want to stick to softer foods while the gum heals and avoid chewing with the teeth near where your tooth was removed.  


If you are experiencing extreme pain or swelling, extensive bleeding or notice that you have a temperature then you should consult your dentist immediately.


Complications


In the days following the removal your face may feel swollen or sore but this should soon pass. In other cases there is the possibility of an unexpected reaction to anaesthetic or other complications such as accidental damage to teeth, nerves, sockets or infection.


Other complications depend on the specifics of your situation. Your dentist will inform you of them ahead of the procedure.


How much does it cost to remove a wisdom tooth?


Wisdom tooth extractions come under Band 2 for NHS dental treatments, currently costing £50.50. If you have the treatment carried out privately you can expect to pay £80-£250 depending on the complexity and time its takes to complete.


Will removal affect my brushing?


You may find it uncomfortable to brush shortly after having wisdom teeth removed, especially around any wounds. For this reason, your dentist might recommend that you use a mouthwash to help keep the area clean.


What is ‘dry socket’?


Dry socket, the informal name for alveolar osteitis, is when the blood clot helping the wound heal around your tooth socket becomes infected, causing severe pain which is not controlled with medicine. Dry socket requires immediate attention. This usually involves anti-inflammatories to ease the discomfort, a medicated antiseptic dressing to promote healing and possibly a course of antibiotics to control the infection.


Can I have wisdom teeth removed whilst pregnant?


There is no reason to believe that the procedure would have any impact on your pregnancy. However, dentists may opt not to use x-rays and you will most likely be put under local, rather than general, anaesthetic. In many cases your dentist is likely to wait and carry out the treatment after the birth, unless it was considered an emergency procedure.


Will I need time off to recover?


Most people need two or three days off work to recover from the effects of the anaesthetic after they have had wisdom teeth removed. Those with a more physical job may need an extra day or two. If your job involves driving you should be fine to return after 24-48 hours after having had anaesthetic, but you need to use your own judgement and seek advise from your dentist if you are unsure. 

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