Wisdom Teeth   (3rd Molars)

Adults normally have 32 teeth including  four wisdom teeth. Wisdom teeth should erupt behind our last (2nd) molar teeth anytime between 16 and 25 years of age. Some people do not experience any discomfort during the eruption phase. If the size and shape of the jaws is adequate the wisdom teeth should erupt normally.

However, not many people in modern society have jaws big enough to accomodate all 4 wisdom teeth. When there is not enough space for the erupting tooth problems may occur.  Wisdom tooth can often get stuck behind the last molar tooth, this is an 'Impacted Wisdom Tooth'.

They can be partially or fully impacted, i.e. sometimes they will come part of the way through the gum and stop, or even move up and back repeatedly; or they can be totally under the gum with no hope of erupting.

Impacted Wisdom Teeth can cause:

  • Soreness, pain, swelling and general discomfort in the gum area around the tooth. This is referred to as Pericoronitis  (common if only a part of the wisdom tooth is erupted into the oral cavity).

  • Ear ache or Tooth ache

  • Swelling in the face, jaw and neck if the tooth becomes badly infected. Swelling should always be taken seriously. In very rare cases it may require hospitalisation for appropriate treatment.

  • Biting on the swollen flap of gum

  • Bad taste and breath from draining pus

  • Decay in the 2nd molar next to the wisdom tooth 

     

Wisdom Tooth Pain Relief: 

Relief from the initial pain and discomfort can be achieved using:

  • Salt and Water mouthwash (1/2 teaspoon of salt dissolved in a cup of lukewarm water). If there is an infection in the gum flap Hydrogen Peroxide rinses are effective.  The patient can rinse regularly
  • Mouthwash from a pharmacy such as Cepacaine (with a numbing agent)
  • Mild pain-killers and anti-inflammatories such as Ibuprofen (e.g. Nurofen), Aspirin or Paracetamol (e.g. Panadol). Recent research has shown a combination of Paracetamol and Ibuprofen to be more effective than either by itself.
  • Antibiotics and sometimes prescription pain-killers  - prescribed by your dentist or doctor

If the above symptoms fail to resolve the pain then Extraction is the usual option.

If it is only the gum that is regularly inflamed, removing the excess flap of gum tissue (operculectomy), may prove successful - assuming good cleaning of the area

 

Wisdom Tooth Extraction

Wisdom teeth, especially Lower wisdom teeth, can be lying at an angle against the 2nd molar tooth. These impacted teeth are sometimes difficult to remove. Your Dentist may decide after reviewing your X-Rays to refer you to an Oral Surgeon. Extraction can be carried out under Local anaesthetic or General Anaesthetic.

Wisdom Tooth Removal Recovery Time

This usually depends on how difficult the extraction was. If there was Minor Oral Surgery involved and stitches used, it is normal to have some pain and discomfort. If there is swelling, it is usually worst after about 36 hours and then gradually goes down. Sometimes there is trismus (where you can't fully open the mouth) which should disappear with time and gentle stretching, as the swelling subsides.  Pain-killers such as Paracetomal or Ibuprofen are usually prescribed. Antibiotics are often prescribed to minimise the risk of infection. If you have any concerns please contact the dentist or oral surgeon.

Risks of wisdom teeth removal

With any extraction, and especially a surgical extraction, just like any operation, there are minor risks that you should be aware of.  The surgeon will go through these with you,  but the main problem if it occurs at all, is damage to the nerves that supply your lip, teeth and tongue which is usually transient, but in rare cases it can be permanent.