All about wisdom tooth extraction

It's estimated that a significant portion of the UK population undergoes wisdom tooth extraction at some point in their lives. The prevalence of wisdom tooth extraction in the UK is similar to that in other developed countries like the United States, with around 85% of people having their wisdom teeth removed due to various reasons such as impaction, crowding, or infection.

Here to explain more about wisdom tooth extraction ish2leading consultant oral and maxillofacial surgeon Miss Katherine George, who explains why it may be necessary, risks linked to tooth extraction and the recovery process following the procedure.

Why may wisdom tooth extraction be necessary?

Wisdom teeth are the last teeth to develop and erupt into the mouth. Often there is not enough room for them to come through fully and they become trapped beneath the gum or grow at an angle. This situation is referred to as impaction. Impacted wisdom teeth can cause pain, infection and damage to nearby teeth and as a result, it may be necessary to extract them to relieve the symptoms. In some cases, wisdom teeth are extracted as part of orthodontic treatment, to enable alignment of other teeth. Although unlikely, a wisdom tooth may be removed due to a cyst or, in extremely rare cases, because a tumour has formed around them.

What is the recovery process following wisdom tooth extraction?

Recovery time after wisdom tooth removal varies from person to person and is often related to the complexity of the extraction as well as differences in the body’s ability to heal and adherence to post-operative instructions. Immediately after wisdom tooth removal, there may be some bleeding, swelling and discomfort. Pain relief will be discussed prior to the procedure and the specialist may prescribe strong painkillers. Antibiotics may be prescribed to reduce the risk of infection. Local measures to reduce the swelling will be discussed, such as the use of ice packs for the first few days and avoidance of vigorous exercise.

Measures to reduce the risk and control any post-operative bleeding will also be discussed such as avoidance of aspirin for pain relief and the use of gauze packs to apply pressure to the extraction socket if bleeding arises. It is important to continue to brush the teeth following the procedure but a soft toothbrush may aid comfort. Most people will fully recover within 2 weeks.

What risks are linked to wisdom tooth extraction?

Wisdom tooth extraction is a very common procedure and it is generally safe. However, like any surgery there are risks. These include:

• Pain, which tends to last for a few days and gradually resolves. Painkillers are often prescribed to help manage this and pain relief is discussed in advance of the procedure and post operatively. Sometimes pain is more severe or prolonged and pain relief is required for a longer period of time.
• Bleeding is a normal part of wisdom tooth extraction. However,  there are several methods to control this, including the use of stitches which dissolve with time. It is uncommon for bleeding to be excessive and for further medical attention to be required.
• Infections can occur following extractions. Symptoms include increased pain, swelling and a bad taste in the mouth. In some cases, further treatment is required with antibiotics, or less commonly, drainage of an abscess.
• A dry socket (alveolar osteitis) occurs when the blood clot that forms in an extraction socket is lost and the underlying bone is exposed. This can cause severe pain and delayed healing. Smoking or vigorous rinsing of the mouth can increase the risk.
• Numbness or altered sensation of the lower lip, chin and tongue which could also impact taste sensation are possible following wisdom tooth extraction, but uncommon. If it happens the sensation usually returns to normal over a few weeks to months. It is uncommon but possible for nerve injury to be permanent.
• Problems with the air sinuses is a potential, but unlikely complication of most wisdom teeth extractions. The upper wisdom teeth lay close to an air sinus in the cheekbone. After extraction of an upper tooth a communication between the air sinus and the mouth can occur which can cause infection in the air sinus (sinusitis) or other sinus issues. A further procedure to close the communication is required if this happens.
• Jaw stiffness: Sometimes the jaw feels stiff after wisdom tooth extraction and this usually resolves with time.
• Damage to other teeth or fillings is unlikely, but can occur.

What happens if the impacted wisdom teeth aren’t removed?

If the impacted wisdom teeth are not removed, they can cause problems such as pain and infection; dental decay; damage to other teeth; sinus problems and cysts. If it is difficult to clean around the wisdom tooth, periodontal disease (gum disease) is a risk. However, the risk varies with each individual case, therefore it is important to seek advice from your dentist or oral and maxillofacial surgeon.

If you require wisdom tooth removal and would like to book a consultation with Miss George, do not hesitate to do so by visiting her Top Doctors profile today.