Ask an expert: What causes wisdom teeth removal?

Wisdom teeth are the last teeth to grow through the gums. By this time, all the other teeth are generally in place, so often, the appearance of wisdom teeth leads to oral health problems.

Here to provide an expert insight into wisdom teeth removal, including why and how are wisdom teeth removed, is Mr Colin Harrop, highly experienced consultant oral and maxillofacial surgeon.

What causes wisdom teeth removal?

Wisdom teeth are the final teeth to appear in our mouths, generally emerging between the ages of 18 to 22. These teeth are commonly short of space and thus, may never push through or perhaps come through only partly. This is known as impacted. Most problems with wisdom teeth are related to the lower wisdom teeth.

Wisdom teeth are most commonly removed due to repeated infections in the flap of gum that often overlies wisdom teeth that are partly through. This process of infection is called pericoronitis.

Other reasons for removal include dental decay in the wisdom teeth and the formation of cysts around the teeth. Wisdom teeth may also make it difficult to effectively clean adjacent teeth, which may lead to the decay of these teeth. Removal of the wisdom teeth in this situation may prevent decay.

What is involved in wisdom teeth removal?

Removal of wisdom teeth may be as simple as a routine dental extraction. However, in many cases, because the tooth is largely buried in the bone of the jaw, a surgical procedure is needed to extract the tooth. This may take place under local or general anaesthetic.

Wisdom teeth removal often begins with an incision in the gum overlying the tooth, to uncover it fully. It may also involve removing a small amount of bone around the tooth and perhaps cutting the tooth into smaller pieces. This is usually done using a dental drill, similar to that used for dental fillings. The incision in the gum is then repaired with stiches.

How long does surgery take for wisdom teeth?

The time needed to remove a lower wisdom tooth may vary, from a few minutes up to one hour.

How long does recovery take after wisdom teeth removal?

Facial swelling is common for a few days following the surgical removal of a lower wisdom tooth, with the swelling usually being most obvious the day after surgery - normally, the swelling decreases every day after this.

Patients may also feel pain. For this reason, regular painkillers are often recommended during the first few days following surgery.

Many patients will be off work for around one week, especially if they have received general anaesthetic. This does, however, vary significantly between different people.

Is wisdom teeth removal considered major surgery?

Wisdom teeth removal is not normally considered to be major surgery, but it can sometimes be a difficult surgery and there are a number of potential complications that should be explained to patients before the extraction.

Upper wisdom tooth extraction rarely causes significant complications.

Extraction of impacted lower wisdom teeth is often followed by swelling and discomfort. There are also rare complications which involve two different nerves that can sometimes lie very close to the wisdom teeth. The first is a nerve that supplies sensation to the gum of the lower jaw and the lip on each side. The second is a nerve that supplies sensation to the side of the tongue on each side.

Injury to these nerves is fortunately rare, bit if it occurs, sensation in the affected area may range from a numb feeling to a faint tingling sensation. In most cases, sensation will slowly return to normal, but this may take several months. Neither of these nerves are involved in facial movement, so the affected area will look and move as before.

All patients having removal of lower wisdom teeth should have an X-ray of the area beforehand. This is because, often, there are features in the patient’s mouth that may increase the risk of complications. In these circumstances, other investigations, such as CT scans, may be advised.

If you would like to discuss your wisdom teeth removal options with an expert, do not hesitate to visit Mr Harrop’s Top Doctors profile today.