Wisdom Tooth Extraction

Wisdom teeth are the third set of molars in the very back of your mouth and are the last adult teeth to emerge in the mouth. There are usually four, two on the top and two on the bottom right at the back of the jaw. These teeth usually start emerging between the ages of 17 and 25 and move up through your jawbone on their journey to break through your gum line and become part of your chewing mechanism. 

There are some people who never develop wisdom teeth while for others, their wisdom teeth erupt just as normally as their other molars did and cause them no issues. 

Most adults have along the way experienced wisdom teeth problems. This is usually because of the eruption pain that occurs when they are coming through, much like teething in children. However, wisdom teeth are very unique in that they can have an abnormal shape, root formation and eruption position.

Quite commonly these teeth can become “impacted” which is the technical term for stuck behind the teeth in front. This is because the angulation they decide to erupt can be somewhat unpredictable.

If they erupt and cause pain, it is usually the soft tissue gum around the tooth which becomes inflamed and becomes a trap for food. This causes further inflammation and swelling around the gum. The opposing wisdom tooth can then bite down on the already inflamed gum causing further swelling and a cycle of recurrent inflammation and infection occurs.

Most of the time this can be treated with good oral hygiene, cleaning the area well either with an electric toothbrush or professionally with a hygienist / dentist. If this persists and the swelling and infection worsens it can result in pain, facial swelling, temperatures and limited mouth opening.

Getting ready for a wisdom tooth extraction can make the experience go smoothly and reduce any discomfort or problems. Here are some tips to help you prepare:

1. Talk to our dentist or oral surgeon: Before you schedule the extraction, have a consultation with our dentist or oral surgeon. They will look at your situation, maybe take some X-rays, and discuss the best way to do the extraction. This is also a chance for you to ask questions or share any worries you have.
2. Understand the procedure: It’s important to know what will happen during the extraction. Our dentist or oral surgeon can explain the steps, like what kind of anaesthesia will be used, how long it will take, and how long it will take to recover. Knowing what to expect can help you feel less anxious and more prepared.
3. Plan for aftercare: After the extraction, you need to take care of the area where the tooth was removed so it can heal properly. Get some soft foods like soups, yoghourt, and applesauce that you can eat easily while you recover. It’s also a good idea to have some over-the-counter pain medicine at home, as our dentist or oral surgeon recommends, in case you have any pain afterwards.
4. Arrange for a ride: Depending on the anaesthesia used, you might not be able to drive yourself home after the procedure. Ask someone to go with you to the appointment and drive you back home safely.
5. Follow instructions before the extraction: Our dentist or oral surgeon will give you specific instructions to follow before the extraction. This might include avoiding certain foods or medicines in the hours leading up to the procedure. It’s important to follow these instructions to make sure the extraction goes well and to reduce any possible problems.

By following these tips and getting ready ahead of time, you can have a successful wisdom tooth extraction. Remember to talk openly with our dentist or oral surgeon during the whole process and don’t hesitate to ask questions or talk about any concerns you have. Your oral health is important, and preparing properly can help things go well.

Before your wisdom tooth extraction, your mouth will be X-rayed to give your Neem Tree dentist a clear picture of the position of your teeth, including the roots. You will be given a local anaesthetic injection. A sedation can also be provided to help you relax if you are nervous about the procedure.

The wisdom tooth extraction procedure depends on the position and angle of your teeth, making each extraction different. Wisdom tooth extraction typically takes around twenty minutes, but the time may vary depending on the patients teeth. After the extraction, some swelling, bruising and stiffness of the jaw is normal, but shop-bought painkillers should be sufficient to manage any pain you may experience.

If your wisdom tooth has not come through the gum, a small incision will be made in the gum to access it. A small piece of the bone covering the tooth will also need to be removed during the procedure. If the tooth has broken through the gum already, there is no need to make an incision in the gum. 

During the procedure you will feel some pressure just before the tooth is removed however, you should not feel any pain as the whole area will be numb. If you do feel any pain during the procedure, you can tell your dentist or oral surgeon so they can give you more anaesthetic.

To minimise recovery time and reduce the chances of complications, it is important to stick to the strict post-surgical care routine advised by your dentist. This will include eating soft foods for the first few days, and avoiding rinsing your mouth out for the first day to prevent damage to the blood clot that will form in the socket of the removed tooth.

How long wisdom tooth removal takes varies depending on your individual case. Simple removal procedures can take a few minutes but it can also take longer than 20 minutes if your situation is more complicated.

Your dentist may recommend that you should have your wisdom teeth removed if they are causing you severe pain or infection. If your wisdom teeth get impacted and cannot break through your gums or crowd your other teeth it may be a good idea to have them removed. 

Not all wisdom teeth removals are necessary but if your wisdom teeth are causing you a lot of pain then it would be wise to get them removed. 

Wisdom tooth extraction should only happen when necessary. Guidelines created by the national institute of clinical excellence (NICE) have provided certain situations where they should be removed, which is based on the most relevant and up to date clinical research.

Situations, where there is decay in the wisdom tooth, decay in the tooth adjacent, several infections requiring 3 or more courses of antibiotics, or one severe infection, are just some of the indications for removal of wisdom teeth.

Ultimately, removing them must provide some benefit to you, but this should be weighed up against the risks.

If your wisdom teeth are causing you discomfort, contact our dental practice in Wandsworth or our Esher dental practice.

Whenever we treat patients, there must be a benefit, which must outweigh the risks. The main risks of wisdom tooth extraction are pain, swelling, bleeding, infection, stitches, damage to adjacent teeth and retained roots. There is also a nerve in very close proximity to lower wisdom teeth which can be susceptible to damage.

This risk can vary from person to person and often depends on how close the nerve actually is to the wisdom tooth.

This must be imaged with a special form of imaging known as OPG (orthopantomogram) / DPT (dental panoramic tomogram) and nowadays 3D scanning with a CBCT (cone beam computerised tomography) is also common practice.

Whilst the risk of nerve damage is quite low in general, if nerve damage does occur, there can be persistent numbness, pain or altered sensation of the lip, chin and tongue which may or may not recover. This is why it is important to be seen and treated by a suitably trained clinician to assess, diagnose and treat you accordingly.

• A key risk of getting your wisdom teeth extracted is dry socket. That can be very painful. 
• Another risk is exposure of bone when the post-surgical clot is lost from the site of the socket where the tooth was removed. 
• Infection in the empty socket is a risk from bacteria or trapped food particles.

Book an appointment with our Wandsworth dentists or our Esher dentists to find out more about having a wisdom tooth pulled.

• Prevents any damage occurring to any nearby teeth
• The biggest benefit is that it reduces any pain you were experiencing with the wisdom teeth
• Prevents cysts, tumours and any jaw damage due to the pressure caused by wisdom teeth
• Prevents food becoming trapped under the gums if the tooth is partially erupted.

Wisdom teeth erupt at different times for everyone. For most people they usually come in between the ages of 17 and 25. If you are worried about your wisdom teeth they can be spotted on X-rays.

Wisdom teeth begin to form around your tenth birthday and are the last set of molars on the tooth-development timeline. This is why you don’t usually erupt until you are between the ages of 17-25. It is normal for wisdom teeth to arrive in your late teens or early twenties. Some people’s wisdom teeth erupt and are positioned straight and normally, but many people’s teeth grow horizontally or at an awkward angle which is what often makes them quite painful and causes them to crowd other teeth. 

Impacted wisdom teeth are misaligned and can’t erupt through the gums, so they stay trapped inside soft tissues. This is what makes them quite painful for some patients which is why they are removed.

Nowadays with the advent of good local anaesthesia and intravenous sedation availability, wisdom tooth extraction is uncomfortable at worst.

However, wisdom teeth that are deeply embedded within the bone may require a surgical approach with bone removal.

If this is the case it is generally the post operative swelling which causes pain afterwards. If this is controlled with local measures such as ice packs and regular anti-inflammatory drugs, the pain can be well tolerated. If you are unlucky to suffer with an infection, this can cause pain which can be remedied by seeing the relevant clinician and treat it accordingly.

If you do feel any pain during the procedure, let your dentist know and they will administer more anesthetic to the area.

Recovering after getting your wisdom teeth removed is important, and there are some things you should know to take care of yourself. After the procedure, it’s normal to have some discomfort, swelling, and bruising in the area where the teeth were removed. But don’t worry, there are ways to manage these symptoms and have a smooth recovery.

First, it’s a good idea to take it easy for a few days after the extraction. Resting and not doing any strenuous activities can help your body heal and prevent any problems. Putting an ice pack on your cheek near the extraction area can also help reduce swelling and make you feel better.

If you have pain after the procedure, our dentist or oral surgeon may give you medicine to take. It’s important to follow their instructions and not take more than they recommend. If you prefer, you can ask your dentist about over-the-counter pain medicine.

Taking care of your mouth is really important during the recovery time. You should still brush your teeth, but be gentle around the area where the teeth were removed. Using a saltwater rinse can also help with healing and lower the chance of infection.

While you’re recovering, there are some things you should avoid so you don’t slow down the healing process. Smoking, for example, can make it take longer for you to heal and might cause problems. It’s best to not smoke for at least a few days after the extraction.

You should also be careful about what you eat during recovery. Eating soft foods like soups, mashed potatoes, yoghurt, and smoothies can be easier on your mouth and won’t put too much strain on the area where the teeth were taken out.

It’s important to keep going to your follow-up appointments with our dentist or oral surgeon. They will check how you’re healing and answer any questions you have. By following the instructions they give you for aftercare, you can have a successful recovery and feel comfortable after getting your wisdom teeth removed.

Most people fully recover from wisdom teeth surgery within a week but it can take up to 2 weeks for some people if your teeth were impacted or came in at an awkward angle. However the wound itself that is left behind after surgery will not be completely healed for months, so you can still develop an infection weeks after the extraction. 

Right after your removal, your cheeks and mouth may be swollen. This may be especially worse during the first couple days but it will gradually improve. Using over the counter pain relief medication and gently pressing a cold cloth to your face will help reduce the pain and swelling. You may also have some mild visible bruising on your cheek. This will also subside within your week or 2 of recovery. 

You will feel more pain after the surgery rather than during. The pain afterwards may be especially worse if the extraction itself was difficult or complicated. 

You may also have an unpleasant taste in your mouth. However, all these are normal symptoms after you have had your wisdom teeth extracted which should all subside after 2 weeks after surgery. 

If you experience any excess bleeding, severe pain, or any other unusual symptoms, report them to your dentist immediately. 

Not necessarily, there are alternative less invasive options which may be more suitable.

Deep cleaning – this can be done with a hygienist or dentist who can then provide some oral hygiene instructions to ensure the area is kept as clean as possible.

Smoothing the opposing wisdom tooth – The pain from wisdom teeth can often come from the gums around them being inflamed. On biting, if the opposing wisdom tooth compresses these inflamed tissues it can result in worsening pain and inflammation. By smoothing this opposing wisdom tooth, it can often alleviate the symptoms without having to remove the wisdom tooth with inflamed gums.

Remove the opposing wisdom tooth – Quite similar to the example above, the removal of the opposing wisdom tooth can be considered if smoothing it doesn’t help.

This is usually reserved for situations where the lower wisdom tooth is quite close the nerve (mentioned above) and is at risk of being damaged. This prevents running the risk of damaging the nerve and removes the problem of the opposing wisdom tooth crushing and compressing the inflamed gums.

As long as there is no dental disease in the wisdom tooth, adjacent teeth or surrounding region, there is no adverse risks in leaving them as they are as long as good oral hygiene is maintained.

It is therefore important to regularly visit the dentist to ensure that the wisdom teeth are in good health in addition to the rest of the mouth.

Wisdom teeth erupt between the ages of 18-25 on average but can occur earlier and even later.

To avoid swelling up, we advise that you take the relevant anti-inflammatory medications as prescribed by your dentist, use local measures such as ice packs and sleep slightly upright.

Wisdom teeth can hurt because of decay in the tooth itself progressing into the nerve of the leading to persistent sensitivity. Furthermore, impacted wisdom teeth can also cause decay in the adjacent teeth.

Improper oral hygiene can also cause gum disease and inflammation around the wisdom tooth. This can quite often be due to difficulty in accessing this area as it is right at the back of the mouth.

If the inflammation persists, this can cause the gums to swell up and lead to discomfort.

If the opposing wisdom tooth compresses these inflamed gums, it can further worsen the pain and swelling.

The cost can vary depending on the extent, severity and procedure involved. But is charged from £650 at the Neem Tree.

It is firstly most important to identify the cause of the wisdom tooth pain which will then help manage it appropriately. By seeking a dentists opinion they will be able to provide the best way to manage the pain.

In the interim warm salty mouth rinses are good in addition to chlorhexidine based mouthwashes which are routinely available from your local pharmacy.

Routine pain killers as best advised by your GP or pharmacist are also recommended whilst you are waiting for your wisdom tooth extraction.

In order to reduce pain and aid recovery you should:

• Use painkillers such as Paracetamol or Ibuprofen (always use these how they are intended). Ibuprofen is arguably one of the best forms of pain relief after wisdom tooth removal.
• Avoid any strenuous activity and exercise until you have recovered after three to four days.
• For at least the first 24 hours, avoid rinsing, spitting, hot drinks or anything else that may dislodge the blood clots that form in the empty tooth socket. This is because the blood clots help the healing process significantly.
• Eat soft foods for the first couple days after surgery.