Wisdom Teeth Removal Sydney Strathfield

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients, it is as early as 12 or 13, and in others, it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

1. Infection
2. Damage to neighbouring teeth and roots
3. Tooth decay
4. Periodontal disease
5. Receding gums
6. Loosened teeth
7. Bone loss
8. Tooth loss

More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage neighbouring teeth and the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumour may develop from its walls and surgery may be needed to remove it.

As wisdom teeth develop, the roots become longer and the jaw bone denser.

When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the postoperative course can be prolonged and there is a higher complication rate.

Treating these complications is often more difficult and less predictable than with a younger patient.  Healing may be slower and the chance of infection can be increased.

If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localised problem (such as cyst formation or localised gum disease and bone loss) develops.

In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

Every patient and every case is unique; therefore a decision regarding surgery must be made after:

1. A careful examination of your mouth
2. A radiographic examination involving x-rays or a CT scan and
3. A discussion with your dentist and oral and maxillofacial surgeon

Depending on the results of your dental examination our surgeon may:

1. Extract the complete tooth
2. Partially remove the tooth (coronectomy); or
3. Observe the tooth over time for changes in condition.

In general, dental professionals agree that third molars should be removed whenever there is evidence of:

1. Periodontal disease
2. Cavities that cannot be restored
3. Infections
4. Cysts or tumours
5. Damage to neighbouring teeth

Third molars may not require surgery if they are:

1. Completely erupted and functional
2. Painless
3. Free of cavities
4. Disease-free
5. In a position that can be kept clean and healthy.

If after discussing your situation with our dentist or surgeon you decide to keep your wisdom teeth, for the time being, it’s important to agree on a long-term plan for monitoring the health and condition of these teeth and their surrounding gum tissue. Most oral surgeons recommend the following maintenance routine:

1. Schedule a dental checkup at least annually
2. X-rays or CT scans should be taken to see the wisdom teeth and surrounding bone
3. A clinical examination should be performed annually to determine whether any disease is developing.
4. Particular care must be taken to clean and floss the area as part of your daily oral health care regimen.

Before leaving for home, your surgeon will give you specific post-surgical instructions and prescriptions for medications that will make your post-surgery experience more comfortable. Following are some additional suggestions you may find helpful:

1. An ice pack may be used during the first 48-72 hours to help reduce temporary swelling and discolouration of the skin.
2. Moist heat applied to the face may be helpful if your jaw is sore and you are unable to open your mouth as wide as usual.
3. If bleeding is excessive after you return home or if you experience increased pain after the first 72 hours following surgery, contact your oral surgeon immediately for instructions.
4. Gently open and close your mouth to help exercise the jaws and restore normal movement.
5. Eat soft foods and drink fluids during the first two days after surgery, but avoid using straws as the suction could disturb clotting.
6. Do not rinse your mouth vigorously until clotting is complete, although gentle rinsing with salt water may be recommended by your surgeon to aid in healing.
7. Avoid eating hard or sticky foods that might damage your jawbone, particularly if a bone was removed during surgery.
8. Do not smoke as this may disturb blood clots and the healing process.
9. Resume brushing your teeth the second day after surgery, but avoid disturbing blood clots with the toothbrush.

Medication prescribed your surgeon will help with any discomfort and you should generally be able to resume normal activities within a relatively short period of time.

On the first day after surgery, you may experience some minor bleeding and pain. You should cover your pillowcase with something so that you don’t get any blood on it.

Each individual’s reaction to surgery varies, and the sensation of pain can range from mild discomfort to severe pain.

A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the second day and should begin resolving on the third day. You can limit the amount of swelling you will have by using ice for the entire first day. The more ice you use the first day, the less swelling you are likely to have on the second day.  Please remember to put ice on the first day even if it is somewhat uncomfortable to have a cold next to your skin.

On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider.

Most of the time you will want to limit your activities for a few days.  We ask that you follow your post-operative instructions closely.  Doing so will make you as comfortable as possible during the first few days following your procedure.

Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.

Wisdom teeth surgery is a common procedure that usually produces few if any, serious complications. However, as with any surgical procedure, you should be aware of the following possible complications and discuss them with your surgeon before surgery.

1. Infection – any infection should be taken seriously and reported to your surgeon who will prescribe appropriate antibiotics to treat the problem. Signs of infection include fever, abnormal swelling and pain, salty or prolonged bad taste and pus formation.
2. Injury – neighbouring teeth, filling material or bridgework located near the wisdom teeth may be damaged during extraction.
3. Dry socket – if a blood clot prematurely dissolves or does not form properly in the empty socket, for example, due to smoking or food impaction, the socket remains “dry” for a period of time and heals more slowly than usual. A dry socket can be quite painful because it leaves the bone in the socket exposed to air, food and fluids. If you experience increases pain a few days after surgery, contact your surgeon. Steps can be taken to reduce discomfort while healing takes place.
4. Numbness, or altered sensation – in some cases major sensory nerves are located near wisdom teeth, and it is possible that one or more of these nerves could be irritated during surgery. If this happens, you may experience altered or total loss of feeling in the lip, tongue, cheek, chin, gums or teeth, depending on the nerve that is involved. Although numbness beyond a relatively short period of time in any location is uncommon and usually temporary, it may be permanent in rare instances.
5. Sinus complications – sometimes upper wisdom teeth are located near the large maxillary sinus and the roots may even penetrate into the sinus cavity. When removed, these wisdom teeth may leave an opening in the sinus that will usually heal without a problem. Rarely, drainage or sinus pain may occur following tooth removal. If these complications develop, contact your oral surgeon.
6. Root fragments – occasionally tooth roots are extremely long or fragile and a piece may break off during surgery. Typically the fragment is removed, but if it is too close to a nerve or the sinus cavity, or if its removal would jeopardize adjacent teeth, the surgeon may decide to leave the fragment in place. This, rarely presents long-term problems, and the fragment can be monitored with x-rays.
7. Jaw fracture – in very rare cases, the removal of wisdom teeth can weaken the jawbone, particularly if the jaw is thin and the teeth are severely impacted. If a fracture occurs, x-rays will reveal the location and your surgeon can treat the problem. Care should be taken to avoid eating hard, crunchy foods that place undue stress on the jaws until healing is completed.
8. Jaw joint pain or abnormal jaw function – while this is a rare occurrence, further treatment may be necessary if you experience such pain. Prior to surgery, be sure to inform your surgeon about any pre-existing joint problems in your jaw.