Wisdom Tooth Surgery

What are Wisdom Teeth?

Your wisdom tooth, also known as the third permanent molars are the very last teeth at the back of your mouth. They are the last teeth to develop – typically between ages 18 to 24 years. Most of us will have up to four wisdom teeth in total, two in the upper jaw and two in the lower jaw.

Importance of removing wisdom tooth/ teeth. What happens if I do not?

1. Unpleasant sensation of pressure at the back of the jaw.
2. Damage to nearby teeth.
3. The upper wisdom tooth bites down on the swollen gum below.
4. Infection and swelling of the gums that affects your ability to eat, talk or sleep.
5. Presence of cysts (fluid-filled sac), abscess (pus-filled infection), and tumours.
6. Pain
7. In some patients, they do not cause any problems so it is not necessary to remove them.

When wisdom teeth do not erupt fully or grow in unusual angles, its position can make it challenging to remove food trap by brushing or flossing, leading to the accumulation of plaque and food particles. This can lead to the development of cavities and/or gum disease. Also, they may damage adjacent teeth, increasing the likelihood of tooth decay. In severe cases, cysts or tumours can form around the impacted tooth. If left untreated, they can destroy the surrounding jawbone, tissues and neighbouring teeth, rendering the need for extensive and costly treatment.

Temporary Treatment

1. Medication, e.g. antibiotics and painkillers, to ease pain & infection. Mouthwash to keep the wisdom tooth area clean.
2. Excision of hyperplastic/ excess gum that grows over the straight erupting wisdom tooth, covering it.
3. Scaling or cleaning around the infected gum to remove trapped food particles.
4. If the upper wisdom tooth is biting on the swollen gum, the tooth may be trimmed out of the way. It is always advised to remove non-functional upper wisdom teeth as they are difficult to keep clean.

Advantages of Wisdom Tooth Surgery

It is highly encouraged to have your wisdom tooth extracted early during adolescence. This will spare you the discomfort from recurrent dental problems and longer post-surgery recovery if you were to remove them at a later age. Also, this may help minimise possible complications as a result of other health conditions later in life.

What is the process of Wisdom Tooth Surgery?
  1. Pre-treatment evaluation and Treatment Planning.
    1. E&D
    2. X-ray ( OPG or CT for more complex cases) and U/L Study models
    3. Sedation? LA or GA
    4. Medical History Inform your dentist about any heart condition or any serious illness you have or had.
    5. Drug Allergies Inform your dentist about any drug allergies you may have.
    6. Make arrangements in advance for a few days of medical leave.
  2. Wisdom Tooth surgery
    During the operation, the gum around the tooth is raised to one side and some bone is removed to gain access to the tooth. Often, the tooth will need to be divided into a few pieces before it can be retrieved. The gum is then stitched back in place with sutures.
  3. After Wisdom Tooth Surgery
    When the anaesthetic wears off, you may need to take painkillers. Antibiotics may also be given to prevent infection of the wound. After the operation. There is usually some swelling and/or bruising of the cheek. This may last about 5 days. The swelling may also cause some stiffness of the jaw. Post surgery instructions will be given. Please follow them carefully.
  4. Post Surgery Review
    Your dentist will check on your condition in about 1 to 2 weeks post surgery. During which, the stitches will be removed.
Suitability for Wisdom Tooth Surgery
  1. Medical Health (e.g. diabetes, reduced body resistance, bleeding disorders, patients with underlying heart conditions)

    Your dentist will liaise with your medical doctor to determine your suitability for the surgery and any prophylactic or precautionary actions required.

  2. Social Health (e.g. smoking)
How long is the Surgery?

The duration of the surgery will depend on the level of difficulty of the extraction, presence of infection, bone quality and quantity.

  1. 20mins to 45min ( including preparation time )

Is it Painful?

The degree of pain is similar to that of an extraction. For patients who are anxious, an arrangement can be made for general anaesthesia/sedation. This will help the patient sleep comfortably throughout the procedure.

Pre- Surgery Precaution?

Pre- medicate with antibiotics and mouthwash.

Post-surgery Care
  1. It is normal to have slight oozing of blood from the surgery site. Bite on the prescribed sterile gauze for 20 minutes. Do not change the gauze frequently, wash your mouth too vigorously, or use your tongue to disturb the wound as you may dislodge the blood clot that is meant to prevent further bleeding. Call your dentist if you think the wound is bleeding badly.
  2. Place a cold compress or ice pack over your cheek to help reduce the pain and swelling
  3. Soft diet and cold food is preferred. Hot food will cause blood vessels to expand which will cause more bleeding.
  4. Normal activity can be resumed after 4-5 days
  5. Take all the medicines prescribed to you at a proper time and complete the whole course of antibiotics.
  6. Do not smoke or drink alcohol as it will delay wound healing or cause it to not heal fully.
  7. Do not engage in strenuous physical activity. Dilated blood vessels will cause more bleeding.
  8. Brush your teeth as per normal, avoiding the surgery site. Gargle with diluted mouthwash if you have difficulty brushing.
How soon can I eat and function after Wisdom Tooth Surgery?

After anaesthesia wears off.   Soft and cold diet is recommended for first few days.

  • Infection; this can be treated with medications;
  • Numbness ( paresthesia ) of the lip, chin, or tongue due to damage to the nerve which can either be temporary or permanent
  • Stiffness ( trismus ) of the jaw
  • Damage to adjacent structures
  • Abrasion to lip, cheek or tongue
  • Root tips not devoid of infection may be left behind
Patient Cost For Wisdom Tooth Surgery

Medisave Claimable.

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