How your wisdom teeth grow
By your late teens, your jawbone has nearly reached its adult size. But sometimes it isn't big enough to hold developing wisdom teeth. When this happens, your teeth become trapped in the bone and grow wherever they can. The crown (chewing surface of the tooth) may only partially break through the gum. In other cases, it may remain completely in the bone. The roots, which hold the tooth in place, may become misshapen or grow dangerously close to a sinus cavity or to the nerve location in your jaw.
Problems Impacted Wisdom Teeth Cause
Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in.
Gum infection: When a wisdom tooth partially breaks through the hum's surface, bacteria can get under the flap of gum and cause a painful infection. We call this Percoronitis and it is treated with antibiotics because it can lead to a serious infection of the head and neck. Chewing is often painful and opening the jaw is difficult. The definitive treatment is tooth removal.
Crowding: Impacted teeth press against adjacent teeth and may injure them or push them out of position. A crowded wisdom tooth growing toward the cheek can irritate nearby tissue.
Decay: A wisdom tooth that is hard to clean because of its position or because it is partially covered by gum tissue may fall victim to cavity-causing bacteria and result in decay.
Cysts: If the sac that holds the crown remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone.
Your Surgery Experience
Preparing for surgery: You may need to take several days off work or school to give yourself time to recover. Specific post-operative instructions will be given to you after your extractions. A follow-up visit should be scheduled one week after the surgery date to check your healing progress. Wear comfortable clothing and arrange for a responsible adult to drive you home after surgery.
In our practice, local anaesthetic alone is used. If you are a terribly nervous patient and feel that you must be put to sleep with a general anaesthetic, please inform us and you will be referred to an oral surgeon. A safe, sedative pill can be prescribed to help you relax.
During Surgery: Expect the procedure itself to last about an hour. Freezing will be place around the tooth before the surgery begins. If wisdom teeth are to extracted from all four corners of your mouth, expect to feel very frozen.
Your wisdom tooth may be removed (extracted) from the socket with forceps. However, the roots are often long and deeply embedded within the jawbone, so the tooth may have to be cut into pieces or bone removed. This necessitates an incision along the gum which is closed with several dissolving stitches.
After Surgery: We'll ask you to rest for 15-20 minutes after your surgery to be certain all bleeding has arrested. You may be given a prescription for pain and antibiotics as well as instructions for home recovery. Plan to rest at home for the remainder of the day.
Risks and Complications
Removal of wisdom teeth is a common procedure, but as with any surgery, there are risks.
Numbness: Impacted teeth may be close to or in actual contact with the nerves that supply sensation to the teeth, gums, tongue, chin, cheeks and lips. Sometimes these nerves are injured when the tooth is removed, causing numbness and tingling. If this occurs, the nerve usually repairs and regenerates itself with a few weeks to months. In some cases, numbness is permanent. Unfortunately, the occurrence and duration of this problem is unpredictable. Any altered sensation does not affect appearance.
Dry Socket: Healing can be delayed if the blood clot covering the socket dissolves or is washed away. This exposes the bone and may lead to constant, deep, throbbing pain, which can be treated with a dressing. Smoking and poor oral hygiene after surgery increases your risk for having a dry socket.
Infection: Infection is a less common complication. It can usually be treated by draining the infection or with antibiotics.
Sinus Problems: Because the upper wisdom teeth are near a sinus cavity, the removal of these teeth can open the sinus cavity on rare occasions. A presence of blood in the nose might be noticed in this case. The sinus usually heals with the help of antibiotics, but if a problem persists, further treatment may be needed.
Weakening of the Jaw: In rare cases, removal of an impacted tooth can weaken the jaw, making it more susceptible to fracture.
Injury to adjacent teeth: Adjacent teeth may be weakened or injured by the presence of an impacted tooth. After wisdom tooth removal, this injury may become apparent in the form of a loose or sensitive tooth. As well, large fillings or caps next to the impacted tooth may be dislodged at surgery. If necessary, a temporary filling will be placed and once healing is completed a permanent filling or the old cap can be recommended.
Stiffness of the Jaw: A stiff jaw often follows wisdom teeth removal, especially if there is a history of clicking or TMJ pain. Opening your jaw wide for the duration of the surgery and swelling both contribute to this problem. Within a few days, your jaw will return to normal. Occasionally, additional treatment may be required.
Medication Side Effects: The Birth Control Pill may be ineffective if you take antibiotics. Please inform us if you have any medication allergies or a history of an ulcer as it will affect the medication chosen for you.
The receipt of this information indicates that in consenting to have impacted teeth removed the patient clearly understands the risks that have been described. Should there be any questions or concerns, it would be our pleasure to discuss these with you. We can be reached via email info@dentistryinfo.com or at 519-742-8308
