ORAL SURGERY – WISDOM TEETH REMOVAL
If a tooth needs to be removed for any reason, it can usually be gripped with a crown forceps and simply pulled out. However, there are cases where this is not possible. Sometimes, oral surgery is needed to extract the damaged tooth.
The removal of wisdom teeth often necessitates a surgical intervention too, if they don’t have enough room in the jawbone to grow – or if their eruption would lead to dental crowding, which can not only cause aesthetic problems later on, but can also lead to inflammation of the gums and cavities.
WHEN IS IT NECESSARY?
Diseased and aching teeth, but even those not yet causing actual discomfort need to be removed in some cases. Removal of the affected tooth may be recommended for the following reasons:
- If there is returning inflammation around the crown (upper part) of an already partially erupted tooth causing unpleasant symptoms, or if a cyst has developed around a crown located in the bone, destroying the bone.
- If an abnormally erupting wisdom tooth could damage the molar seated in front of it by the pressure it exerts.
- If the inflammation around an abnormally erupting tooth could spread to more distant areas of the body, causing a condition known as a “focal infection”.
- If the pressure from the tooth erupting in an abnormal direction could distort the entire lower row of teeth, which could lead to development of bite problems, which may require orthodontic therapy.
- Before making restorations, in order to avoid complications later.
- If the wisdom tooth developed cavities.
- In the case of pre-existing periodontal disease, if removal is necessary in order to improve the treatment and cleaning possibilities of the tooth in front of it.
- If the end result of an already completed orthodontic process could be negatively affected by a wisdom tooth erupting later.
HOW ARE WISDOM TEETH REMOVED?
Firstly, it’s important to eat before the procedure, as it is not recommended to eat again afterwards until the anesthetic wears off, and going without food for a time can cause nausea.
THE STEPS OF THE PROCEDURE
Tooth extraction can be carried out with flap or flapless, using a forceps or an elevator, and if necessary, removing the bone surrounding the root. In the case of surgical removal, the gum is peeled from the bone under local anesthesia, the tooth is cleared using a drill, after which it is removed in one or more pieces (depending on location and size). This is sometimes followed by gentle curettage (scraping) of the socket, taking care to protect the surrounding structures. The wound is bandaged with a pressure gauze and/or stitched.
IMPORTANT TO KNOW AFTER THE PROCEDURE
It is important that you do not eat or drink until the anesthetic wears off, because the numbing effect can lead to difficulties with swallowing and possibly even chewing.
In the first 1 or 2 days, it is recommended to cool the face with a cooling gel. It should be cooled 4 to 5 times a day for at least 10 minutes. Be careful though, because excessive cooling of the face can cause other issues (such as frostbite) if you’re using a device which is not appropriate for this function.
Despite cooling, you can expect the face to be swollen for about 5 days, and sometimes even discoloration of the skin can present.
You may encounter limited mouth opening, in which case it is advised to gently exercise the chewing muscles. You may ache for a few days, which can be relieved with the prescribed painkillers. Antibiotics, painkillers and probiotics should be always taken as instructed by your dentist!
Avoid dairy products until the stitches are removed. As far as possible, choose soft foods.
You can brush your teeth as usual, but do not rub hard on the stitches.
Use Curasept ADS 220 solution twice a day after brushing. Take the concentrated solution in your mouth and keep it there for at least a minute. Do not rinse your mouth afterwards, do not swish the liquid around vigorously, so that the blood clot remains inside the socket. The post-operative symptoms will gradually disappear in 3 to 4 days. A week after the operation the wound has healed completely. If stitches were needed after the extraction, these will be removed after one week, or in rare cases, no later than 2 weeks.
Watch POSSIBLE COMPLICATIONS
The roots of the lower wisdom teeth – especially when deep teeth have to be surgically removed – can sometimes be very close to the nerve canal in the lower jaw, which means nerve damage cannot be avoided in some cases. This may cause temporary (in some rare cases, permanent) loss of sensation and numbness on the same side of the lower lip. Lip movements are not impaired.
A rare complication is damage to the nerve running along the inner surface of the lower jawbone (the one innervating the tongue), which can occur during anaesthesia or during surgery. This can cause temporary or permanent numbness, loss of sense, or loss of taste on the same side of the tongue.
Fracture of the mandible is a very rare complication, which can successfully be treated by surgical or conservative means.
When a tooth is removed from the upper jaw (the maxilla), the roots sometimes protrude into the maxillary sinus. In these cases, the sinus and the oral cavity might become connected after extraction, which can lead to inflammation caused by external bacteria. In such cases, the wound has to be closed with sutures. If this is required, sneezing and blowing your nose will be prohibited for 6 weeks! Fracture of the upper jaw is a rare complication, which can successfully be treated by surgical or conservative means.
Any surgical intervention might be followed by some post-operative bleeding, wound healing issues or inflammation, but in practice you shouldn’t be afraid of any further complications. If you experience any of these complaints, please contact our dental clinic immediately!
We believe in the importance of patient information, as giving accurate instructions to follow can make a big difference to the outcome of a procedure. You can read and download our patient information leaflet here, which will hopefully be helpful.
PATIENT INFORMATION LEAFLETS
OUR DENTISTS UNDERTAKING THE PROCEDURE
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