What are wisdom teeth?
Contrary to its name, wisdom teeth do not grant an individual more wisdom but are named so as these teeth appear later in life when we are more mature. Wisdom teeth are third molars that develop as the last tooth in each quadrant of the dental arch and typically erupt around the age of 18 to 25 years, although in some cases, they may erupt later. Wisdom teeth can erupt properly and upright, erupt at an angle to the second molar (impacted), remain partially covered by gums (partially erupted), or remain buried in bone (unerupted).
Why should I seek treatment?
Impacted wisdom teeth can cause problems such as food trap, dental caries, or gum disease, affecting both the wisdom tooth and the second molar next to it. When such problems occur, you might develop signs and symptoms of localised pain and swelling, indicating an ongoing infection. In severe cases, the infection may spread to involve the deeper spaces in the head and neck region, causing fever, facial swelling, and limited mouth opening.
Unerupted wisdom teeth can also be associated with an enlarged dental follicle or cystic lesion, and such changes necessitate the need for removal and a biopsy of the cystic lesion. The cystic lesion can also occasionally get infected, causing pain and swelling.
Wisdom teeth that have erupted properly and upright can be left alone and maintained, although you may elect to have them removed if they are not functional.
What are the treatment options?
Impacted wisdom teeth will need to be removed by surgery (excision). Surgical removal of impacted wisdom teeth involves cutting and lifting the overlying gum, drilling the bone, exposing the teeth, sectioning, and splitting the teeth before the teeth are removed in pieces. The gum is then stitched. Such surgery can be performed under local anesthesia, sedation, or general anesthesia. Fully erupted wisdom teeth can be extracted without surgery.
Discuss with your surgeon to decide which treatment is best for you.
What to expect after treatment?
Recovery from wisdom tooth surgery usually takes 1 week, during which a soft diet is advisable. Antibiotics are not always required after wisdom tooth surgery, but painkillers and antibacterial mouthwash will usually be prescribed.
A small amount of bleeding and a short period of swelling and pain are expected sequelae after wisdom teeth surgery. You may have limited mouth opening for this period of recovery. If there is unexpected bleeding after surgery, you may insert and bite on a piece of moist gauze for 30 minutes to stop the bleeding. Profuse uncontrolled bleeding will need to be managed promptly.
Facial swelling that worsens over the first three days after surgery is also expected and will gradually improve thereafter. Applying ice packs to the face (on the side of the surgery) on and off for 20 minutes each time for the first 3 days may help reduce swelling. If the swelling worsens after 3 days and is accompanied by increasing pain, difficulty opening your mouth, or pain/difficulty in swallowing, this may represent an infection and should also be managed promptly.