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Introduction
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Wisdom teeth are generally the last teeth to erupt and often there is not enough room for them to come through completely. Some remain buried and others come through normally, particularly if other teeth have been lost.
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Why do wisdom teeth cause problems?
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Even if the wisdom tooth is erupting normally, there may be some soreness of the gum. This is just like the teething pain suffered by babies. This soreness may settle when the tooth is fully through.
Some wisdom teeth erupt part of the way but get stuck (impacted) against the tooth in front; this tends to happen more with lower wisdom teeth than upper ones. A flap of gum may cover part of the wisdom tooth and this can become painful and swollen, especially if food debris collects and infection develops. An infection may have to be treated before the wisdom tooth can be removed.
Some wisdom teeth become decayed and cannot be restored. Occasionally wisdom teeth are involved with cysts and other lesions needing removal.
What are the signs of infection?
Soreness and swelling of the gum around the tooth and possibly swelling of the face and lymph glands in the neck. Some people have pain or difficulty when opening their mouths and there may be bad breath or an unpleasant taste.
The infection may make you feel generally unwell and give you a fever.
Treatment of the infection:
- Brush and clean the teeth.
- Bathe the mouth as often as possible with antiseptic mouthwash. Mouthwashes soothe the area and help to keep the gum flap clean. Do not apply heat to the outside of the face.
- Take painkillers if you need them but do not exceed the recommended dose.
- A course of antibiotics is sometimes necessary. Always complete the course.
- If you fell unwell or have a fever then take plenty of fluids and rest.
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Should my wisdom teeth be taken out?
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Removal of impacted wisdom teeth, particularly if there has been infection, is often advised. Partially erupted teeth are more likely to become decayed and infected. Gum disease may develop and the next tooth can become decayed.
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How will my wisdom teeth be taken out?
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Wisdom teeth can be removed painlessly under local anaesthesia (injection to numb the jaw). Only difficult wisdom teeth are taken out under general anaesthesia (whilst you are asleep). The type of anaesthetic will be discussed with you before the operation, together with any possible complications of the surgery.
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What should I expect after the operation?
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There is usually some swelling of the face and discomfort in the mouth for at least a week. You may find it painful or difficult to open your mouth after the operation but this is normal. Stitches are usually needed but these will dissolve.
A small number of patients may notice some tingling or numbness of the lower lip or tongue after the operation. This is because the nerves to your lower lip and tongue lie near to the wisdom tooth and may be bruised/disturbed during the operation. In most cases this gets better quickly. Occasionally, it persists for several months and, in a very small number of patients it may be permanent. This does not affect how the muscles work or the way things look.
You will be given postoperative advice on discharge. Remember to take it easy for a few days.
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Review appointment
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It is important that you attend this appointment which is usually 14 - 21 days after the operation. This is to check that healing has been satisfactory.
Remember that the sockets may take 3 - 4 weeks to settle.
If you are at all worried please contact your consultant maxillofacial surgeon or the Hospital where you had the operation.
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