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Wisdom tooth removal

A wisdom tooth is removed when it is causing pain, infection, decay or crowding, or when it cannot come through properly. It is done under local anaesthetic and usually takes twenty to forty minutes. Expect swelling and soreness for three to four days afterwards, which is worst on day two and then improves steadily.

When a wisdom tooth needs to come out

Not all of them do. The reasons that justify removal are:

  • Repeated infection around a partly erupted tooth, where the gum flap traps bacteria and the area swells periodically.
  • Decay in the wisdom tooth or, more often, in the back of the healthy tooth in front of it, where the two meet and cannot be cleaned.
  • Pressure and damage to the tooth in front from a tooth growing at an angle.
  • Pain that has a clear cause on examination.
  • A cyst forming around a buried tooth, which is uncommon but needs action.

A wisdom tooth that is fully through, cleanable and quiet does not need removing because it exists.

How the procedure runs

  1. Examination and an X-ray or 3D scan, which shows the root shape and where the nerve runs. For a buried lower tooth this is not optional.
  2. Local anaesthetic, and enough time for it to take properly.
  3. Removal. A simple tooth lifts out. A buried one needs a small opening in the gum, and the tooth is often divided into pieces so it can come out through a smaller space. Dividing it is a good sign, not a bad one: it means less bone is being removed.
  4. Stitches, usually the dissolving kind, and a gauze pack to bite on.

Twenty to forty minutes for most cases.

Afterwards

Bite on the gauze for an hour. Take painkillers before the numbness wears off. Cold compress on the outside of the face for the first day.

For the first twenty four hours: no rinsing, no spitting, no straws, no smoking. All four dislodge the clot, and the clot is what protects the socket.

Soft food, eat on the other side, and expect a stiff jaw for a few days. Day two is the peak. If things are getting worse after day three, call us.

When to call the clinic

Pain increasing after day three, a deep ache that painkillers do not touch, a fever, bleeding that will not stop with pressure, or numbness of the lip that is still there the next day.

Questions people ask

Not necessarily. A wisdom tooth that has come through properly, is cleanable and is causing no problems can be left alone. The argument for removing a symptomless tooth is usually that it is partly buried and repeatedly getting infected, or that it is damaging the tooth in front of it.

Day two is the worst: swelling, a stiff jaw, and soreness that painkillers manage. By day four most people are functioning normally, and by a week it is mostly gone. A straightforward upper wisdom tooth is much easier than a buried lower one, and we will tell you which you have.

For a simple removal, usually yes. For a buried lower wisdom tooth, take the next day off if you can. Your face will be swollen and your jaw stiff, and you will not enjoy a day of meetings.

When the blood clot protecting the socket is lost, exposing bone. It typically appears three to five days after removal as a deep ache that painkillers barely touch, sometimes with a bad taste. It is treatable quickly and easily, so call us rather than enduring it.

The nerve supplying feeling to the lower lip runs near the roots of lower wisdom teeth. Temporary numbness after a difficult removal is uncommon and permanent numbness is rare. A 3D scan beforehand shows exactly where the nerve is relative to the roots, which is how the risk is managed.

Appointments

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