Wisdom teeth removal

What is wisdom teeth removal?

Wisdom teeth are the last teeth to arrive, usually in the late teens or early twenties. Often there is not enough room at the back of the jaw, so they come through at an angle, only part of the way, or stay trapped under the gum and bone. That is what impaction means. A partly erupted wisdom tooth is the one that causes most trouble, because the gum flap over it traps food and bacteria and cannot be cleaned properly, so it swells and becomes painful, sometimes again and again. Impacted teeth can also push against the tooth in front, which is the tooth worth protecting, and decay can start where the two meet. Removing the wisdom tooth prevents that. Plenty of wisdom teeth never cause any of this. A wisdom tooth that has come through straight, has a tooth to bite against and can be reached with a toothbrush is doing no harm, and taking it out for the sake of it is surgery with nothing to gain. Those teeth are watched at your check-ups instead. Removal is also surgery, and it has risks worth knowing before you agree: swelling, bruising and a stiff jaw for some days, bleeding, infection, and dry socket, where the blood clot is lost and the socket becomes painful several days later. The roots of lower wisdom teeth can sit close to the nerve that supplies the lip, chin and tongue, so bruising of that nerve can leave an area numb or tingling, usually settling but occasionally lasting. Upper wisdom teeth sit near the sinus. Your dentist checks all of this on your x-rays first, explains what applies to your teeth, and refers you on if your case is better handled elsewhere. Sedation can be arranged: a visiting registered specialist anaesthetist attends on set sedation days, booked in advance, and charges their own fee.

When might you need wisdom teeth removal?

• Repeated infection around the gum

  A gum flap over a partly erupted wisdom tooth traps food and bacteria, swells and becomes painful, often more than once.

• Impaction

  There is not enough room for the tooth to come through straight, so it sits at an angle or stays under the gum and bone.

• Damage to the tooth in front

  A wisdom tooth pressing on its neighbour can cause decay or gum problems where the two meet, and that tooth matters more than the wisdom tooth does.

• Decay in the wisdom tooth itself

  Wisdom teeth are hard to reach and clean, and a decayed one is often not worth restoring when it is not doing useful work.

• A cyst around an unerupted tooth

  Uncommonly, a fluid-filled sac forms around a buried wisdom tooth. It is usually found on an x-ray before it causes symptoms.

• Pain when biting on the gum behind the last tooth

  An upper wisdom tooth with nothing to bite against can over-erupt and chew on the gum below it.

What happens, in short

1. Examination and x-rays

   An x-ray shows the angle of each tooth, the shape of the roots and how close the lower roots sit to the nerve. A wide film covering the whole jaw is the usual one.

2. The recommendation

   Your dentist explains which teeth, if any, are worth removing, whether removal would be simple or surgical, and what the risks are for your teeth specifically.

3. Planning the appointment

   You are told how to prepare, how much time to allow, and whether an anaesthetist needs to be booked separately.

4. Removal

   The area is numbed. A tooth that is fully through can often be lifted out simply. An impacted tooth needs a small cut in the gum, sometimes a little bone removed and the tooth divided so it comes out in pieces, then stitches.

5. Healing and review

   You go home with written aftercare and a plan for pain relief. Healing is checked afterwards, and any stitches that do not dissolve are removed.

What does it cost?

A straightforward wisdom tooth extraction is from $400. Surgical removal is quoted individually once your dentist has seen the x-ray, because the work involved depends on the angle and the roots. If an anaesthetist is arranged, they bill their fee separately. You get a written, itemised quote with item numbers before anything is booked.

You get a written, itemised quote with item numbers before any treatment starts, so you can check it with your health fund. Health funds · Payment options

Do all wisdom teeth need to come out?

No. A wisdom tooth that is through straight, easy to clean and causing no trouble can stay and be watched at your check-ups.

Removing a healthy, working tooth means accepting the risks of surgery for no gain. If yours are fine, we will tell you so.

When is a wisdom tooth worth removing?

When it keeps getting infected, is damaging the tooth in front, has decay that is not worth repairing, or cannot be kept clean.

One episode of swelling around a gum flap does not on its own mean the tooth has to go, and swelling is only one of the things weighed. Wisdom teeth are assessed on their position in the jaw, whether there is adequate space for them, whether they can be kept clean and maintained, and whether they are causing or likely to cause problems for the teeth and structures next to them. A wisdom tooth may also need to come out if clear aligner treatment is planned. Repeated episodes of swelling count, because the problem tends to keep happening, but they are weighed alongside the rest.

What are the risks of having a wisdom tooth out?

Swelling, bruising and a stiff jaw for some days are expected. Bleeding, infection and dry socket are the common complications, and nerve bruising is the one to understand before you agree.

Dry socket is the painful one: the clot is lost a few days in and the socket aches deeply. It is treatable and we will see you for it. Where a lower root sits against the nerve, the lip, chin or tongue can be numb or tingly afterwards, usually settling, occasionally lasting. Your x-ray tells us whether that risk applies to you.

Is removing a wisdom tooth painful?

The removal itself should not hurt, because the area is numbed and tested first. You feel firm pressure and hear noise.

Soreness afterwards is expected and is managed with pain relief and the aftercare instructions you go home with. A surgical removal is sorer than a simple one.

Is it better to have them out young?

Removal is generally more straightforward in the late teens and twenties, when the roots are less developed and the bone is more forgiving.

That is a reason to deal with a problem tooth sooner rather than later. It is not a reason to remove a healthy one, and age alone is not a diagnosis.

Can all four come out at once?

Sometimes. It depends on how they are positioned, how you feel about it and whether an anaesthetist is involved.

Doing all four together means one recovery instead of two or more. Doing one side at a time leaves you a side to chew on. Your dentist will go through both after looking at the x-ray.

What happens if you leave a problem wisdom tooth alone?

The infections tend to come back, and decay in the tooth in front can turn a wisdom tooth problem into losing a tooth that mattered.

Waiting also tends to make the removal itself harder as the roots develop. Where there is genuinely no problem, though, leaving it alone is a proper option, not a delay.

Symptoms that can lead here

• Wisdom tooth pain
• Toothache

More about wisdom teeth removal

• What it costs
• What to expect at the appointment
• Aftercare and recovery