Wisdom teeth

The aim of this leaflet is to give a written overview of the management of wisdom teeth.

Why are some wisdom teeth removed?

Wisdom teeth are the last adult teeth to emerge. Sometimes they will grow (erupt) normally and cause no problems.

However, in some cases, there is not enough room for them to grow properly.

They can:

Stay under the gum (unerupted)
Grow at unusual angles (impacted)
Cause pain or infection

Wisdom teeth might need treatment if:

They have decay
Severe and repeating pain
Severe infection
Pus or swelling
A cystic (a fluid filled lump)
Other evidence of disease as per the National Institute for Clinical Excellence (NICE) guidance on wisdom tooth removal.

How are wisdom teeth treated?

You may be offered:

Checking with X-rays, advice about cleaning or other conservative management

Whole tooth removed

Removing just the top of the tooth and leaving the roots in place

How is the tooth removed?

Some wisdom teeth can be removed like normal teeth but others need surgical removal.

The dentist will make a small cut in the gum and remove bone if needed. It is normal for the wisdom tooth to come out in several pieces. Your gum will then usually be stitched back together.

What are the benefits of removing wisdom teeth?

Removing pain and infection
Avoiding future problems

Pain – Common for 2-3 days and painkillers can help.
Bleeding – A small amount is normal.
Bruising – This can be around the face and neck.
Swelling – Can last up to 2 weeks.
Stiff jaw – Can be worse if you already have problems with jaw pain.
Infection – This is rare.
Dry socket – This is a common problem where the area doesn’t heal well and is painful.
Sinus opening – Can happen if an upper tooth is near the sinus.
Nerve injury – Sometimes 2 nerves can be damaged when lower wisdom teeth are removed. This can cause numbness or change in feeling which is sometimes painful. This can be temporary or permanent. This can affect the lower lip, chin, gums, lower teeth and tongue (including taste).

Your dentist will explain your risks and may suggest a 3D x-ray (cone beam CT scan) to help with this. If the nerve is close to the roots a coronectomy may be discussed.

If you are high risk, your dentist will discuss this and may offer a procedure called a coronectomy with you.

What is a coronectomy?

This means removing the top of the tooth but leaving the root. This may lower the chance of nerve injury. The root might cause problems later and need to be removed.

The procedure is similar to that of a surgical extraction with the risks including pain, swelling, bruising, bleeding and infection.

How will I feel after my operation?

You may feel sore and tired, more than after a normal extraction. Some people need 1-2 weeks to feel better. Avoid having the procedure close to an important event. You may want to take time off or get help at home.

You will be given written and spoken instructions.
Keep your mouth clean. Brush twice daily.
After 24 hours, rinse gently with warm salty water after meals (3-4 times per day).
Avoid smoking for 5 days.
Avoid alcohol until your mouth has healed.
You will be advised about pain relief and, in rare cases, given antibiotics.
If you are worried, call the helpline number we give you.

On the day of your operation

Your treatment may be under local anaesthesia, sedation or general anaesthetic. Please refer to your personal appointment letter for specific details.

If you are concerned following removal of your wisdom teeth, you should telephone the Help number which will be given to you on discharge.

Useful sources of further information and resources used to create this leaflet

If you have any questions about the management of your wisdom teeth or if you have any doubts about your operation, please ask before your operation

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