Wisdom Tooth Extraction

65% of people worldwide will have to deal with the emergence of wisdom teeth during their lifetimes.

Wisdom teeth are a third set of molars, two at the top and two on the bottom back corners of the mouth, and generally emerging from the gumline during your late teenage years or early twenties. Most of us will have a full set of four wisdom teeth, often coming through in a staggered manner or over several months or even years – however some people will develop fewer than four, and approximately 30% of people develop no wisdom teeth at all.

Why Should I Have My Wisdom Teeth Removed?

Why Should I Have My Wisdom Teeth Removed?

For some lucky individuals, their wisdom teeth will emerge fully and without complication into the mouth and will function like additional normal teeth. However, for the majority of patients the emergence of their wisdom teeth can cause overcrowding in the back of the mouth, and this lack of available space can often lead to the wisdom tooth only partially emerging or growing into the mouth crooked (what are known as impacted wisdom teeth).

Wisdom teeth are notorious for coming in at all angles and they can sometimes push otherwise straight teeth out of alignment. In order to have the least impact on nearby teeth, bone and gum tissue, it is advisable that they be removed earlier as opposed to later.

As the new tooth struggles to erupt into the mouth, it develops an overhanging ‘flap’ of gum tissue, and this pocket greatly increases the difficulty of keeping that area clean, which can result in:

  • Recurrent infection and disease of the gum
  • Severe pain of the tooth and/or jaw
  • Increased vulnerability to tooth decay and plaque, of the wisdom tooth itself and adjacent teeth
  • Damage to or misalignment of adjacent teeth due to the angle of eruption of the wisdom tooth, affecting overall bite and jaw symmetry
  • Cyst formation around the impacted wisdom tooth, which can cause pain or further complications

While some impacted wisdom teeth can cause no symptoms in the short or long-term for some individuals, signs of a problematic wisdom tooth can develop at any time which negatively affect that patient’s quality of life, such as:

  • Severe pain around the impacted tooth, jaw and lower face
  • Swelling of the gum and/or face
  • Difficulty chewing
  • Aching in the back of the mouth
  •  Persistent bad breath or bad taste in the mouth

What To Expect During a Wisdom Tooth Extraction

What To Expect During a Wisdom Tooth Extraction

Initial consultation

Whether you attend Truly Dental with pain from a wisdom tooth or in the surrounding teeth or jaw, or if your appointment is for a routine dental check-up - your dentist will carry out a comprehensive dental exam to assess your risk of wisdom tooth problems both now and in the future. They may take some dental X-rays to get a better idea of the position and shape of your tooth and to determine if any damage, decay or misalignment has occurred to the adjacent teeth.

Following this examination your dentist will discuss with you the best course of treatment for both your wisdom tooth itself and any related issues, and will also address any questions or concerns you may have regarding the recommended procedure and your treatment options, including discussing conscious IV sedation with you at that time if appropriate for you 

During the procedure

Your dentist will ensure that your gum and tooth are completely numb using local anaesthetic, ensuring you will experience absolutely no pain before they begin any treatment.

If your wisdom tooth or teeth have grown in straight, then the removal procedure is fairly straightforward. Your dentist will be able to let you know this right away, as they can successfully remove the teeth using standard dental tools and surgery will not be required.

However, in most cases the angle at which the wisdom teeth have emerged does mean that the teeth are impacted (not fully erupted from the gumline) – in that majority of cases the wisdom teeth will have to be removed surgically.

We can guarantee that you will feel little more than some pressure throughout the procedure once the anaesthetic has been administered.

 To complete a surgical extraction your dentist will:

  • Cut an incision in the gum to expose the tooth and bone
  • Remove some bone to loosen the tooth root
  • Split the tooth into sections
  • Extract the tooth
  • Clean the site
  • Stitch the wound closed to facilitate healing
  • Apply gauze over the wound to control bleeding

After the procedure

If you receive dental sedation it will be necessary for a designated, responsible adult to accompany you to your appointment, as they will also be required to escort you home from the clinic as well as take care of you for the 24 hours following the procedure.

You (and your escort, if applicable) will be given full aftercare instructions by your dentist, who will likewise advise you to rest for the remainder of the day.

Common symptoms after a tooth extraction include swelling, bleeding, bruising and pain at the surgical site, and these may last for up to 48 hours. The body’s natural healing processes begin almost immediately following the procedure, and your dentist will also give you comprehensive instructions to promote and aid healing after your treatment, and it can take in total a week or two following your appointment to fully recover.

To help you prepare for your immediate needs following a wisdom tooth extraction, your dentist’s aftercare instructions are summarised below:

Rinse

To prevent infection you should gently rinse your mouth after meals using warm, salty water. You should start to do this the day after treatment

Food

Avoid alcohol, hot drinks and very hard or chewy foods. A soft diet is recommended to reduce discomfort when eating, and limiting alcohol and hot drinks will aid in recovery and reduction of any post-surgical bleeding at the extraction site

Bleeding

Some very mild bleeding is expected after your extraction. If you experience more persistent bleeding following your appointment you should apply damp gauze to the area for 30 minutes

Pain relief

Your dentist will provide you with a dental prescription - you should take this exactly as directed to significantly reduce any discomfort and to promote healing

Questions? Answers?

What could happen if I don’t get my wisdom teeth removed?

When your dentist is carrying out a regular check-up, or an examination to investigate any recent pain or changes to your oral routine, part of this will involve a check to ensure that any wisdom teeth you have are growing in straight, that they are erupting through the gums normally, and that they are positioned in such a way that they don’t impact on your other teeth, your bite, or your ability to clean adequately around those teeth.

Some patients are lucky enough to never experience any problems arising from their wisdom teeth, so if this is you, you may be fortunate enough not to ever need your wisdom teeth taken out, as long as you are attending your dentist for a regular check-up on the recommended 6-monthly schedule and making an appointment if you feel any new pain, toothache or discomfort in your jaw, lower face or sinuses.

However, if your dentist finds on examination that an impacted wisdom tooth is causing problems for surrounding teeth, is showing signs of decay or a site of disease or other issues for your overall oral health, then they may recommend removal to correct these problems and prevent worsening or future problems. In these cases, it is always better to listen to the advice of your dentist regarding removing the wisdom teeth rather than risk complications, misalignment of your overall bite and the rest of your teeth, or recurrent infections, cysts and increased vulnerability to tooth and gum decay.

Is there a recommended age to have wisdom teeth removed?

Wisdom teeth are easier to remove in patients who are in their teens or early twenties, shortly after emergence of the new teeth, as the roots have not fully developed by this stage. While some wisdom teeth, even impacted teeth, can be managed simply through observation by your dentist and an excellent oral hygiene routine, some may show signs of developing problematically at a future stage even if not currently symptomatic, and in those cases your dentist will recognise and discuss with you the risk of future problems and recommend removal of the wisdom tooth or teeth. 

What is an impacted wisdom tooth?

This refers to a wisdom tooth that has not emerged fully from the jaw bone through the gum line into the mouth, and remains partially or completely buried in the soft tissue of the gum or in the jaw bone itself. Because their placement and inaccessibility mean they cannot be sufficiently kept clean even with a thorough oral hygiene regime, impacted wisdom teeth carry a greatly increased risk of tooth decay and developing gum disease – although rarer, cysts can even develop around infections caused by tooth decay of irregularly shaped, impacted teeth.

 Impaction is quite a common outcome for wisdom teeth growing in, as there is generally not enough space for them to grow into fully in a typical mouth, and so they are very prone to becoming impacted, or developing complications for the surrounding teeth if they do continue to erupt fully into the mouth and push and misalign those adjacent teeth, or indeed both.

What risks are involved in wisdom tooth extraction?

The vast majority of wisdom tooth extractions carry no long-term complications at all, and our highly-skilled dentists have undertaken intensive additional training specifically in wisdom tooth extraction, including complex or difficult cases, to ensure they are fully experienced and prepared to surgically remove any wisdom tooth without stress.

However, while they can be mitigated with skill and experience, as with any surgical procedure certain risks can never be 100% ruled out. Removing a wisdom tooth is still in the majority of cases a surgical method of tooth extraction, as an incision in the gum line must be made and a small amount of bone removed along with the tooth. 

Rare complications of wisdom tooth extraction can include:

Dry socket; when the bone and nerve endings at the surgical extraction site become exposed due to the blood clot (which forms a protective barrier at any surgical wound site) not forming properly, or becoming dislodged during aftercare from the wound site on the gum (the ‘socket’.) Risk factors which can contribute to the chance of developing dry socket following any tooth extraction include: smoking, as well as other tobacco products and other suction consumables, including the use of straws following surgical dental work; having a recent or active tooth or gum infection in the area around the extracted tooth; taking certain oral contraceptives, as high estrogen levels have been linked to a disruption of normal healing processes such as clot formation; and a history of dry socket in the past.

 Following your procedure, your dentist will go through the correct aftercare guidelines with you in detail, including advised hygiene methods to employ to decrease your risk of developing dry socket – you will also be advised of what to look out for following your treatment, as in most cases dry socket is extremely painful, and cannot be managed with OTC pain relief alone. Always contact Truly Dental for a follow-up if you are in a lot of pain, or notice any of the other signs of dry socket, following a tooth extraction, as your dentist will be able to see you very quickly to provide a prescription to get you out of pain, and a dressing to protect the socket until it has healed naturally.

Infection in the socket, often caused by bacteria or trapped food particles getting into the socket following the loss of the blood clot; apart from the exposure of your nerve endings if you experience dry socket, the pain of dry socket is often made worse by the unprotected ‘socket’ being vulnerable to trapping food, leading to further pain from a gum infection, and in some cases an unpleasant smell. It is very important to follow your dentist’s aftercare instructions exactly following your wisdom tooth extraction, particularly if your dentist has informed you of any trauma to the area or complications identified during your extraction, to minimise your chances of developing dry socket or a subsequent infection. And again, it is vital to contact the clinic if you have severe pain more than 2-3 days following a tooth extraction, as, while painful, a dry socket is not a serious complication provided you re-attend your dentist to ensure there is no infection taking place, and to be prescribed strong antibiotics if that is the case.

Nerve injury; a rare risk of wisdom tooth extraction, and dependent on the positioning of an impacted wisdom tooth. Because of the position of the wisdom teeth behind the molars, they are the closest teeth to touching a major facial nerve, sections of which run throughout your face along your lower jaw, and complex extractions, generally of impacted wisdom teeth, can sometimes bruise that nerve. Your dentist will be able to prepare you for this possibility following your pre-treatment X-Rays and once your procedure is complete, if there was a greater risk of nerve damage complications from the extraction of your wisdom tooth.

Bruising or damage to the nerve can cause numbness or a tingling sensation to the tongue, lower lips, chin, teeth and/or gums, and sometimes some pain. Nerve injury damage is usually temporary, lasting for a few weeks or months following a wisdom tooth extraction, although in severe cases of damage it can be permanent. A nerve injury of this type can interfere with day-to-day activities such as chewing or drinking, due to issues with altered sensation, however it will not cause any weakness or loss of mobility to the area.

Why do I have to have X-rays taken before wisdom tooth extraction?

If you are experiencing pain, swelling or recurrent issues which may be caused by your wisdom teeth, or if your dentist identifies a cause for concern during a check-up, the recommendation to have the problem tooth extracted, particularly if the tooth is impacted, is still a surgical recommendation and cannot be made lightly. Your dentist will need to take X-rays to ensure that a full picture of your exact situation is available for evaluation, both to determine whether removing the wisdom tooth or teeth is the best option for you, and also to provide a full view of the position and angling of the teeth. This is not only necessary preparation for the successful completion of any surgical procedure, but will also allow your dentist to best advise you regarding likely complications or risk factors in your particular case.

Will I feel any pain during wisdom tooth extraction?

No, absolutely not - you will always receive an anaesthetic to numb all pain from the procedure before anything begins. What kind you receive will depend on the complexity and the length of the planned removal – a local anaesthetic is generally sufficient for most patients for an extraction of one wisdom tooth, but your dentist will discuss this and other sedation options with you fully during your initial consultation, as in some cases (for example, the extraction of all four of a patient’s wisdom teeth at once) a general anaesthetic may be advised.

Should I be sedated for a wisdom tooth extraction?

This is entirely up to you, however following your initial examination and any X-rays, your dentist will discuss with you in full your planned wisdom tooth extraction, including how long the procedure is expected to take, and will be happy to answer any questions in advance of the surgical appointment to help you decide if undergoing the extraction under conscious sedation might be right for you. You will still always receive an anaesthetic to numb all pain from the procedure whether you also decide to be sedated or not.

Patients choose to undergo dental treatments under IV sedation for a number of reasons, including general fear or anxiety surrounding dental procedures or of previous bad memories of dental work, and as a way to comfortably undertake lengthier amounts of work during a single appointment. Quite a lot of patients prefer to be sedated during surgical procedures such as an impacted wisdom tooth extraction, as IV sedation, that is administered through a vein in your arm, will make you feel completely calm and relieve all worry, anxiety and sense of time passing, while still being able to follow simple directions, and so multiple extractions can be carried out if necessary far more easily and with no added stress to you – once the sedation has worn off you won’t have any unpleasant memories at all of the procedure, and it will feel as though it took no time at all.

More information to help answer any concerns you have regarding IV conscious sedation can be found here

Can I claim tax back on a wisdom tooth extraction?

Yes, in Ireland you can claim tax relief for all non-routine dental care, which includes surgical extraction of impacted wisdom teeth (although routine extractions, ie. non-surgical are not eligible for tax back).

Non-routine dental care in Ireland is tax deductable, meaning you will receive 20% of the cost of your treatment back from the government once you submit a claim through Revenue. You will also need to keep a Form Med 2 receipt of your dental care available for Revenue’s records should they request to see it, which your dental team at Truly Dental will provide you after any non-routine dental treatment.

Does insurance cover wisdom tooth extraction in Ireland?

Most major Irish dental and general health insurance policies contribute towards the cost of wisdom tooth removal. We would encourage you to contact your provider directly to find out the amount they will contribute exactly, especially as this can vary depending on your policy, and whether you require a routine extraction, or surgical extraction of an impacted wisdom tooth. 

You can also still submit a claim to Revenue at the end of each tax year for a tax refund for non-routine dental expenses, even if a portion of your expenses has been paid by your medical insurers. Surgical extractions of impacted wisdom teeth count as non-routine dental care, and so the remainder which you paid yourself for your treatment is tax deductible at a rate of 20% when you submit a claim to Revenue at the end of the tax year.

Why should I choose Truly Dental for my wisdom tooth extraction?

Truly Dental’s oral surgery team have each an additional 2 to 3 years of specialist dental training in routine and complex surgical procedures and extractions, and a wealth of experience using only the most modern equipment and techniques – meaning that when you place your trust and your care in our hands, you ensure that your treatment will be carried out to the highest quality standards of care, expertise and comfort. 

Wisdom teeth coming in for the first time, or starting to give you pain or discomfort?

Call Truly Dental or book your initial consultation with one of our experienced dentists to get out of pain and discuss Wisdom Tooth Extraction today

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