
Oral & Maxillofacial
Surgical Removal of Impacted / Wisdom tooth
Wisdom teeth usually come in around the age of 17-25. Impacted wisdom tooth refers to the condition that the tooth will be blocked from erupting completely in the mouth by the permanent second molars or the surrounding bone and gums due to the smaller jaw space.
The impacted wisdom tooth needs to be removed as they are causing infection, swelling of the face, severe pain, and temperature. For some more complex situations, they will cause gum problems and cavities of the teeth in front.
The standard treatment for impacted wisdom teeth is minor oral surgery to remove the wisdom. As the location of the impacted wisdom teeth is close to blood vessels and nerves, it is better to have the treatment done by experienced dentists or oral maxilla-facial surgeons, some patients may need to have a coronectomy treatment to avoid damaging the nerves.
Where are wisdom teeth located?
Wisdom teeth, also known as third molars, are the teeth located at the back of the mouth, behind the second molars. Most people develop four wisdom teeth, two on the upper jaw and two on the lower jaw, although some people may have fewer or none at all.
Due to their tendency to cause problems, many dentists recommend removing wisdom teeth before they cause issues. However, if they are healthy, fully erupted and properly positioned, they can be kept and maintained like any other teeth with regular brushing, flossing, and dental check-ups. Your dentist or oral surgeon can evaluate your wisdom teeth and determine the best course of action for your individual situation.
Problems caused by impacted wisdom teeth
Wisdom teeth impaction can cause various oral problems, usually occurring in the lower jaw. The tooth crown of wisdom teeth can cover the gums and food residues and bacteria hidden between teeth. If not properly cleaned, it can lead to decay of the wisdom teeth and adjacent teeth, making the periodontal tissue prone to inflammation (periodontitis), and the wound difficult to heal. This condition not only causes pain for the patient but also presents symptoms such as swollen and painful gums around the wisdom teeth, bad breath, swelling of the lymph nodes in the lower jaw, and difficulty opening the mouth and pain while swallowing. To avoid causing various oral diseases, wisdom teeth extraction surgery is recommended.
The surgical procedure for removing wisdom teeth typically involves the following steps:
Before the surgery
The patient will undergo an X-ray and a dental evaluation. The dentist will explain the entire wisdom teeth extraction procedure to the patient and ask the patient to sign a consent form.
Anesthesia
The dentist will use local anesthesia or general anesthesia to numb the tissues surrounding the patient's mouth.
Opening the gums
After the anesthesia takes effect, the dentist will use a mouth retractor or other tools to carefully cut or push aside the tissues surrounding the gums to expose the wisdom teeth that need to be removed.
Removing bone
If the wisdom teeth are not fully erupted, the dentist may need to remove part of the gum or bone to fully expose the wisdom teeth. The dentist will use an electric saw or other tools to divide the wisdom teeth into several pieces and remove them one by one.
Removing the wisdom teeth
Once the wisdom teeth are fully exposed, the dentist will use special tools such as forceps and mallets to gradually push the wisdom teeth out of the socket. The dentist may need to use some force to ensure the wisdom teeth are completely removed.
Suturing
The entire surgery usually takes between 30-60 minutes. After the surgery, the dentist will suture the gums to promote wound healing and reduce the risk of bleeding. During the suturing process, the dentist may use absorbable sutures to eliminate the need for suture removal.