Know These Four Things Before Getting Your Wisdom Teeth RemovedNovember 1, 2017
The idea of wisdom teeth removal can be a scary thing for teenagers and young adults. People often talk about the swelling, the pain, the time off work, school or university which builds up the ‘fear factor’ and because of this they may delay treatment.
It is recommended that most people have their wisdom teeth removed by their early 20’s, when the teeth are erupting through the gums. In some cases, people’s wisdom teeth come through totally fine and they will not need to be extracted. However, ‘impacted’ wisdom teeth are common – this means the teeth are not growing correctly, usually pushing and damaging other teeth.
When not resolved, impacted wisdom teeth can cause issues like:
- Pain and swelling.
- Development of cysts in the jawbone.
- Infection of the gums which can cause pain and bad breath.
- Root resorption of other teeth, making them come loose over time and likely to die at some stage in the future.
- Crowding which may push your teeth out of place, even if you have had orthodontics.
At Laser + Holistic Dental, our dentists recommend that you read this article to understand what is involved in the wisdom teeth removal process – making sure you are informed when it comes to making important decisions about your health care.
1. Know where your wisdom teeth are and what they are doing:
The absolute number one priority before having a wisdom teeth extraction procedure is to have correct, detailed diagnostics done. This would involve an x-ray, or as we prefer at Laser + Holistic Dental, a 3D CBVT scan that provides much more detail than a traditional x-ray.
A CBVT scan creates a 3D image of the head and mouth so the dentists and oral surgeons cannot only see the teeth, but also other related anatomical structures like nerve canals and blood vessels.
Everyone is anatomically different; a CBVT scan allows our team to identify important factors that will influence the wisdom teeth removal procedure such as:
- If the wisdom teeth are pushing and damaging other teeth.
- If the upper wisdom teeth roots are penetrating into the sinus area. In this case, the patient is at increased risk of serious sinus infections following the removal of the wisdom teeth unless treated correctly.
- If the bottom wisdom teeth roots are involved with nerves and blood vessels in the inferior dental canal. This is extremely important as wisdom teeth removals can damage these sensitive areas – leading to long-term complications (more on this later).
When having your wisdom teeth removed – it is best to be proactive. Plan a few months ahead of when you would like to have the procedure done and have your x-rays or CBVT scan well in advance.
2. Is your priority on minimizing anxiousness or a faster recovery time?
There are two main options for having your wisdom teeth removed:
- In hospital under a General Anaesthetic (GA) by a specialist Oral and Maxillofacial Surgeon.
- In the dental chair, usually incorporating some form of sedation.
For very anxious patients:
If you are extremely nervous about visits to the dentist, or about having your wisdom teeth extracted, it is probably best to have your treatment done by an oral surgeon in a hospital setting with a General Anaesthetic. Normally, the oral surgeon will remove all of the wisdom teeth in one appointment.
This means you will be unconscious for the procedure and woken back up when it is complete. Generally, the wisdom teeth removal procedure will take a couple of hours and you will be required to be at the hospital for most of the day. You will not be able to drive, so someone will need to stay with you for the day.
As your mouth will have been held open with a bite-prop – your jaw and mouth will probably be very sore for at least a few days. It is common to have significant swelling and it is not recommended to eat anything other than soft foods for the first few days after treatment.
You will probably need to have a review appointment with your oral surgeon and have the stitches removed about five days after the procedure.
Please be aware that some people cannot tolerate a General Anaesthetic for medical reasons, and if you have a family history of bad anaesthetic reactions – this option would not be available to you.
For patients who care about speed and a quick recovery:
Many patients do not want to take a lot of time off work or university to recover from their wisdom teeth removal appointment. In this case, it is best to have the procedure done in house at Laser + Holistic Dental.
Our dentists will generally split the wisdom teeth removal procedure into two appointments – doing one side of the mouth at a time. This means the treatments are done quickly, and will not stop you from eating relatively normally. By splitting up the procedure - one side of your mouth will be fine for regular chewing and swallowing.
Patients who choose this option will generally book a Friday or Saturday appointment slot so that they can recover over the weekend and be fine for work or university on Monday.
At Laser + Holistic Dental we provide patients with the options of oral sedation and stem cell treatment using Concentrated Growth Factors (CGF). Oral sedation is recommended to minimize any anxiety and the CGF treatment is recommended to reduce pain, swelling, speed up recovery and improve the bone density during healing. This helps to protect and maintain a healthy level of bone around the molar teeth throughout the rest of your life.
3. Be aware of the potential long-term complications from wisdom teeth extractions:
Wisdom teeth removal is a major surgical procedure and should not be taken lightly. There are a number of negative long-term complications that can occur – so it is important to be informed of the risks.
Nerve and blood vessel damage
When the wisdom teeth roots are penetrating into the inferior dental canal, they can be closely involved with major nerves and blood vessels. It is possible that during the removal of the tooth these nerves and blood vessels could be damaged.
If these structures are damaged it can lead to permanent numbness, permanent changes in sensation and possibly severe pain syndromes – which have very limited treatment options.
At Laser + Holistic Dental, we always recommend having a CBVT scan so your dentist and/or oral surgeon can clearly see these sensitive structures when planning the treatment to minimize the risk of these complications.
Risks of bone cysts developing
There is increasing evidence suggesting that wisdom teeth removal procedures play a role in the formation of jawbone cysts, ‘cavitations’ or ‘NICO lesions’. The cavitation grows when all of the cells haven’t been removed, or perhaps a tooth root was left behind in jaw.
Over time, the cysts create a soft, squishy section in the bone that can harbor serious infections. These infections can be a cause of systemic illness many years after the initial surgery. After an extraction, healthy bone should fill in the extraction socket space within three to four months. If a someone has developed cysts or infections, Laser + Holistic Dental can use peizo ultrasound technology and our lasers to clean out the site, following with a stem cell and alkalizing "bone " crystal mix to regrow healthy bone in the area damaged by the cyst or infection.
To minimise the risks of cysts developing in the first place - the team at Laser + Holistic Dental always recommend our surgical protocol of laser curettage and stem cell/CGF based sticky bone for all tooth extractions, including for wisdom teeth.
4. If you fit into one of these groups - don’t delay treatment:
It is always best to be proactive about health care, and for these populations we recommended that you avoid putting off having your wisdom teeth dealt with due to the increased likelihood of infections in the area.
Teenagers and Young Adults
Teens and young adults are the most vulnerable to a wisdom teeth flare up as the teeth begin to erupt through the gums. As the teeth come through the gums many people will develop pericoronitis, a very bad gum infection caused by bacteria trapped in the flaps of gum surrounding the partially erupted wisdom tooth.
Pericoronitis can be extremely painful, which will often lead to an emergency dental visit to remove the wisdom teeth.
It has become increasingly common for children to have orthodontic treatments, usually finished towards the end of their high school years. This is roughly the same time wisdom teeth will start to become active – as they push through, the wisdom teeth can impact on other teeth creating crowding issues.
In some cases the wisdom teeth will push the other teeth out of alignment, even after orthodontics have been completed. The crowding caused by the wisdom teeth can create a need for further orthodontic treatment which can be an expensive and frustrating exercise - an important reason why teenagers need to be strict about wearing their orthodontic retainers.
High Stress Lifestyle
A high paced, high stress lifestyle does come at a cost to the body – triggering increased cortisol levels which suppresses the immune system and increases the likelihood of becoming sick, or in this case – developing an infection in the wisdom teeth area.
With a suppressed immune system, harmful bacteria can build up in the gum and bone surrounding a partially erupted or impacted wisdom tooth. This can become extremely painful in a short amount of time, triggering the need for an emergency extraction.
It is always best to avoid the need for emergency treatments, so if you cannot afford down time to recover from wisdom teeth surgery it is recommended to have them assessed and removed if needed as soon as possible.
Living or working or travelling to remote areas
For those who live or work in remote areas, or for people travelling to an exotic and remote destination, access to high quality health care, especially in an emergency situation can be a challenge.
If your wisdom teeth have started erupting, please plan ahead to have appropriate diagnostic scans, have your wisdom teeth assessed and organize the necessary treatment before it becomes an emergency.
People planning a pregnancy
Pregnancy is a massive stress on the female body – triggering a host of hormonal changes, one of which contributes to increased risk of gum disease.
With the gums being vulnerable, it is possible that painful cases of pericoronitis can develop. Pain and the need for emergency treatments have the potential to impact on a pregnancy and should be avoided wherever possible.
If you are planning a pregnancy, please have your wisdom teeth assessed and appropriate treatment completed before conceiving to avoid any potentially risky procedures down the track.
People with medical conditions
For people with certain medical conditions, it is important to treat problematic wisdom teeth as soon as possible. Conditions like osteoporosis, Paget's disease, multiple myeloma, breast and prostate cancer are often treated with bisphosonate bone medications. A side effect of using this medication is that a very serious, painful and untreatable condition called Osteonecrosis of the jaws (ONJ) can develop following dental extractions.
For those who are about to undergo chemotherapy and/or radiotherapy, it is recommended to complete the wisdom teeth surgical process, along with any other dental procedures in order to be fully healed and be declared dentally “fit” prior to starting medical management.
The body undergoes a huge amount of stress during chemotherapy and radiation therapy. Often there is oral ulcerations and gum, teeth and bone infections may develop at a greater rate due to a suppressed immune system. Prioritizing dental treatment before embarking on cancer therapy help reduce these complications and frequent professional oral hygiene maintenance is recommended throughout cancer therapy.