Article by Dr Angela Ngauw, General Dental Surgeon, BDS (S’pore)
Wisdom teeth are part of the normal complement of 32 adult teeth and are also known as the third molars. They are usually the last adult teeth to appear in the mouth and they normally appear during the late teens to early twenties. Most people will have all 4 wisdom teeth but, it is not uncommon to have fewer or even none at all.
How do I know if I have wisdom teeth?
There is often discomfort associated with the eruption of the tooth into the mouth. This may be followed by gum swellings around the tooth, or food trap in the area. Conversely, some patients have no symptoms at all, and the wisdom teeth are only discovered during routine dental checkups and X-rays.
An X ray showing impacted wisdom teeth
Do all wisdom teeth give problems and need to be removed?
Wisdom teeth which have erupted completely into the mouth and have proper access for cleaning usually do not present with problems. However, wisdom teeth which are partially erupted or impacted (blocked from erupting completely) with poor access for cleaning will present problems such as pain, gum swellings, food trap and tooth decay. For wisdom teeth presenting such problems, removal is recommended.
Impacted wisdom teeth can sometimes present pathological changes, such as cysts. Cysts associated with impacted wisdom teeth can grow to large sizes without presenting any signs and symptoms. As such, if one chooses not to remove an impacted wisdom tooth, regular reviews through X-rays are advised.
Cyst associated with buried wisdom tooth
Do all wisdom teeth need to be removed by surgery?
No, wisdom teeth which are erupted normally or minimally impacted can be removed without surgery. However, buried or more severely impacted wisdom teeth would require surgical removal. Your dentist will need to examine and take X-rays of the tooth in order to advise you.
What can I expect during wisdom teeth surgery?
There are several options for removal of wisdom teeth: under local anesthesia, general anesthesia, or sedation.
Most patients usually undergo removal of wisdom teeth under local anesthesia. For removal of teeth under local anesthesia, an injection would be given to numb the area prior to surgery. A small cut would be made on the gums and some bone around the tooth would be removed. The wisdom tooth itself would usually also need to be divided into smaller pieces to facilitate its removal. After the tooth has been removed, stitches would have to be placed to close up the wound. Necessary medications would be given for relief of pain post operatively. A review would be arranged in 1 week to monitor healing and for the removal of the stitches.
What are the complications of wisdom tooth surgery?
Possible complications of wisdom tooth surgery include infection, broken roots which cannot be retrieved, possibility of damage to surrounding vital structures eg nerves, and sinus perforation. However, these complications are relatively uncommon.
How long does it take to recover from wisdom teeth surgery?
Most of the discomfort occurs within the first 2-3 days. Most patients are generally well and can resume their normal activities in 1-2 weeks.