Wisdom teeth are the third and final molars on each side of the upper and lower jaws. They are the last teeth to erupt and usually come through when a person is in their late teens or early twenties.

When should my wisdom teeth be removed?

Contrary to popular belief, wisdom teeth do not need to be removed. If they grow through straight and healthy, they can be a valuable asset to the mouth. However, as they’re the last teeth to erupt, there is often not enough room left in the mouth to accommodate them. When this occurs, wisdom teeth can become impacted (meaning they’re unable to fully erupt and are kept below the gum line), causing pain, tenderness and often infection. Wisdom teeth fighting for room can cause misaligned issues, and overcrowding which affects the front teeth. This can be rather daunting to someone who has undergone orthodontic treatment to achieve a straight smile.

Reasons why people have their wisdom teeth removed:

• When they’re unable to erupt normally and remain impacted within the jaw. This can lead to infection, cysts, damage to other teeth roots and the jaw bone.
• They only partially erupt. This is often painful, making them difficult to clean, and can lead to gum disease and oral infection.
• Crowd nearby teeth. If they do not have enough room to erupt properly, they may crowd or damage other teeth.
• If they grow through rotten.
• If they’re difficult to clean. This could lead to not only the damage and loss of the wisdom teeth, but the neighboring tooth too.
• If they’re causing sinus pain or congestion.
• If they’re causing too much pain or discomfort.

What to expect before and after wisdom teeth removal?

The wisdom teeth extraction procedure will vary depending on the placement and condition of the teeth. For example, wisdom teeth that have fully erupted and are being removed due to cleaning difficulty, or because they have caused crowding, is a much simpler and less invasive procedure than someone having theirs removed due to impaction. For severe cases, where the teeth are still impacted in the bone, the patient is likely to be put to sleep and the procedure carried out at a hospital. Whereas, a minor case can be performed in the dental chair under local anesthetic.

Here is a general outline of what you can expect during the wisdom teeth removal procedure:

1. The dentist will first conduct an oral examination to determine the level of complication and what removal procedure to follow.
2. Using either local anesthetic, sedation, or general anaesthesia (or a combination), the dentist will numb your mouth and/or suppress your consciousness during the surgery.
3. Depending on the level of eruption or severity of the impaction, the dentist will either remove the tooth or create an incision in the gum to expose the tooth and bone before removing it.
4. Any bone blocking access to the root of the tooth will need to be removed.
5. In situations where the tooth root is strong and/or the removal is difficult, the tooth may be divided into several pieces.
6. The extraction site is cleaned to prevent infection.
7. The site is stitched up, usually using dissolvable stiches.
8. A gauze is placed over the extraction site to reduce and stop any bleeding and assist the formation of a blood clot.
9. The dentist will outline how to prevent dry socket from occurring and how to care for your healing gums.

How much does wisdom teeth removal cost?

The cost of a wisdom tooth extraction varies between patients, as it is dependent on the degree of impaction. The cost is per tooth and can range from as little as $75 to $800+. If the wisdom teeth are severely impacted (still situated within the jaw bone) and general anesthetic is required, there will also be the additional fees of the anesthetist and the hospital stay. However, costs can often be offset by dental and medical insurance. The best way to find out how much wisdom teeth removal is going to cost, is by making an appointment with your dentist. After a consultation and oral examination, they will be able to give you a personalised quote.

Factors that will influence the cost of wisdom teeth extraction:

• Is the wisdom tooth impacted?
• Has the wisdom tooth erupted?
• What is the degree of impaction/eruption?
• What position is the tooth lying in? i.e. are they at an angle?
• Was the tooth easily removed, or was further breaking up required?
• Was sedation required?
• What level of sedation was required?
• How long did the process take?
• Do you have dental insurance?

 
Contact South Street Dental today and request an appointment to have your wisdom teeth examined by one of our dentists.

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Warfarin treatment does not automatically mean you can’t have teeth removed or undergo dental implant treatment. Indirectly though, surgery for anyone on blood thinners can be more complicated because blood will not clot normally and bleeding could be more difficult to stop.

However, tooth removal is usually considered minor oral surgery, especially with a minimum of trauma in careful and experienced surgical hands.

The surgeon who assesses your condition should work with your medical doctor to determine the risk and monitor your Warfarin dosage appropriately. Maintaining or reducing your dosage to accommodate minor oral surgery will depend on what condition you are taking the thinners for and the type of surgery you need.

Your medical doctor may reduce your Warfarin dosage based on the PT/INR levels, which together with local treatment (ie stitching) will ensure that you have sufficient ability to stop bleeding and heal well. The key is communication between you, your doctor, and your dentist. It is not considered safe for you to stop Warfarin completely without your doctor’s approval.

For the surgical procedure, your dental surgical specialist will take special precautions to help insure blood clotting and healing after surgery. These include treatment of the surgical site with special haemostatic agents which helps stabilize a blood clot, carefully suturing the gum tissues to reduce the surface area of the wound opening, and putting pressure on the wound edges to prevent the capillaries (tiny blood vessels) from bleeding excessively. It is also common practice to place a bone graft into an extraction socket to replace bone volume, especially important if you are contemplating implant tooth replacement.

This graft procedure may reduce the amount of bleeding.

Good pain control and anti-inflammatory medication, together with rest and avoidance of vigorous activity or aggressive irrigation of the wound will all help ensure a comfortable and safe recuperative period.

We will always give you aftercare instructions and provide you with after hours contact details should any concerns arise. You will usually be able to resume Warfarin (or aspirin for those who take it) afterwards under the direction of your doctors.

Be sure to consult with both your physician and dentist or surgical specialist even if you think you are on a low dose of blood thinners.

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There are some good reasons for early surgical intervention. The ease of removal is optimal before the wisdom teeth roots have fully formed, before they extend closer to the nerves. In the younger patient, the jawbone is softer, and recovery is quicker. (Most private health funds will cover wisdom teeth extraction surgery fee for patients below 18 and still under their parent’s policy.)

If removal of otherwise trouble-free wisdom teeth is not justified, then these young patients are exposed to the risks of anaesthesia and surgery. Patients, their parents and dentist should discuss whether to keep symptom-free wisdom teeth until (and only if) issues develop.

However, statistics show that 60% of these symptom-free wisdom teeth end up developing gum disease or cavities due to their position in the mouth. Surgery to remove wisdom teeth after disease has taken hold may add complications to recovery. In addition, fully developed wisdom teeth, after the age of 25, have large roots that are notoriously close to the nerves of the jaw.

However, most dentists now agree that wisdom teeth that are completely erupted and functional, painless, cavity-free, in a hygienic environment with healthy gum tissue should be OK to keep – on the condition that it is monitored by regular exams and X-rays.

Still, those healthy teeth pose a dilemma, because there’s no hard evidence on whether it’s better to remove or retain them. Immediate surgery on a young patient has risks. About one in 20 patients develop an infection, one in 100 has hard-to-control bleeding and another one in 100 loses some feeling in the lips or tongue, usually temporarily. There are also risks and concerns with regards to general anaesthesia, if used.

Keeping wisdom teeth until issues arise may mean a more complicated surgery later. It also means spending time and money on regular exams and X-rays. The problem is that no one can predict which teeth will stay healthy.

Given that unpredictability, the best course is leaving healthy teeth alone, especially since some impacted teeth will eventually emerge.

Regular exams will detect swelling, bleeding and other signs to diagnose gum disease around any tooth. When those signs appear around wisdom teeth, it is worth consulting also with a periodontist about whether the best course is extraction or other treatments, such as medication and trimming of tissue around the teeth.

Most dentist recommend extraction when signs of gum disease are present. In our experience, even when wisdom teeth are healthy, less than half our patients choose to keep them.

Every patient is unique, our dentists will educate and discuss all options in the management of wisdom teeth. Removal may not be necessary in some cases as long as a monitoring system is in place.

The post Wisdom teeth – to keep or not to keep? appeared first on South Steet Dental.

Though most of us would like or need them out at some stage, there is something special about them. The dental pulp of wisdom teeth contain stem cells which researchers claim can be used to make neural, bone and other cells.

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Read more on ScienceLine

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