Wisdom teeth 

A consultant oral and maxillofacial surgeon explains why people have problems with their wisdom teeth, the treatments available and the important things to ask before treatment.

Read more about wisdom tooth removal

Transcript of Wisdom teeth

My name is Carrie Newlands

and I'm a consultant oral and maxillofacial surgeon

at the Royal Surrey County Hospital in Guildford.

If you think your wisdom teeth are giving your problems,

talk to your dentist to see whether you need to have them removed

and also if you need to be referred to hospital to have that done.

The wisdom teeth are the last teeth to come through,

and as such they often get stuck because the jaw runs out of room.

If they do get stuck, they become difficult to clean,

and that can lead to problems

with infection around the gum or decay in the teeth.

Those are the two most common reasons

why people end up have their wisdom teeth taken out.

If I were a patient, I would want to know

how many wisdom teeth do I need to have removed,

do I need to have them taken out under local or general anaesthetic

and whereabouts would I have that done if I needed to have it done.

I'd also want to know

what risks there were associated with the operation for me.

I would also like to talk somebody

about whether I would need time off work afterwards.

There are horror stories about wisdom teeth being removed.

When people know they're having their wisdom teeth out,

they will be told lots of things about how awful it's going to be.

Some wisdom teeth can be taken out at the dentist's,

but other people need to see a specialist surgeon at the hospital.

In this country, most wisdom teeth are removed

by oral and maxillofacial surgeons in hospital units.

If your wisdom teeth are removed under local anaesthetic,

it shouldn't be painful at all.

A local anaesthetic is an injection into the gum to make the area numb,

but you will feel some noise from the drilling

and you will also feel pressure as the wisdom tooth's taken out.

If you're having your wisdom teeth out under general anaesthetic,

that will be done at hospital, usually on a day case basis.

You go in in the morning or afternoon and go home later the same day.

If a wisdom tooth isn't terribly stuck, sometimes, it can be taken out simply.

If the gum is sitting partly over the tooth

and the tooth is stuck underneath some bone,

then we usually need to fold the gum back on the tooth

and sometimes drill some bone away around the tooth.

More difficult wisdom teeth have to be divided with the drill

and cut into smaller pieces in order to make the removal easier,

and then the gum is stitched back with some dissolving stitches.

There are some risks associated with having wisdom teeth out.

It's usual for your mouth to be sore for up to a week afterwards

and it's quite common for there to be some swelling,

particularly around the cheeks, and sometimes some bruising.

There'll be some stiffness of the jaw,

so it'll be difficult to open your mouth,

but that normally comes back to normal within a week or so.

One important risk associated with having wisdom teeth taken out

relates to a couple of nerves which run in and near the jawbone

which supply the feeling but not the movement

to the lower lip and chin and also one which goes to the tongue.

These nerves can get bumped or bruised when a wisdom tooth is removed,

and that can result in a feeling of numbness or tingling

in the lower lip, chin or tongue afterwards.

That's quite uncommon, and if it does happen,

it usually comes back to normal, but in rare cases it can be permanent.

So that's something that's important to talk to your surgeon about

as to what the risks might be in your own particular case.

Afterwards it's important to take it easy.

Be aware that you might need to recover for up to a week or so

and, if necessary, take some time off work.

It's a good idea to keep your mouth clean, so do use a toothbrush.

You're likely to have some dissolving stitches,

so brush carefully around those,

but it is important to keep the area clean,

and it's a good idea to use an antiseptic mouthwash

or sometimes simply a hot salt mouthwash will work very well.

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