Waiting times for extractions on the NHS are variable and may be several months in hospital. At Ashwell Dental Surgery we now have an experienced Oral Surgeon, Mr Bikram Bal , Please call the surgery to make an appointment.

Wisdom teeth

Why do we have wisdom teeth?

Adults can have up to 32 teeth. The wisdom teeth are the last to come through, right at the back. They usually appear when you are between 17 and 25. Although sometimes they appear many years later.

Nowadays people often have jaws that are too small for all 32 teeth – 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly.

Do wisdom teeth always cause problems?

No. If there is enough room they will usually come through into a useful position and cause no more problems than any other tooth.

Often there will be some slight discomfort as they come through, but this is only temporary and will disappear once the tooth is fully in position.

What is an impacted wisdom tooth?

If there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as ‘impacted’.

What problems should I be prepared for with wisdom teeth?

If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. Food particles and bacteria can collect under the gum edge, and it will be difficult to clean the area effectively. This is known as pericoronitis.

This is a temporary problem that can be dealt with by using mouthwashes and special cleaning methods and possibly antibiotics. If the problem keeps coming back, it may be better to have the tooth removed.

What can I do to help relieve the discomfort of wisdom teeth?

A mouthwash of medium hot water with a teaspoonful of salt will help to reduce gum soreness and inflammation. (Check that it is not too hot before using it.) Swish the salt water around the tooth, trying to get into the areas your toothbrush cannot reach. This should be done several times a day. An antibacterial mouthwash containing chlorhexidine can also reduce the inflammation. Pain-relieving tablets such as paracetamol or aspirin can also be useful in the short term, but consult your dentist if the pain continues. These should always be swallowed and in no circumstances be placed on the area.

But if it does not help?

If the pain does not go away or if you find it difficult to open your mouth, you should see a dentist. They will be able to see the cause of the problem, and advise you accordingly. It may be useful to clean around the tooth very thoroughly, and an antibiotic may be prescribed.

What are the main reasons for taking wisdom teeth out?

Far fewer wisdom teeth are now taken out than in the past. If the tooth is not causing problems, your dentist will not want to remove it. They will only remove wisdom teeth:

   • when it is clear that they will not be able to come through into a useful position because there is      not enough room, and they are also causing some pain or discomfort
   • if they have only partly come through and are decayed – such teeth will often decay
   • if they are painful.

Are wisdom teeth difficult to take out?

It all depends on the position and the shape of the roots. Your dentist will tell you how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often easier to remove than lower ones, which are more likely to be impacted. Your dentist will say whether the tooth should be taken out at the dental practice, or whether you should be referred to an oral surgeon. Very occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth – your dentist will tell you if it is possible in your case.

Either local anaesthetic – as you would have for a filling – or sedation will probably be recommended. A general anaesthetic (where you would be asleep), can also be used, but this will only be given in a hospital.

What should I expect after a wisdom tooth is taken out?

The amount of discomfort will depend on how easy the removal of the tooth was. There is usually some swelling and discomfort for a few days afterwards, and it is important to follow any advice you get about mouthwashes etc, to help with the healing. Usual pain-killers such as paracetamol or ibuprofen will usually deal with any pain. It is best to stay fairly quiet and relaxed and avoid smoking and drinking for 24 hours afterwards to make sue there are no bleeding problems. There may be some stitches to help the gum heal over – your dentist will probably want to see you again about a week later to check on the healing, and to remove any stitches.