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Wisdom teeth cause problems in many people from their teenage years, and are a common reason for a complex tooth extraction. Mr Karim Hussain explains why it is best not to delay treatment of these problems.

About Dr Karim Hussain

Dr Karim Hussain is a Senior Consultant oral and maxillofacial Surgeon with over 20 years of experience treating conditions of the mouth, face, jaws, neck & teeth.
View Dr Karim Hussain’s full profile

Graphic showing an impacted wisdom tooth alongside two regular teeth

WISDOM TEETH OFTEN CAUSE PROBLEMS

Wisdom teeth usually come through between the ages of 18 and 25. For some people, they cause few problems, but others experience a great deal of discomfort.

The problems arise when the teeth fail to come through at all, because:

  • the jaw is too small to allow them room to erupt
  • the only partly erupt through the gum tissue

Some patien ts have completely impacted wisdom teeth. This is when their molars are being pushed upwards but are covered by bone so cannot break through.

In other patients the teeth are at an angle and they come partially through the gum. The jaw provides just enough room for them to pierce the surface of the gum but then they get stuck. The gum often becomes sore, ulcerated and infected, and an abscess can form.

This continues for some time, causing pain and swelling at rhe back of the mouth, which  can lead to the healthy teeth just in front of the wisdom  teeth becoming damaged.

THE RISKS OF DELAYING WISDOM TOOTH EXTRACTION

I often see people in their late 20s or older who need wisdom tooth extraction to remove the partially erupted impacted teeth that have made it difficult to maintain oral hygiene.

In many cases, this has resulted in decay not only in the wisdom tooth but also in the molar immediately next to the wisdom tooth.

This makes it necessary to treat the molar tooth as well; some decayed molars can be filled but many need to have root canal treatment or have to be extracted together with the wisdom tooth.

“Problem wisdom teeth can affect the teeth adjacent to them because their position prevents the patient cleaning them properly. If the problem is ignored, the wisdom teeth and the next molar tooth along can both become decayed.

It is not always a good idea to wait to see if problems occur with the wisdom teeth. Having them removed early can help prevent losing more teeth than you need to.

People who leave their wisdom teeth longer than they should also experience a slower recovery after the operation to remove their wisdom teeth because the jaw bone is more pliable in the late teens and early 20s. As you get older it becomes more difficult to get the teeth out, and recovery may not be as quick afterwards.

More rarely, problem wisdom teeth left in place stimulate the formation of large cysts within the jaw. These can involve much of the jaw bone and when they need to be removed along with the wisdom tooth, this is a much more complex operation.

Anaesthetic choice for wisdom tooth extraction

I believe that wisdom tooth extraction and the ancillary dental treatment required to sort out adjacent teeth should be done as gently and sympathetically as possible.

For patients having all of their wisdom teeth out, The London Clinic offers a general anaesthetic and that is what many people seem to prefer. They really do not want to be aware of it as it is happening!

There are some patients who prefer a local anaesthetic and we can certainly offer this to someone who prefers to remain awake and can also combine the local anaesthetic with sedation as this makes the experience less stressful.

Whatever form of anaesthetic is used, the procedure is usually done in the morning and the patient can leave for home in the afternoon. It is rare that someone needs to stay in The Clinic overnight.

Other oral and dental surgery available at The Clinic

Dental implants to replace teeth that have been removed or lost through trauma are an option.

Many people prefer to have a natural and permanent dental implant rather than putting up with the daily inconvenience of dentures, and they feel more confident in social situations, particularly where eating and drinking is involved.

The dental implants that we use have a titanium base that is implanted into the bone of the jaw in a relatively short operation. This bonds with the bone and stops the jaw deteriorating; we then attach small posts to the implant that stick up through the gum.

These are then used to fix the permanent tooth replacement, which is made to match the patient’s other teeth.

I also treat patients who have lumps such as cysts of the lips, mucoceles (cysts that result from a ruptured salivary gland), polyps in the mouth, mouth ulcers, white patches and red patches.

We have to be very careful with even small lesions in the mouth as they can be a sign that pre-cancerous or even cancerous changes are taking place.

Although cysts are usually not premalignant, white patches, red patches and ulcers need careful evaluation because some white patches and red patches can be the start of cancer.”

Although the patches themselves may seem minor and a general physician may not pick them up, it is a good idea to see an oral specialist to put your mind at rest.

I once had a young patient in his late 20s who had a very small lump in the mouth. He almost cancelled his appointment because he was busy arranging his wedding, planning to move location and working on his career.

The lump turned out to be cancerous and he needed an operation to remove part of his top lip, with reconstruction at the same time. This was major surgery, but we did manage to catch the cancer early enough, and he has now married and relocated.

Had he waited, it could have been a very different story.

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