Microsoft word - wisdom teeth
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Why do we have wisdom teeth?
Adults can have a maximum of 32 teeth. The wisdom teeth are the last to come though, right at
the back of your mouth. They usually appear between the ages of 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 they always cause problems?
No. If there is enough room they will 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?
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.
Your dentist will advise you whether this is a temporary problem that can be dealt with by using
mouthwashes and special cleaning methods (and possibly antibiotics), or whether it is better to
have the tooth removed. What can I do to help myself?
A mouthwash of medium hot water with a teaspoon of salt will help to reduce gum soreness and
inflammation. (Check that it is not too hot before using it). Swish the solution around the tooth,
trying to get it into the areas your toothbrush cannot reach. An antibacterial mouthwash such as
Corsodyl can also be very useful to reduce the inflammation. Pain-relieving tablets such as
paracetamol or aspirin can also be useful for short-term use, but consult your dentist if the pain
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. Are radiographs (pictures) needed?
The dentist will usually take radiographs of the teeth to see the position of the root, and to assess
whether there is room for the tooth to come through into a useful position. What are the main reasons for taking wisdom teeth out?
When it is clear that the wisdom teeth will not be able to come through into a useful position
because there is not enough room, and when they are also causing some pain or discomfort.
If they have only partially come through and are decayed – such teeth will often be
susceptible to decay as it will be difficult to clean them as thoroughly as your own teeth.
If the wisdom tooth is causing a cleaning problem and has no real use.
If a wisdom tooth starts to ‘over-grow’. This often happens if the lower one has already been
removed or is impacted and cannot come through, and the upper one has no tooth to bite against. The upper one will come down too far, looking for a tooth to make contact with.
Are wisdom teeth difficult to take out?
It all depends on the position and the shape of the roots. Your dentist will advise you as to how
easy or difficult each tooth will be to remove after looking at the radiographs. Upper wisdom teeth
are often more straightforward to remove than the lower ones, which are more likely to be
impacted. Your dentist will advise you whether the tooth should be taken out at the dental
practice, or whether you should be referred to a specialist (oral surgeon) at the hospital. Very
occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth –
your dentist will tell you of the level of risk in your case.
Either local anaesthetic – as you would have for a filling – or sedation, will probably be
recommended. A general anaesthetic (when you would be asleep) can also be used, but this will
only be given in a hospital in exceptional circumstances. Will it make any difference to my face or mouth?
Removing wisdom teeth may produce some swelling for a few days but as soon as the area is
healed, there will be no difference to your face or appearance. Your mouth will feel more
comfortable and less crowded, especially if the teeth are impacted. 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 will be given about mouthwashes, etc, to help with the healing. Some people also find
homeopathic remedies helpful in reducing discomfort. Usual pain-killers such as paracetamol,
aspirin or ibuprofen will usually deal with any pain. It is best to stay fairly quiet and relaxed for 24
hours afterwards to make sure 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. What does it cost?
Any hospital treatment is free. In general practice it is free if you are under 18, or exempt from
NHS charges. Otherwise the cost depends on what is involved. It is important that you discuss
costs and payment methods with your dentist before starting treatment.
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