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Do I need to have my wisdom teeth removed?

About Wisdom Teeth

Wisdom teeth usually start to grow between the ages of 17 and 25. They are the third molars located at the end of gum. It is very common to see people born with one or more missing wisdom teeth.

When the dental arches do not have enough space to accommodate the wisdom teeth, or the wisdom teeth grow at wrong positions or angles, the wisdom teeth cannot fully grow and become impacted. They may cause a series of problems, including pain, gum abscess, bad breath, swelling in the affected facial areas and difficulty in mouth opening, etc.


When should wisdom teeth be removed? No pain, no extraction?

Wisdom teeth can cause serious dental problems or complications. If you have any of the following conditions, seek help from your dentist as soon as possible.  

  1. Wisdom teeth are decayed.
  2. Coronitis occurs, usually in lower jaw wisdom teeth. Periodontal tissues easily become inflamed due to the accumulation of food debris and bacteria between the crowns of the wisdom teeth and the gum that covers them. Symptoms include swelling of cheeks, pain while swallowing, swelling of lower jaw lymph, fever and bad breath.
  3. Front teeth are affected, such as tooth decay, tooth root resorption, etc.
  4. Wisdom teeth lesions occure, such as cysts and damages to jaw tissue.
  5. Preventive extraction. If food debris easily accumulates and the wisdom teeth are difficult to be cleaned, wisdom teeth removal should be considered to avoid the above problems in the future.

Common Misconceptions about Wisdom Teeth

My face will look slimmer after wisdom tooth extraction?

No. The shape of the face is determined by cheekbones, maxilla and mandible, with little contribution by teeth. Removing wisdom teeth has actually little to do with facial appearance.

Will lower front teeth be misaligned if lower jaw wisdom teeth are not extracted?

The misalignment of lower front teeth is believed to be caused by multiple reasons, with wisdom teeth probably being one of them. But the consensus is that wisdom teeth should not be removed just for avoiding the misalignment of lower front teeth.

No pain, no extraction?

Patients are usually accidentally discovered with impacted wisdom teeth in X-ray examinations. Therefore, symptoms such as pain or gum inflammation cannot accurately reflect whether the teeth are in good health conditions.

Are there any sequelae or complications resulting from wisdom teeth removal?

Wisdom teeth removal is an oral surgery. The most common sequela are facial swelling and pain, wound bleeding, inflammation and tooth root fracture. The removal of lower jaw wisdom teeth may cause damages to nearby nerves, which may affect the senses of touch and taste of the face, lips and tongue in serious cases.

How to deal with the risks of wisdom teeth removal?

At first glance, wisdom teeth removal may seem risky. Fortunately, new dental technologies have been developed in recent years to reduce the occurrence of complications:

  1. 3D scanning - using 3D images to accurately display the positions of wisdom teeth and nerve cords, so that dentists can divide the teeth into small parts and remove them during surgery to reduce the chance of alveolar nerve damage.
  2. Crown excision - wisdom tooth extraction involves the risk of nerve cord damage if they are too close. In this way, Coronectomy can be considered - only the crowns of the wisdom teeth are removed without root extraction, leaving part of the roots in the ridge to reduce the risk of nerve damage. For most patients, the wounds will heal normally. However, this approach cannot be adopted if the gum or roots of the wisdom teeth is/are infected. In addition, the remaining roots have to be regularly checked with X-ray. In a small number of patients, the roots will slowly emerge. At this time, another surgery is required to remove them. As the roots have become far away from the nerve cords, the procedure will be relatively simple with relatively less risks.

What is the procedure of wisdom teeth surgery?

Wisdom tooth extraction is generally recommended to be performed in two rounds on the left and right sides respectively, for example, removing a pair of wisdom teeth on the upper and lower rows on either the left or the right side each round. The patient can chew on the other side while the wounds are recovering. Wisdom teeth surgery is a traditional way to remove impacted wisdom teeth.

The dentists will first conduct a detailed examination for the patient to understand the conditions of the wisdom teeth. X-ray or computer scan (CBCT) will be taken to more accurately determine the positions of the wisdom teeth, the conditions of the tooth roots and their distance to nearby important structures (such as nerves, sinuses and blood vessels), to enhance the accuracy and reduce the risks of the surgery. Before the surgery, the dentist will explain in detail points to be noted of the surgery, which will be carried out with the patient’s consent and understanding.

Usually, local anesthesia is sufficient, but general anesthesia or sedation may be used for complicated cases.

The surgical procedure mainly includes 5 steps:

  1. Make an incision on the gum and determine the positions of the wisdom teeth
  2. Remove the alveolar bone surrounding the teeth
  3. Depending on the situation, the teeth may be divided into several parts for extraction
  4. Clean the alveolar sockets and remove inflamed tissues
  5. Suture the wounds and ensure they stop bleeding

Follow up at the dentist’s office about a week after the completion of the above two surgeries to check the progress of wound healing and remove the stitches. Wounds will usually heal within two weeks approximately.

Precautions after surgery

– Eat soft and cold food and chew with teeth on the other side
– Rinse with warm salt water

Rinse with warm salt water 24 hours after the surgery to keep the surgical site clean. The ratio of the salt water should be 1 cup of water to 1.5 teaspoons of salt.

– Do not smoke, use a straw or rinse your mouth vigorously
   **To avoid the dislodging of blood clots in the extraction areas

–Keep your mouth clean to reduce the chance of wound infection.

– Avoid strenuous exercises for 3 days to prevent the wounds from bleeding again.

If the below situations arise, please follow up with your dentist as soon as possible:
* Swelling gets worse but not better
* Fever, chill or redness
* Have difficulty swallowing
* Persistent oozing or bleeding from the surgical site within 24 hours after surgery
* Tongue, jaw or lips still feel numb 3 to 4 hours after surgery
* Extraction site is very painful, which can be a symptom of dry socket

With the advancement of medical technology and drugs as well as the use of more advanced examination instruments and more effective drugs, the risks and postoperative discomfort of wisdom tooth surgery are significantly reduced. If you have any question, seek advice from a familiar dentist.