Wisdom teeth removal

Mr Luke Cascarini is doubly qualified in medicine and dentistry and has considerable experience in oral and maxillofacial techniques. One common problem that requires surgical expertise are impacted wisdom teeth.

Wisdom teeth can cause problems if they become impacted when they start to emerge through the gums. If this leads to inflammation, pain and infection, it is likely that you will need to have the wisdom tooth removed.

How are wisdom teeth removed?

Each case is different, but usually the wisdom tooth is not pulled out. It is elevated away from the gum using special instruments.

The gum around the tooth may need to be cut and lifted away from the tooth (we call this raising a flap). The tooth may also be cut into smaller pieces and in some cases a small amount of bone may be removed from around the tooth using a tiny surgical drill.

If Luke feels there is a risk of injury to the inferior dental nerve, he may recommend a coronectomy, where the crown of the tooth is removed but the roots are left in place. A coronectomy isn’t commonly recommended for young people who need a wisdom tooth removed because the tooth’s roots are not fully formed. Younger people also tend to heal faster and better than older individuals.

What kind of anaesthetic will I have?

Luke will offer you the safest type of anaesthetic that is right for you:

• If the surgery is simple and you are happy with the thought of oral surgery, the tooth can be removed with just an injection to numb the area. This is a local anaesthetic and can be done in a clinic or in a hospital operating theatre.
• If you feel the need for something to help with anxiety you can have local anaesthetic with some intra-venous sedation administered by a consultant anaesthetist.
• Alternatively, if you are very anxious or the position of the wisdom tooth makes the surgery difficult, you can have a full general anaesthetic with a consultant anaesthetist. This can only be done in a hospital operating theatre.

How do I prepare for wisdom tooth removal?

• If you have a local anaesthetic you may eat and drink as normal before the wisdom tooth removal and will go home an hour or so after the procedure.
• If you have intra-venous sedation or a general anaesthetic you will need to be starved for six hours pre-operatively (no food or drink including water) and will remain with us for a few hours afterwards until the drugs wear off. This is called day case surgery as you arrive, have surgery and go home on the same day. You will need someone to take you home and stay with you overnight as you may feel a bit unsteady and drowsy.

It is very rare for a wisdom tooth patient to remain in hospital overnight unless they have particular social circumstances or medical problems that make this necessary. You will be given all the information you need prior to any surgery with Mr Cascarini.

How is the gum wound repaired?

Some wisdom teeth come out easily and do not need sutures (stitches). If any are used, they will be dissolvable and it can take anywhere from five days to a month for them to disappear, depending on your body’s enzymatic activity.

How do I look after my mouth after surgery?

After wisdom tooth surgery your mouth will be numb for a couple of hours due to the local anaesthetic used – even if you have a general anaesthetic we still inject some local anaesthetic to reduce post-operative pain. During this time, it is important not to eat or drink anything very hot and be careful not to bite your lip.

It is important to understand good healing depends on a healthy blood clot in the tooth socket and this means it must not be rinsed out in the first 24 hours after surgery otherwise you may develop a dry socket, which can lead to an infection. After this time the blood clot will be firmly in place and it is important that you rinse your mouth with warm salty mouth wash and clean all your teeth as normal with a toothbrush.

You should start taking painkillers straight away. In most cases taking paracetamol and ibuprofen for a couple of days is all that you will need. If we feel your surgery requires it we will prescribe stronger pain relief. You will also be assessed to see if you need antibiotics, but even taking antibiotics cannot reduce your risk of infection to zero.

You will want to avoid chewing over the area for a couple of weeks and most people prefer soft, cool foods. The wound should have almost healed up after a week to ten days. Most people need a day or two off work and some difficult cases require longer to recover.

Find out more about surgery to remove wisdom teeth removal.

How can I pay for surgical wisdom tooth extraction?

If you have private medical insurance, you will almost certainly find they will cover you fully for impacted wisdom tooth removal. Your policy should cover hospital costs, surgeon’s fees and, where applicable, anaesthetist’s fees. The insurance code for surgical removal of impacted tooth or teeth is F0910.

If you do not have medical insurance but want to have this treatment carried out privately with Luke, there are a number of options to pay for yourself – please contact us to find out more.