Wisdom Tooth Extraction & Surgery in Singapore

What are wisdom teeth?

Wisdom teeth, also known as third molars, are the final set of molars that typically emerge in late adolescence or early adulthood. Most people have four wisdom teeth—one in each corner of the mouth, with two on the upper jaw and two on the lower jaw. However, some people may have fewer wisdom teeth and others none at all.

These teeth are commonly referred to as "wisdom teeth" because they usually emerge during the ages of 17 to 25, a period traditionally associated with gaining wisdom.

Why wisdom teeth should be removed?

Wisdom teeth often face challenges during eruption due to limited space in the jaw. They may emerge at awkward angles or become impacted, meaning they do not fully emerge from the gum line.

Impacted wisdom teeth can cause various issues, including pain, infection, and damage to neighbouring teeth.

Is wisdom tooth extraction necessary? 

What happens if you do not remove your wisdom teeth? Wisdom teeth can pose several problems due to their late eruption and limited space in the jaw. Some common issues associated with wisdom teeth include:

1. Difficulty in cleaning:

   • Wisdom teeth are located at the back of the mouth, making them challenging to clean properly. Poor oral hygiene around wisdom teeth can lead to decay and gum disease.

2. Infection and gum disease:

   • Partially erupted or impacted wisdom teeth can create pockets where bacteria can accumulate, leading to infection or gum disease (periodontal disease).

3. Pericoronitis:

   • Pericoronitis is the inflammation of the gum tissue surrounding a partially erupted wisdom tooth, leading to symptoms such as pain, swelling, and difficulty in opening the mouth. In rare instances, it can escalate to a potentially life-threatening condition known as Ludwig's Angina.

4. Damage to adjacent teeth:

   • Wisdom teeth that emerge at odd angles or push against neighbouring teeth can lead to the entrapment of food, hence causing decay in both the wisdom tooth and the adjacent teeth.

5. Cyst formation:

   • In some cases, a cyst (fluid-filled sac) can form around an impacted wisdom tooth. Cysts can cause damage to the surrounding bone and teeth.

How do you know if your wisdom teeth need to be removed?

The decision to extract wisdom teeth is typically based on a dentist's or oral surgeon's evaluation of various factors. Here are some signs and indicators that may suggest a need for wisdom tooth extraction:

1. Pain or discomfort:

   • Persistent pain or discomfort in the back of the mouth, especially around the jaw, may be a sign that your wisdom teeth are causing issues.

2. Swelling and redness:

   • Swelling, redness, or inflammation of the gums in the back of the mouth may indicate problems with wisdom teeth, such as impaction or infection

3. Difficulty opening the mouth:

   • If you experience difficulty or pain when opening your mouth, it could be a sign of issues with your wisdom teeth.

4. Bad breath or unpleasant taste:

   • Infections around wisdom teeth can lead to bad breath or an unpleasant taste in the mouth.

5. Cysts or tumors:

   • In some cases, cysts or tumors may develop around impacted wisdom teeth. These can be detected through dental imaging and may be a reason for extraction.

6. X-ray findings:

   • Regular dental X-rays can reveal the position, development, and potential issues with wisdom teeth. If X-rays show that your wisdom teeth are decayed, impacted, misaligned, or causing other problems, extraction may be recommended.

7. Recurrent infections:

   • If you experience recurrent infections around a wisdom tooth, such as pericoronitis (inflammation around a partially erupted tooth), your dentist may recommend extraction.

8. Preventive extraction:

   • Some individuals undergo preventive extraction of wisdom teeth, especially if there is a high likelihood of future issues based on the examination and X-rays. This is often done during the late teenage years or early twenties.

It is important to note that not everyone will experience symptoms, and the absence of pain or discomfort does not necessarily mean that wisdom teeth are not causing issues. Regular dental check-ups, including X-rays, play a crucial role in monitoring the development of wisdom teeth and identifying potential problems early on.

If you are experiencing any of the signs mentioned above or if you have concerns about your wisdom teeth, it is recommended to schedule a consultation with a dentist. They can conduct a thorough examination, take X-rays, and discuss the appropriate course of action based on your specific situation.

Does removing wisdom teeth require surgery?

The need for surgery to remove wisdom teeth depends on several factors, including the position of the teeth, their stage of development, and any existing complications. In many cases, the extraction of wisdom teeth does require a surgical procedure, while in other cases, a simple extraction may be possible. Here are the two main types of procedures:

1. Simple extraction

2. Surgical extraction

Simple extraction

If a wisdom tooth has fully erupted and is positioned in a way that allows for easy removal, a simple extraction may be performed. In a simple extraction, the dentist or oral surgeon uses forceps to grasp and remove the tooth. Local anesthesia is usually sufficient for pain control during this procedure.

Surgical extraction

Surgical extraction is typically necessary when a wisdom tooth is impacted, partially erupted, or positioned in a way that makes it difficult to access. This procedure involves making an incision in the gum tissue to expose the tooth and, if needed, removing a portion of the jawbone to access the tooth. Surgical extraction is often performed under local anesthesia, and in some cases, sedation or general anesthesia may be used for the patient's comfort.

Factors that may indicate the need for surgical extraction include:

• Impacted wisdom teeth (teeth that have not fully emerged from the gums).

• Wisdom teeth that are tilted, rotated, or positioned at an angle.

• Wisdom teeth located close to nerves or sinuses.

• Wisdom teeth that are still in the early stages of development.

The decision between a simple extraction and a surgical extraction is typically based on the individual's oral health, the position of the wisdom teeth, and the dentist's or oral surgeon's assessment.

It is important to note that even if a simple extraction is possible, some discomfort and swelling can be expected after the procedure. Following post-operative care instructions, including taking prescribed medications and practicing good oral hygiene, is crucial for a smooth recovery.

If you are experiencing issues with your wisdom teeth or if your dentist recommends removal, they will assess your specific situation and discuss the appropriate extraction method with you. Regular dental check-ups and X-rays play a key role in monitoring the development of wisdom teeth and identifying the need for extraction before complications arise.

What are the risks of wisdom teeth surgery?

While wisdom teeth surgery is a common and generally safe procedure, like any surgical intervention, it comes with certain risks and potential complications. It is important to be aware of these risks and discuss them with your dentist or oral surgeon before the surgery. Some potential risks of wisdom teeth surgery include:

1. Pain and discomfort:

   • Pain and discomfort are common after wisdom teeth surgery. While pain management medications are prescribed to alleviate discomfort, individual pain thresholds may vary.

2. Swelling and bruising:

   • Swelling and bruising around the jawline and cheeks are common after surgery. These symptoms usually subside within a few days to a fortnight.

3. Bleeding:

   • Some bleeding is normal after the extraction procedure. Your dentist or oral surgeon will provide instructions on how to control and manage bleeding.

4. Infection:

   • Infection is a potential risk after wisdom teeth surgery. It can occur in the surgical sites or the surrounding tissues. Following post-operative care instructions, including proper oral hygiene, helps reduce the risk of infection.

5. Dry socket:

   • Dry socket occurs when the blood clot that normally forms after tooth extraction is dislodged or dissolves prematurely, exposing the underlying bone and nerves. This can lead to severe pain. Proper post-operative care, including avoiding certain behaviours like smoking, and drinking through a straw, can help prevent dry socket.

6. Nerve damage:

   • Nerve damage can occur during surgery, leading to temporary or, rarely, permanent numbness or altered sensation in the lips, tongue, or cheeks. The risk is generally low, and your dentist or oral surgeon will take precautions to minimise this risk.

7. Sinus issues (upper wisdom teeth):

   • Wisdom teeth in the upper jaw, particularly if they are close to the sinus cavity, may pose a risk of sinus issues or infection. Proper surgical techniques and evaluation of the sinus anatomy help minimise this risk.

8. Jaw stiffness:

   • Some individuals may experience jaw stiffness after the procedure. Gentle jaw exercises and movement can help alleviate stiffness over time.

9. Allergic reactions:

   • While rare, allergic reactions to medications used during the procedure or prescribed afterward can occur. Inform your dental team of any known allergies.

10. Anesthesia complications:

    • Anesthesia is generally safe, but there are risks associated with it. Your oral surgeon will review your medical history to determine the most suitable type of anesthesia for you and discuss associated risks.

It is essential to follow the post-operative care instructions provided by your dentist or oral surgeon and attend any scheduled follow-up appointments. If you experience severe or worsening symptoms, such as persistent pain, excessive bleeding, or signs of infection, contact your dental care provider promptly.

Discuss your medical history, any concerns, and questions with your dentist or oral surgeon before the surgery to ensure that you are well-informed about the procedure and its potential risks.

What to expect after a wisdom tooth surgery?

Recovery after wisdom teeth surgery varies from person to person, but there are common experiences and expectations for most individuals. Here is what you can generally expect after wisdom teeth surgery:

1. Immediate post-operative period:

   • Gauze: 

     • You may have gauze packs placed over the surgical areas to control bleeding. Bite down on them with firm pressure as instructed by your dentist or oral surgeon.

   • Rest:

     • Plan to rest for the remainder of the day after the surgery. Avoid strenuous activities and get plenty of rest to aid the healing process.

2. Pain and discomfort:

   • Pain management: 

     • It is normal to experience some pain and discomfort after the anesthesia wears off. Your dentist or oral surgeon will likely prescribe or recommend pain medications to manage discomfort. Take the medications as directed.

   • Ice packs: 

     • Applying ice packs to the sides of your face can help reduce swelling and alleviate pain. Use them intermittently during the first 24 hours.

3. Swelling and bruising:

   • Swelling: 

     • Swelling is a common side effect, and it usually peaks within the first 24 to 48 hours. You can minimise swelling by applying ice packs during the first day.

   • Bruising: 

     • Some individuals may experience bruising around the jawline, which is normal and will gradually fade.

4. Diet and nutrition:

   • Soft diet: 

     • Stick to a soft diet for the first few days, including items like yogurt, pudding, porridge, mashed potatoes, and soups. Avoid hard, crunchy, or spicy foods.

   • Hydration:

     • Drink plenty of water, but avoid using straws for the first few days, as sucking motions can disrupt the healing process.

5. Oral hygiene:

   • Gentle rinsing: 

     • Your dentist or oral surgeon may provide instructions for gentle rinsing with a saline solution to keep the surgical areas clean. Occasionally they may prescribe antibacterial mouthwash to be used to prevent infection and aid in healing.

   • Avoiding disturbance: 

     • Avoid vigorous brushing, flossing, or any actions that could disturb the surgical sites for the first few days.

6. Activity and rest:

   • Rest: 

     • Allow yourself time to rest and recover. Avoid strenuous physical activities for at least a few days.

   • Head elevation: 

     • Keeping your head elevated, even while sleeping, can help reduce swelling.

7. Follow-up appointments:

   • Scheduled check-ups:

     • Attend any follow-up appointments scheduled by your dentist or oral surgeon. They will monitor your healing progress and address any concerns.

8. Medication compliance:

   • Antibiotics: 

     • If prescribed antibiotics, take the full course as directed by your dentist or oral surgeon.

   • Pain medications: 

     • Take pain medications as prescribed, but avoid driving or operating heavy machinery if they cause drowsiness.

Some degree of discomfort, swelling, and bruising is normal after wisdom teeth surgery. These symptoms typically improve in the days following the procedure. Remember that individual experiences may vary, and it is essential to follow the specific post-operative care instructions provided by your dentist or oral surgeon. If you experience severe or worsening pain, excessive bleeding, persistent swelling, or any other concerns, contact your dentist or oral surgeon promptly.

If you have any questions or concerns during your recovery, do not hesitate to reach out to your dental care provider for guidance.

FAQ

Why do wisdom teeth need to be removed?

Wisdom teeth are often removed to prevent potential issues such as impaction, crowding, infection, cyst formation, and damage to neighboring teeth. Not everyone requires wisdom teeth removal, but it is common for those experiencing problems with their wisdom teeth.

When should wisdom teeth be removed?

The timing for wisdom teeth removal varies, but it is often recommended during the late teenage years or early twenties. Early removal can prevent potential complications and promote optimal healing.

Do all wisdom teeth need to be removed?

Not everyone needs their wisdom teeth removed. Some people have sufficient space and proper alignment for their wisdom teeth to erupt without causing issues. The decision to remove wisdom teeth is based on factors such as their position, development, and potential impact on oral health.

Is wisdom teeth surgery painful?

Wisdom teeth surgery is typically performed under local anesthesia, and patients should not feel pain during the procedure. Occasionally the procedure may be done under sedation or even general anesthesia for your comfort. After the surgery, some discomfort and swelling are common, but pain management medications are prescribed to alleviate these symptoms.

How long does wisdom tooth extraction take?

The duration of a wisdom tooth extraction can vary depending on several factors, including the complexity of the extraction, the number of wisdom teeth being removed, the position of the teeth, and the patient's individual circumstances. On average, a straightforward wisdom tooth extraction may take about 20-30 minutes per tooth. However, if the extraction is more complicated, such as if the tooth is deeply impacted or if the tooth is tilted at an unfavourable angle, it may take longer.

It is important to note that the time spent on the actual extraction is just one part of the overall process. Pre-operative preparation, anesthesia administration, and post-operative recovery also contribute to the total time spent at the dental or oral surgeon's office.

Your dentist or oral surgeon will be able to provide you with a more accurate estimate based on your specific situation during a consultation. Additionally, they will discuss the procedure, recovery process, and any post-operative care instructions with you before the extraction.

How long does wisdom tooth extraction take to heal?

The initial recovery period is usually a few days to a week, but full healing may take several weeks. Patients are advised to rest, follow post-operative care instructions, and attend any scheduled follow-up appointments.

Can I go back to work or school the next day?

The ability to return to work or school depends on individual factors, such as the complexity of the surgery and the nature of one's activities. Many people take a day or two off to rest and recover.

Can I eat normally after wisdom teeth surgery?

Initially, a soft diet is recommended to avoid disruption to the surgical sites. As healing progresses, patients can gradually reintroduce regular foods. Follow dietary recommendations provided by the dental team will aid in a smooth recovery process.

Can I drive after wisdom teeth surgery?

After wisdom teeth surgery, the use of anesthesia may impact your ability to drive. It is advisable to arrange for someone to drive you home following the surgery. Once the effects of anesthesia subside and if you are not taking medications that impede driving, you should regain the ability to drive safely.

What is dry socket, and how can it be prevented?

Dry socket is a condition where the blood clot that forms after tooth extraction becomes dislodged or dissolves prematurely. It can lead to severe pain. Following post-operative care instructions such as avoiding smoking, using a straw and consumption of alcohol can help prevent dry socket.

When can I resume regular oral hygiene practices?

Gentle oral hygiene practices, such as brushing and rinsing with a mild saline solution, can usually be resumed after the first day or as advised by the dental team. Follow their specific instructions to avoid disturbing the surgical sites.

How do you know if something is wrong after wisdom teeth removal?

Signs of complications may include persistent or worsening pain, excessive bleeding, swelling, signs of infection (such as fever), or other unusual symptoms. If you experience any concerning symptoms, contact your dental care provider promptly.

Always consult with your dentist or oral surgeon for personalised advice and information based on your specific situation.