Wisdom teeth

Wisdom teeth are the third molar tooth erupting at the end of the jaws. They erupt around the age of 16 years old. Their late eruption is the reason behind many problems associated with wisdom teeth.

Wisdom teeth extraction is often required to prevent complications related to their impaction or partial eruption. However, due to their strong relation to vital structures such as the mandibular canal, it is advised to seek professional help to extract the wisdom teeth.

Dulwich Dental Office is London’s number 1 Dental Centre providing high-quality care to extract your wisdom tooth. Our expert oral surgeons have performed over 5,000 successful wisdom teeth extractions using innovative technologies for maximum comfort during extraction and minimal pain during recovery.

The Function of Wisdom Teeth

Our ancestors were dependent on raw plants and rough meat for feeding, this is why wisdom teeth were significant at that time for proper chewing and digestion.

Nowadays, the food nature has dramatically changed. The food became softer, so we don’t need wisdom teeth anymore. The decreased masticatory forces due to the softer diet also caused the jaws to become smaller leading to the famous wisdom teeth impaction problem because there is no room for wisdom teeth eruption.

Common Complications Associated with Wisdom Teeth

Wisdom tooth eruption pain

Located at the corner of the mouth, wisdom teeth eruption is accompanied by pain, gum swelling, and stiffness. This may even lead to the inability to open your mouth.

Wisdom teeth caries and abscess

In some cases, due to the limited space available for wisdom teeth eruption, they may erupt in a titled position. Titled wisdom teeth are often difficult to clean, which increases the incidence of decay. Decayed third molars are often difficult to treat because of limited mouth opening, which may cause abscess formation.

Pericoronitis and gum diseases

Partial eruption of wisdom teeth is when the erupted wisdom tooth is covered with a soft tissue. This soft tissue is called the operculum and is considered an area of food accumulation and plaque buildup which causes increased incidence of gum inflammation.

Impacted wisdom teeth

Impacted wisdom teeth are wisdom teeth that fail to erupt. The impacted wisdom tooth may still cause some complications if it is misdirected toward the roots of the neighbouring teeth.

Damage to neighbouring teeth

Partial eruption of wisdom teeth provides an area of food accumulation and plaque buildup causing an increased risk of decay and root resorption of the neighbouring teeth. Also, during the eruption, pressure from the erupting wisdom tooth may cause movement of the second molar.

Dulwich Dental Office: Your Go-To Dental Destination for Wisdom Teeth Extraction

If you are experiencing problems related to wisdom teeth, our dental experts may recommend wisdom tooth extraction.

Dulwich Dental Office is a leading dental surgical centre for wisdom teeth extraction. Our dental clinic is equipped with cutting-edge imaging diagnostic tools to study the relationship between the impacted wisdom tooth and the nearby viral structures to avoid damage.

Before initiating the wisdom tooth extraction, our surgeons prioritise your comfort by administering appropriate anesthesia. Local anesthesia is the most common choice, and it is typically administered as follows:

• Topical Anesthetic Gel: A topical anesthetic gel may be applied to the gum tissue at the extraction site. This gel numbs the surface area, ensuring that you do not feel the initial needle prick.
• Local Anesthetic Injection: Our surgeons will then carefully inject a local anesthetic solution into the gum tissue near the wisdom tooth. This solution contains a numbing agent, typically lidocaine or articaine, which blocks pain signals from the nerve endings in the area. You may feel a slight pinch during the injection, but this discomfort is momentary, and the area quickly becomes numb.

After administering the local anaesthesia, our surgeons will take a few moments to ensure that the entire extraction site is adequately numbed. We may use a dental probe to confirm that you do not feel any pain. If needed, additional anaesthetic may be administered to ensure complete numbness.

Tooth Extraction

Tooth Mobility Assessment

Before initiating the extraction process, our experienced surgeons perform a comprehensive assessment of the wisdom tooth’s mobility. This evaluation helps determine the complexity of the extraction. Wisdom teeth can vary in their positioning and attachment to the surrounding bone, which can affect the extraction technique used.

• Tooth Loosening: To begin, our surgeons use dental instruments to assess the mobility of the wisdom tooth. A gentle rocking motion is applied to ascertain the degree of looseness. In some cases, a tooth may already be somewhat mobile due to the natural eruption process or impaction.
• Assessing Bone Attachment: In cases where the tooth is firmly anchored to the surrounding bone, our surgeons carefully evaluate the attachment points. The extent of bone contact and the presence of bony overgrowths or irregularities are taken into account.

Elevator Usage

Once the mobility of the wisdom tooth has been assessed, our surgeons proceed with the extraction process. An elevator, a specialised dental instrument, plays a crucial role in facilitating the extraction. Here’s how it works:

• Placement: The elevator is carefully inserted into the space between the tooth and the surrounding bone. It is positioned in a way that minimises trauma to the adjacent tissues, such as the gum and the neighbouring teeth.
• Leverage and Lift: Using precise and controlled movements, our surgeons apply gentle pressure with the elevator. This leverage action serves to gradually separate the wisdom tooth from the surrounding tissues and bone. The elevator’s design allows for precise manipulation while minimising trauma to the neighbouring structures.
• Tooth Elevation: As the elevator is manoeuvred, it lifts the wisdom tooth within its socket. This elevation process further loosens the tooth, making it easier to extract. The gradual and careful nature of this step helps prevent damage to the surrounding bone and tissues.

Tooth Removal

With the wisdom tooth adequately loosened and elevated, our surgeons proceed to the final stages of extraction:

• Tooth Grasping: Using dental forceps specially designed for tooth extraction, our surgeons securely grasp the wisdom tooth. The forceps provide a controlled grip, allowing for precise manipulation during the removal process.
• Gentle and Gradual Extraction: Our surgeons employ a gentle and gradual extraction technique. The tooth is moved along its natural axis, following the path of least resistance. This minimises the risk of fracturing the tooth or damaging the surrounding bone.
• Possible Sectioning: In certain cases, such as when a wisdom tooth is deeply impacted or its shape makes removal challenging, our surgeons may opt to section the tooth into smaller pieces for easier extraction. This method minimises trauma to the surrounding tissues and facilitates the removal of particularly stubborn wisdom teeth.
• Socket Assessment: Once the wisdom tooth has been successfully extracted, our surgeons inspect the socket – the space left in the bone where the tooth once resided. The socket’s cleanliness and integrity are carefully evaluated to ensure optimal healing.

Haemostasis and Closure

After the wisdom tooth has been removed, our surgeons focus on promoting healing and preventing bleeding:

• Haemostasis: Haemostatic agents may be applied to the socket if necessary to promote blood clot formation and control bleeding.
• Socket Inspection: The socket is inspected again to ensure that there are no sharp bony edges or debris that could impede healing.
• Closure (if necessary): If an incision was made to access an impacted wisdom tooth, our surgeons may use dissolvable sutures to close the incision. These sutures are designed to facilitate proper healing and minimise the risk of infection. The use of sutures is determined on a case-by-case basis.

Cleaning and Stitching (if necessary)

After the wisdom tooth is successfully extracted, our surgeons focus on the following steps:

• Cleaning the Extraction Site: The extraction site is meticulously cleaned to remove any remaining debris, fragments, or infection. Thorough cleaning reduces the risk of postoperative complications.
• Socket Examination: Our surgeons inspect the socket (the space in the bone where the tooth was located) to ensure it is free from any sharp bony edges or irregularities.
• Suturing (if necessary): In cases where an incision was made to access an impacted wisdom tooth, our surgeons may use dissolvable sutures to close the incision. These sutures promote proper healing and minimise the risk of infection.

Recovery Instructions Following Wisdom Tooth Extraction

Following the wisdom tooth extraction procedure, our surgeons provide you with detailed postoperative care instructions, which may include:

• Pain Management: Guidance on managing post-operative pain and discomfort, including the use of prescribed pain medications or over-the-counter pain relievers.
• Oral Hygiene: Instructions on how to maintain oral hygiene while avoiding the extraction site during the initial healing period. This often involves gentle rinsing with a saltwater solution and avoiding vigorous brushing or flossing near the extraction site.
• Dietary Recommendations: Dietary guidelines, such as following a soft-food diet for a few days to a week, can prevent irritation of the extraction site and promote healing.
• Follow-up appointments: Scheduling follow-up appointments to monitor your healing progress, remove sutures if necessary, and address any questions or concerns.

Caring for Fully Erupted Wisdom Teeth

If you have fully erupted wisdom teeth, it is essential to include it in your oral hygiene. The position of the wisdom tooth at the end of the dental arch makes it difficult to clean. Brush and floss your wisdom teeth as usual but make sure the toothbrush reaches the wisdom tooth to clean it.