The Wisdom Tooth is the third molar in each of the four corners of our mouth (called quadrants). These 4 teeth often start to come through the gum in our teenage years. In 75% of the population, there is a lack of space in our mouth to accommodate these teeth. When the wisdom tooth fails to erupt properly and becomes “stuck” in the jaw or behind our second molar, we call this pattern- impacted. Impacted wisdom teeth may cause one of the following problems:
- food trapping
- gum infection
- dental decay with our second molar or the wisdom tooth itself
- abscess of teeth
- radiating pain to jaws, ear and eye
- formation of cysts and tumours which may require major surgery
- disruption of previous orthodontic work
Early removal of impacted wisdom teeth during teenage years (age 17 ideal) is recommended to avoid the problems listed above. Early removal decreases the surgical risks due to the soft nature of the jaw bone during teenage years. Improved and quicker healing is also noticed when young. Delayed removal of wisdom teeth beyond age 21 increases the risks involved and increases the recovery time involved after the procedure.
Risks involved with removal of wisdom teeth:
Most infections occurs with the lower (mandible) jaw sites. Rate of infection is 12% without post operative antibiotics; 5% infection rate with postoperative antibiotics (4 year study by Dr. Vigna presented to Michigan Chalmers J. Lyons Academy).
- Nerve Injury
Injury to the sensory (feeling) nerve of the lower jaw may occur with the removal of lower third molars (wisdom teeth). This occurs approximately 1% of the time. If this nerve injury occurs as a teenager, it is usually temporary for the teenager is still growing and the nerve will regenerate. As a grown adult, nerve healing also occurs but may not recover 100% and a residual numbness may remain with the lower lip, chin or tongue. None of this affects the way you look, talk or move your lip and tongue.
Removal of Wisdom Teeth under Anesthesia
Wisdom Teeth are typically removed under general anesthesia (fully asleep). The local anesthetic (freezing) is injected once the patient is asleep. Medical anesthesiologists (specialists) ensure you are fully asleep, safe and comfortable during the entire procedure. Nurses are also in the operating room helping the anesthetist at all times. The patient is awoken once the procedure is complete. Long acting freezing is used to ensure 6 to 8 hours of pain relief after the procedure. There is no possibility of waking or being aware during the procedure.
St. Catharines Oral Surgery is the only oral surgery facility in the Niagara Region that uses Medical Anesthesiologists and provides general anesthesia for it’s patients. In our opinion, intravenous sedation is not recommended due to the possibility of awareness and movement during the surgery, aspiration of fluids, apnea (stopping to breath) and feeling pain during the procedure. Recovery occurs in the Recovery Room under the Supervision of a Registered Nurse. Postoperative instructions and Prescriptions will be given in Recovery to a family member. This often includes pain killers (narcotic), antibiotic and an antiseptic rinse. A follow up appointment will be made for the following week. The stitches (sutures) used are self dissolving and are often gone in one week. (See Postoperative Instruction in Forms Section).