The Removal of Wisdom Teeth

  • Reference Number: HEY-168/2014
  • Departments: Maxillofacial Department

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Why do I need my wisdom teeth removing?

There are a number of situations where the removal of wisdom teeth becomes necessary.  The most common of these is because of infection, particularly in lower wisdom teeth. Often these teeth become impacted with the result that they only partly come through the gum. Injury to the gum from the upper teeth and trapping of food can lead to repeated bouts of infection, which may be severe and may spread to involve the face and the neck. If you have an infection, it may often be treated with antibiotics before your wisdom teeth are removed.

It is common practice to remove not only the lower wisdom teeth where the infection is situated, but also the upper wisdom teeth which injure the lower gum.  Other reasons for removing wisdom teeth include, untreatable tooth decay, abscesses and disease of the tissue around the tooth such as cysts and tumours and prior to corrective jaw surgery.

Can there be complications or risks?

Numbness of the lower lip or the tongue are well recognised complications following the removal of lower wisdom teeth. The reason for this is that the nerves which carry sensation pass very close to the wisdom teeth.

On a national basis one in ten operations will result in some numbness or tingling. Sometimes it only lasts a few hours but on average it lasts for six weeks. Permanent cases are rare but are known to occur.

There are risks associated with general anaesthesia, but this depends on your overall health. Risks vary with each patient. Your anaesthetist will discuss these issues with you, but it is important that you raise any concerns that you have.

How do I prepare for the operation?

Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this operation.

You will be given a letter detailing where you should attend, starving instructions and the time to report to the ward. Staff will greet you and show you around the ward. You will be seen by the doctor and possibly the anaesthetist. The type of anaesthetic you will be having is called a general anaesthetic. You will be prescribed pain relief to manage any pain you may suffer following the operation.

You will usually be invited to a pre-assessment before surgery where the nurse will check that you are fit for surgery and explain the operation. She will also answer any questions that you may have.

What does the operation involve?

This surgery may be performed under a local anaesthetic, general anaesthetic or sedation. The doctor will discuss which is best for you, taking into account how difficult the operation is likely to be.

The number of teeth, the depth of the teeth in the jaw and the shape of the roots are all factors that are taken into consideration. The operation itself usually involves surgery to the jaw bone rather than just the teeth themselves. The gum is often cut to expose the tooth and you may require dissolvable stitches.

Does it hurt?

If you are having a local anaesthetic you will have an injection in your gum, similar to one you receive at the dentist. This will make the area numb so that the surgery will not be painful.

What happens afterwards?

Whether you have had a general anaesthetic or local anaesthetic you are likely to have the following:

Swelling and Bruising

There will be some swelling or bruising of the face to a greater or lesser degree. This is because the surgery has involved your gum and jaw. Sometimes the bruising tracks down under the skin to appear as a yellow mark on the front of the chest. This can commonly last for 10 days.

A Stiff Jaw

You may have difficulty moving your jaw and this can last for about the same period of 10 days. This tends to be at its most severe two days after the operation and then gradually eases off. It is nature’s way of helping the healing process and is due to spasm in the jaw muscles. You should not try and force your mouth open as that would be fighting nature, but rather you should restrict yourself to softer food, taking small mouthfuls, and stifling yawns.

What you should do following surgery

Following surgery you may be prescribed antibiotics and antiseptic mouthwashes to prevent infection. The most important thing you can do is to have frequent hot salt mouth washes. You will be given instructions regarding this and all other measures that you should take after your operation. Please seek your doctor’s advice with regard to taking time off from work/education. You may be asked to come back for a follow-up appointment. In some situations following removal of wisdom teeth with no complications you will be discharged back to the care of your dentist.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.