Wisdom Tooth Extraction: When Do You Need It Removed?

Do you know that one in three people experience complications with their wisdom teeth? These third molars, emerging in one’s late teens to early twenties, are the final set of teeth to develop.

While a fortunate few enjoy ample space in their jaws, allowing these teeth to grow unhindered, many are not so lucky. Impacted wisdom teeth, unable to fully emerge or align correctly, often cause debilitating pain, infections, and other severe dental issues like crowding or damage to adjacent teeth.

To alleviate these painful symptoms and to prevent further oral health complications, wisdom tooth extraction becomes a necessity.

This common but critical procedure demands careful consideration of timing and methods of removal, followed by meticulous post-operative care. Thus, wisdom tooth extraction is not only about addressing current pain but also about safeguarding the future of one’s dental health, playing an indispensable role in both preventive and remedial dental care strategies.

What is wisdom tooth extraction, and when is it needed?

Wisdom tooth extraction refers to the surgical or non-surgical removal of one or more of the four wisdom teeth, the last adult teeth to emerge in the mouth.

These teeth, which usually appear between the ages of 17 and 25, are located at the very back of both the upper and lower dental arches. Because they emerge so late, wisdom teeth frequently encounter issues during the eruption, often requiring their removal to prevent or address complications.

Here are some of the reasons for extraction:

1. Impaction: The most common problem associated with wisdom teeth is impaction, where the teeth fail to fully break through the gum line.
   This often happens when there isn’t enough room in the jaw or when the teeth emerge at an angle, either partially or completely sideways.
   This can sometimes cause intense pain, swelling, and inflammation and may cause more serious complications, such as infections or cysts that can damage the jawbone and neighbouring teeth.
2. Crowding and misalignment: When wisdom teeth do manage to erupt, they can push against other teeth, causing crowding and misalignment.
   This can disrupt the alignment of teeth that have been corrected by orthodontics or naturally well-aligned teeth, leading to aesthetic and functional dental issues.
3. Oral health complications: Wisdom teeth are hard to reach and clean effectively, which makes them quite vulnerable to tooth decay and gum disease.
   If a wisdom tooth develops cavities or periodontal issues, it may be necessary to remove it to preserve the health of the entire mouth.
4. Preventive removal: Even if a wisdom tooth isn’t currently causing problems, dentists often recommend removal to prevent potential future issues, especially if diagnostic images show that problems are likely to develop.
   This is particularly common in younger adults, where removal can lead to simpler procedures and quicker recoveries.

Wisdom tooth extraction pros and cons

While wisdom tooth extraction is commonly recommended for preventive and curative reasons, it has a range of pros and cons. Understanding these can help individuals make informed decisions about whether to proceed with this dental procedure.

What are the benefits of removing wisdom teeth?

1. Prevention of dental problems: One of the primary benefits of removing wisdom teeth is the prevention of future dental issues. Impacted wisdom teeth can lead to crowding, misalignment, and damage to adjacent teeth. Removing them can help to prevent any of these issues and help maintain optimal health and alignment of other teeth.
2. Reduced risk of oral infection: Impacted or partially erupted wisdom teeth are highly susceptible to infections because they create pockets where bacteria can accumulate. This can lead to pain, swelling, and more severe conditions like abscesses or systemic diseases. Extraction eliminates these pockets, reducing the risk of such complications.
3. Decreased gum disease: Wisdom teeth can contribute to gum disease around the teeth and in surrounding areas. Their awkward placement makes thorough cleaning difficult, increasing the risk of periodontal disease.
4. Relief from pain and discomfort: Many people experience discomfort or pain from emerging wisdom teeth, especially if they are impacted. Removal of these teeth can provide relief from chronic pain and discomfort associated with their eruption and misalignment.
5. Prevention of cysts and tumours: In some cases, the sac which surrounds an impacted wisdom tooth can fill with fluid, forming a cyst that can damage bone and roots of nearby teeth. In rare cases, tumours might develop, requiring more extensive surgical procedures. Removing problematic wisdom teeth can prevent these serious complications.

What are the side effects of getting your wisdom teeth removed?

1. Pain and swelling: The most immediate side effects of wisdom tooth extraction are pain and swelling around the extraction site. This usually subsides within a few days but can be uncomfortable.
   
2. Bleeding: Postoperative bleeding is common, especially within the first 24 hours after extraction. Proper care is required to manage and minimise bleeding.
3. Dry socket: One of the more painful complications associated with wisdom tooth extraction is a dry socket, a specific condition in which the blood clot at the area of the tooth extraction dissolves before the wound is fully healed or fails to develop. This can risk the exposure of underlying bone and nerves, resulting in intense pain.
4. Infection: Although rare when post-operative care guidelines are followed, there is a risk of infection at the site of extraction, which can lead to delayed healing and other complications.
5. Nerve damage: In very rare cases, the surgery can result in permanent or temporary nerve damage. This might cause numbness or a tingling sensation in the tongue, lower lip, chin, teeth, and gums.
6. Jaw stiffness and soreness: Patients often experience temporary jaw stiffness and soreness after wisdom tooth extraction. This typically resolves within a week but can be momentarily debilitating.

How is wisdom tooth extraction performed?

Wisdom tooth extraction can be performed using surgical or non-surgical methods, depending on the position of the wisdom teeth, their development, and the complexity of the case.

The process generally involves numbing the area around the tooth with a local anaesthetic to minimise pain during the procedure, though more complex cases may require sedation or general anaesthesia.

Surgical extraction of wisdom tooth

Surgical extraction is required when a wisdom tooth is impacted, meaning the tooth is covered by gum tissue and possibly bone, or when the tooth has not fully emerged into the mouth. Here’s a detailed breakdown of the surgical extraction process:

1. Preparation and anaesthesia: The oral surgeon administers local anaesthesia to numb the area. If the procedure is expected to be particularly lengthy or complicated, or if the patient is very anxious, sedation or general anaesthesia may be used.
   
2. Incision: Once the area is numb, the dentist makes a small incision in the gum tissue to expose the tooth and bone. This allows the surgeon to access the tooth that needs to be removed.
3. Bone removal: If bone blocks access to the root of the tooth, it will need to be removed. The surgeon may use a drill or other surgical instruments to remove any bone covering the tooth carefully.
4. Tooth sectioning: If the wisdom tooth is particularly large or awkwardly positioned, the surgeon might cut it into smaller pieces to make it easier to remove through the opening created.
5. Tooth removal: The surgeon then carefully extracts the tooth. Forceps may be used to grasp and gently move the teeth back and forth until they break free from the ligaments holding them in place.
6. Cleaning and stitching: After the wisdom teeth are removed, the area is thoroughly cleaned of any debris from the tooth or bone. The surgeon may place stitches to help the gum tissue heal properly.
7. Recovery: A gauze is placed over the extraction site to help control bleeding and to aid in the formation of a blood clot.

Non-surgical wisdom tooth extraction

Non-surgical extraction is performed when the wisdom tooth has fully erupted into the mouth and is visible, similar to a routine tooth extraction. The steps include:

1. Preparation and anesthesia: Local anaesthesia is administered to numb the extraction area.
2. Loosening and removal: The dentist uses a device called an elevator to loosen the tooth from the jawbone and ligaments. Once the tooth is loose, dental forceps are used to Carefully wiggle the tooth back and forth until it can be fully extracted.
3. Completion: The area is cleaned, and gauze is placed to control any bleeding. Stitches are typically not necessary for non-surgical extractions.

Both methods of extraction aim to minimise patient discomfort and promote quick recovery, though surgical extractions tend to involve more complex post-operative care due to their invasiveness. In either case, following the dentist or surgeon’s post-operative instructions is crucial for healing and avoiding complications.

What to expect after wisdom tooth extraction?

After wisdom tooth extraction, it is common to experience:

• Swelling: Apply an ice pack to manage swelling; it typically subsides within a few days.
• Throbbing pain: Pain relief medications prescribed by your dentist can manage this.
• Ulcer: Occasionally, an ulcer may form near the extraction site; it usually heals on its own.
• Bleeding: Some bleeding is normal and should stop with proper care, like biting gently on a gauze pad.
• Sore throat: This can occur when the muscles in the throat are inflamed; hydration and soft foods help.
  

Wisdom tooth extraction recovery – How long does it take to heal?

Recovery from wisdom tooth extraction varies from person to person, depending on the complexity of the extraction and the individual’s overall health. Typically, the healing process can be broken down into several stages:

Initial healing phase

The first few days after the extraction are crucial for recovery. During this time, it’s important to manage bleeding and allow a proper blood clot to form in the socket—the first step in healing. Swelling and pain are most prominent during this phase. The soft tissue will begin to heal within a week, and most people start to feel significantly better after about 3-5 days.

Secondary healing phase

Over the following weeks, the gum tissues continue to heal, and the bone where the tooth was removed begins to solidify. However complete bone healing may take several months, but usually, discomfort should significantly decrease after the first couple of weeks.

Full recovery

Full recovery and complete bone healing might take up to six months. However, the absence of pain and noticeable discomfort typically occurs much earlier. Most people return to normal daily activities within a week, although the surgical site itself may require several weeks to heal fully.

Pain management after wisdom tooth extraction

Effective pain management is very important for a comfortable recovery period following a wisdom tooth extraction. Here are some strategies to manage pain:

1. Medication

Immediately following the procedure, your dentist or surgeon will likely prescribe or recommend pain relievers. These may include:

• Over-the-counter pain relievers: Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) are commonly recommended. These medications not only help reduce pain but also decrease inflammation.
• Prescription pain medication: In cases of intense pain or more complex surgical extractions, stronger prescription painkillers may be prescribed. It is important to use these strictly as directed due to their addictive nature and potential side effects.

2. Home care techniques

• Ice Packs: Placing ice packs on the cheek near the extraction site can help lessen swelling and alleviate pain during the first 24 to 48 hours.
• Soft Diet: Eating soft and cool foods can prevent irritation of the extraction site and provide comfort.
• Rest: Reducing physical activity for a few days helps reduce throbbing and bleeding, thus minimising pain.

3. Long-term pain management

Most severe pain should diminish within a few days. Persistent pain may indicate complications such as a dry socket or infection. If pain worsens after several days rather than improving, it is crucial to contact your dental professional for advice.

In conclusion, understanding and following your dentist’s recommendations for post-operative care and pain management will facilitate a smoother and quicker healing process.

While the physical recovery from a wisdom tooth extraction might be relatively fast, allowing several weeks for complete healing ensures a better long-term outcome.

Post-wisdom tooth extraction care

After wisdom tooth extraction, it’s essential to follow a soft diet, avoid vigorous mouth rinsing or touching the extraction area to prevent dislodging the blood clot and keep the area clean with gentle saltwater rinses starting 24 hours after the surgery.

Proper adherence to these care instructions promotes healing and helps prevent complications such as infection or dry sockets.

Wisdom tooth extraction costs malaysia

In Malaysia, the charges for wisdom tooth extraction can vary mainly depending on the type and complexity of the procedure, the type of anaesthesia used, and the clinic’s location and reputation.

Generally, the price for non-surgical extraction ranges from MYR 300 to MYR 800 per tooth, while surgical extraction can cost between MYR 800 and MYR 1500 or more per tooth. These costs can be higher in more urban areas or clinics with specialised dental services. Patients are generally advised to consult with their dental care providers to get a detailed estimate based on their specific circumstances.

Where to get wisdom tooth extraction in Malaysia?

In Malaysia, wisdom tooth extraction services are widely available across various types of dental clinics, ranging from private practices to larger dental hospitals. Many of these provide a comfortable environment and personalised care.

Look for a dentist with extensive experience and expertise in the process.  Additionally, consider patient reviews and testimonials to gauge satisfaction levels. Ensure the dental clinic is equipped with state-of-the-art technology and facilities to provide comprehensive services.

For wisdom tooth extraction in Malaysia, consider consulting with mydentist®, a trusted provider known for delivering exceptional dental care and personalised transformations