Oral & Maxillofacial Surgery In London
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Should we extract Wisdom Teeth?

Scan of wisdom tooth and nerve
The scan shows an impacted wisdom tooth digging into an alveolar nerve, undesirable, potentially painful and with one solution.

Whether or not to extract a wisdom tooth is clear in the case above, although each situation will be unique, requiring specialist analysis.

If there is space in the mouth and the tooth grows normally, extraction may not be appropriate, even with temporary symptoms. We should however bear in mind that wisdom teeth are inessential and can cause problems in later life.

About 80% of wisdom teeth require extraction before people reach 70 years of age. Removing them at a time when our bone is more amenable and general health issues are likely to be lower holds advantages.

Your consultant will still discuss and consider medical history at any age, which could increase, or reduce the logic on extraction. They will also take scans, or x-rays and review your individual symptoms.

In some cases, a balanced decision will need to be made, in others, additional factors will point to the right solution for you.

Wisdom Tooth Diseases

A range of conditions can make extraction more of a requirement. The location of wisdom teeth makes them awkward to clean and the way they erupt can help to create common issues:

  • Pericoronitis is an infection of the gums around a wisdom tooth and a leading reason for extraction. You tend to encounter greater pain and swelling than normal growth would produce.
  • Wisdom teeth themselves, or others close by can be subject to general gum disease, called periodontitis. There may be no immediate symptoms but this is a pervasive condition.
  • Tooth decay in wisdom teeth, or their neighbours is fairly prevalent. Restorative work to preserve, or rebuild the wisdom teeth might not be the best answer looking to the future.
  • More serious conditions such as oral cysts, or spreading infection can evolve from wisdom teeth. Removing the tooth and therefore the source is likely to be a sensible step.

Wisdom teeth can also have root issues of their own, or affect the root of an adjacent tooth, along with other local tissue. In rare cases, this can impinge on your ability to eat, or breathe.

There are clearly a number of cases where extraction is the only option, antibiotics, or improved oral hygiene would simply be palliative. We should still consider any points which may be against extraction.

Risks On Extraction

Our mouthes are a key part of the sensory system, with the mouth and jaw holding a network of nerves. Dental treatment has the potential to cause damage, which can bring pain, or affect the sensations you feel in parts of the face.

As with any surgery, post operative infection can occur. Dry socket is another possibility, where a blood clot fails to develop correctly following extraction.

We should however note that research points to a rate below 5% for any notable downside and below 2% for nerve damage. In specialist hands with sound preparation, rates will be lower still.

If an issue does occur, this can normally be solved. Cases requiring significant intervention, such as surgical repair of nerve damage, are quite uncommon.

The reality is that where required, wisdom tooth extraction is likely to prevent more oral disease than this could ever create. A procedure which can be pain free and cause relatively little inconvenience.

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