Dr Shady Abdelsalam, our visiting Oral Surgeon at Cranbourne Dental Centre, has substantial experience treating patients with troublesome wisdom teeth. Below are some frequently asked questions regarding wisdom teeth removal.

Q. Why are they called "wisdom” teeth & how are they different from other teeth?
Wisdom teeth (also known as third molars) earned their name because they appear during the “age of wisdom” – your late teens to early twenties. Unlike your other teeth, wisdom teeth show up when you’re supposedly getting “wiser” – though they often bring more trouble than wisdom!
Q. Why do we have wisdom teeth, and why are they treated differently from other teeth?
Wisdom teeth are leftovers from our ancestors who needed extra molars to chew tough, uncooked foods. As our diets softened, our jaws evolved and became smaller over time, meaning there was less room to accommodate our third molars. This can lead to them getting impacted (buried) in the jawbone, coming in at awkward angles, or causing pain and infection. That’s why they often require special attention or removal to prevent them from causing any further issues.
Q. How many wisdom teeth are there?
Ordinarily, there are four wisdom teeth, one in each quadrant of the mouth.
Q. What are common issues with wisdom teeth?

Impaction:
When there isn’t enough space in the jaw for wisdom teeth to emerge properly, they may become impacted or buried in the jawbone. Completely impacted third molars can occasionally push against neighbouring teeth and structures, potentially causing damage, pressure and/or pain.

Partial eruption or partial impaction:
Sometimes, wisdom teeth only partially break through the gum, meaning they are partially impacted. This can create a flap of gum tissue that acts as a trap for plaque, food and bacteria, leading to pericoronitis, a potentially painful infection.

Malalignment and damage to neighbouring teeth:
When there isn’t sufficient space for them to erupt, wisdom teeth might push forward against neighbouring teeth. Over time, this may cause damage to the neighbouring teeth.

Cyst formation:
In rare cases, the tissues around an impacted wisdom tooth can slowly develop a cyst, a fluid-filled sac that can damage the surrounding bone and teeth.

Q. Signs of wisdom tooth problems
  • Pain or tenderness at the back of the mouth (where your last tooth is present)
  • Swelling of the gums or jaw
  • Limitation of mouth opening
  • Bad breath or an unpleasant taste in the mouth
  • Headaches or jaw pain
  • Swollen & painful lymph nodes in the neck

Please contact us if you are experiencing any of these symptoms. Our Specialist Oral Surgeon, Dr. Shady Abdelsalam, can clinically assess your third molars and discuss options for treatment.

Whether you require any further treatment and/or surgical intervention depends on the frequency & severity of symptoms and the position of your wisdom teeth. This is ascertained following a consultation, where we use a combination of clinical examination and radiographs (X-rays) to assess the angulation and position of your wisdom teeth and determine if they’re causing, or are likely to cause, problems.

Based on the findings of your consultation, we may suggest one of the following treatment options:

a) Monitoring:
If your wisdom teeth are healthy, properly positioned, and not causing any issues, we may recommend simply monitoring them through regular dental check-ups.

b) Coronectomy (Partial removal):

This is a treatment modality whereby the crown (top of the tooth) is removed and the roots are left in place. The main indication for this procedure is wisdom teeth that are near a nerve that supplies sensation to the jawbone, called the Inferior Alveolar Nerve.

c) Surgical Removal (Extraction): In many cases, complete removal of wisdom teeth is advised to address existing problems or prevent potential problems from occurring. This is especially true if the teeth are impacted or causing pain, infection, or damaging the neighbouring teeth.

Surgical removal of wisdom teeth can be performed in the dental chair (local anaesthesia) or under general anaesthesia at a hospital. The recommendation of either treatment setting is made on a case-by-case basis; it depends on the position of the wisdom teeth, the patient’s medical history and other patient-specific factors.

Q. Do all wisdom teeth need to be removed?

No, not all wisdom teeth require removal. If they are healthy, fully erupted, properly positioned and easy to clean, they can remain in the mouth without causing any issues. However, regular monitoring is essential to ensure they do not lead to problems later on.

If your wisdom teeth do not require removal, it’s important to maintain good oral hygiene to prevent future problems.

Here are some tips to help with that:

  • Regular dental checkups allow us for monitoring and early detection of potential issues.
  • Proper brushing and flossing to prevent plaque buildup and decay.
  • Know & identify the signs and symptoms of wisdom teeth pain, infection and/or inflammation. If any of them occur, we recommend you contact us promptly.
Q. What if it is recommended that my wisdom teeth are removed?

Surgically removing wisdom teeth is slightly different from the extraction of other teeth, as they are often partially or fully impacted (buried) in the jaw. The different steps involved with the surgical procedure are described in more detail below.

a) Preoperative preparation:

Before the procedure, we will discuss the suggested procedure, common side effects, discuss your medical history in detail and answer any questions you may have.

If you have any questions before your procedure, our office staff and skilled surgical team are happy to help in any way possible. Please feel free to contact us with any enquiries at any time, before or after your surgery.

Wisdom tooth removal is a common and relatively straightforward surgical procedure. However, as with any surgery, there are potential complications associated with the surgical procedure. These include, but are not limited to, the following:

  • Postoperative swelling (which reaches its peak after 3-5 days, settling down after 7-10 days on average), bruising and discomfort after the procedure. The postoperative swelling may also result in temporary trismus (limited mouth opening) and/or TMJ (jaw joint) pain.
  • Infection and Alveolar Osteitis (Dry socket): Please follow post-operative care instructions carefully to minimize this risk. This includes adequate oral hygiene and taking any prescribed antibiotics as directed. Dry socket occurs when the blood clot at the extraction site dislodges or dissolves prematurely. To minimise the risk of this, avoid smoking, using straws, or vigorous rinsing for the first few days after surgery.
  • Nerve damage: Permanent numbness over the lip, tongue, or chin and/or altered taste sensation are uncommon side effects of wisdom tooth removal. The risk of nerve damage, and subsequent management if it does occur, will be discussed in detail during your initial consultation.
  • Sinus communication: This is a risk for upper wisdom teeth, when upper wisdom teeth are impacted high in the upper jaw or have long roots. If this occurs, the communication with the sinus will be repaired and you will be given specific sinus precautions for the first 2-4 weeks after surgery.
  • Mild oozing from the extraction site may occur on the day of your procedure. Please avoid excessive spitting so you don’t dislodge or disturb the blood clot.
  • Damage to the neighbouring teeth
  • Any allergic reactions
  • Risk of jaw or root fracture
  • Risk of swallowing or displacement of the wisdom tooth and/or any instruments

b) The surgical procedure:

  • The area around the tooth is numbed up with local anaesthesia. When performed under local anaesthesia, it is normal to experience some pressure during the procedure, but there shouldn’t be any significant pain.
  • If the tooth has not completely erupted, an incision is made in the gums to access it.
  • The wisdom tooth may be divided into sections for easier removal.
  • The tooth is extracted, and the extraction site is cleaned of any debris.
  • Stitches are used to close the wound, which dissolve on their own in the first few weeks after surgery.
  • A gauze pack is placed over the extraction site, which helps control any further oozing.

c) Postoperative recovery:

  • On average, the initial recovery period typically lasts anywhere from 1-3 weeks. After this initial period, the healing and remodelling process lasts for 3-6 months, but is generally asymptomatic, as most side effects following the surgery would have usually subsided.
  • We will provide you with detailed aftercare instructions, including how to manage pain and swelling, what to eat, and how to keep the extraction sites clean. These are briefly described below.
Q. Wisdom tooth removal aftercare:

Please use ice packs on the day of the surgery, to help manage swelling. Do not repeat ice packs the day after the surgery.

Take pain medication as directed or prescribed to help manage pain.

For the first 24 hours after your surgery, please avoid the following if possible:

  • i. Rinsing
  • ii. Spitting
  • iii. Hot food and beverages
  • iv. Toothbrushing
  • v. Smoking
  • vi. Alcohol
  • vii. Drinking through a straw, as this can dislodge the blood clot from the extraction site.

Good nutrition is key to smooth healing after wisdom tooth surgery. Please make sure to drink plenty of fluids and eat after your surgery. We generally recommend a soft, easy-to-chew diet for the first week after surgery. Try to avoid hard, chewy and spicy foods, as these can irritate the wound.

Resume eating semisoft foods, once you’re confident you can tolerate them.

We recommend you resume brushing your teeth the day after your surgery. When you do get back to brushing your teeth, please be gentle around the extraction site.

The day after the surgery, we advise you start gently rinsing your mouth with warm saltwater for up to two weeks, or as advised by your Oral Surgeon.

We generally recommend refraining from vigorous physical activity for the first 5-7 days following your surgery.

If you have any further concerns or enquiries regarding your wisdom teeth, please feel free to reach out to us at Cranbourne Dental Centre.