Having problems with your wisdom teeth is not unusual.
These are the last adult teeth to break through the gums and, for reasons that
are not entirely clear, modern humans often do not have sufficient space in
their jaw for this process to be easy and wisdom tooth extraction is a common
operation. Eruption of the wisdom teeth usually starts in the late teens, but
it may take until the early 20s for all four teeth to become fully visible.
Sometimes this never happens; the wisdom teeth become
lodged under a spur of bone, causing frequent tooth ache and soreness in the
gum. If the teeth are impacted like this, or they come through at an angle,
wisdom tooth extraction is the only effective treatment. Your main choice is
whether to have the wisdom tooth extraction surgery done by a National Health
Service (NHS) dentist or hospital, or whether to opt for private treatment.
What is the
function of the wisdom teeth?
As the final set of large molars to erupt through the
gums at the very back of the jaw, they function in the same way as the other
molars, providing an efficient grinding surface for chewing food that is tough.
Wisdom teeth in modern humans are obviously not really necessary as so many
people today have wisdom tooth extraction in early adulthood. The other sets of
molars do the job of chewing pretty well, and modern humans don’t eat food such
as sinewy meat and tough roots as they did when the human jaw first evolved.
Do I need wisdom
tooth extraction?
If you are having frequent problems with your wisdom
teeth coming through, your dentist will probably recommend wisdom tooth
extraction. The most common problems that occur are:
-
Impacted
wisdom teeth: if there is not enough room for wisdom teeth to come through,
they tend to emerge from the gum at an angle and can then become impacted, or
trapped under a spur of jaw bone or lodged against the neighbouring tooth.
-
Non-erupting
wisdom teeth - some wisdom teeth may be straight but just do not push up
sufficiently to clear the gum. They can be near to the surface, so can cause
frequent gum ulceration that can only be relieved by wisdom tooth extraction.
There is no need for wisdom tooth
extraction if the impacted tooth is not painful or causing infection or decay.
However, impacted or non-erupting wisdom teeth often cause inflammation that
can lead to gum disease, infection, cysts or decay because food becomes trapped
or plaque builds up and there isn’t enough space to clean it away. As well as
pain in the tooth, this can also lead to bad breath and stiffness or soreness
in the jaw muscles.
Can I avoid wisdom
tooth extraction?
It may be a good idea to wait a few months to see what
happens, but most people get to the point when the thought of having a wisdom
tooth extraction becomes more appealing than experiencing the pain and
discomfort their wisdom teeth are causing. Some dentists will use an interim
measure to trim the gum away from non-erupting wisdom teeth, or may drill away
the spur of bone if an impacted wisdom tooth is coming through straight. If
these are successful and your wisdom teeth then come through fine, a wisdom
tooth extraction may no longer be necessary.
Choosing between
private and NHS wisdom tooth extraction
A private or NHS dentist or dental surgeon can carry out
a wisdom tooth extraction, and the processes and standards of care for wisdom
tooth removal should be the same. However, unless you are already registered
with an NHS dentist, it may be difficult to find a practice to accept you as a
new NHS patient. You can check out online the practices in your local area that
are still accepting NHS patients.
If you have severely impacted wisdom teeth, your wisdom
tooth extraction may be too complex to be done in the dentist’s chair and you
will need a referral to a dental hospital. This can involve a wait for an
initial appointment and then a further wait for the actual wisdom tooth
extraction. Unless you are under 18 or exempt from dental treatment charges,
there will also be a fee for the wisdom tooth extraction. This will vary
according to the work required, but is likely to cost less than having the
operation done privately.
Finding a private dental practice for wisdom tooth
removal is generally easier and there is less likely to be a wait either for
the initial appointment or for the subsequent operation. It is usually also
possible to have some say in the timing of the wisdom tooth extraction if it
has to be done under hospital conditions, to fit in with work and other
commitments. The cost of the wisdom tooth extraction is, of course, likely to
be higher than going through the NHS.
Your wisdom tooth
extraction: what to expect
Once you have made your choice to go with an NHS dentist
or a private dentist, the process should be very much the same.
An X-ray will tell your dentist if it is possible to
carry out the wisdom tooth removal under a local anaesthetic. This just numbs
the gum, and you will be awake for the wisdom tooth extraction, though you may
be given a sedative to make you feel relaxed. Single wisdom tooth extraction
can take up to three quarters of an hour, but often only takes a few minutes. The
dentist or dental surgeon may be able to simply loosen the tooth in its socket
to complete the wisdom tooth extraction very quickly.
If the wisdom tooth extraction is likely to be
complicated, a dental surgeon may need to do the operation under a general
anaesthetic. He or she may have to cut a flap in the gum to remove the tooth, and
then drill away a piece of the jawbone.
