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Understanding Wisdom Teeth and Complicated Extractions
Wisdom teeth are not all the same. Some people are fortunate to have wisdom teeth that have come out properly in the mouth, while most are unlucky and develop impacted wisdom teeth. Even impacted wisdom teeth are different from one another. Some are only partially embedded in the bone, while some are fully submerged. Some wisdom teeth are angled to the tooth adjacent to it, while some can push against the cheek.
These complexities of the wisdom teeth are the reason why routine dental check-ups are important. It helps your dentist assess whether there will be problems with the wisdom tooth and if you need to have it removed or not.
What Makes a Wisdom Tooth Extraction Complicated?
A simple wisdom tooth extraction can be done like a routine tooth removal, where the tooth is loosened out of the socket and then pulled out as a whole. But, certain variations in the anatomy and development of the tooth and other medical situations make the procedure complicated.
- Impaction: The level of impaction directly influences the complexity of the procedure. This is determined by how much of the tooth is covered in bone. A partially visible wisdom tooth is easier to locate and remove compared to a tooth that is completely hidden by bone.
- Proximity to nerves or sinuses: If the tooth is too deep in the bone, its close proximity to vital structures such as nerves and the sinus is expected and can make removal a challenge. Scans are important as they are the best way to extract the tooth and avoid disturbing these areas.
- Curved or irregular roots: Some wisdom teeth have complex root systems in that they may be curved or irregularly shaped, resulting in a complicated tooth extraction. This will require that the tooth be sectioned into parts for easier removal.
- Positioning and angle of the tooth: During treatment planning, your dentist will identify whether the tooth is angled horizontally, vertically, or diagonally. Each has varying levels of difficulty, depending on the position.
Certain medical conditions, such as clotting diseases, diabetes, and hypertension, also make it hard for your dentist to do wisdom tooth removal. It is best to consult your physician to obtain a medical clearance before surgery.
Signs You May Need a Wisdom Tooth Extraction
Not every wisdom tooth requires removal, but several signs may indicate extraction is necessary:
- Difficulty cleaning and bleeding around the back teeth
- Persistent pain or discomfort in the back of your mouth
- Swelling of the gums or jaw
- Difficulty opening the mouth
- Crowding or shifting of other teeth
- Recurring infection near the wisdom tooth area
- Cysts or tumours around the wisdom tooth, as detected by X-rays
If you are experiencing any of these symptoms, a consultation with your oral and maxillofacial surgeon is essential for the timely removal of your problematic wisdom tooth before further complications arise.
Process of Complicated Wisdom Tooth Extraction
Impacted wisdom teeth removal and other complicated tooth extractions differ from simple tooth removal because they require more detailed planning to ensure a predictable surgery and outcome.
- Pre-surgery consultation includes going through your medical and dental history, charts, and scans to plan an efficient and effective treatment.
- Anaesthesia options depend on the difficulty of the procedure. Some sedation techniques that your surgeon may recommend include IV sedation, laughing gas, local anaesthetics, or general anaesthesia.
- Once the numbness has set in, your surgeon will begin the wisdom tooth extraction. It starts by making an incision on the gum and removing bone to gain access to the tooth. Sectioning may be done by dividing the tooth into parts to make removal easier.
- Then, stitches are placed to cover the wound as it heals. You may be required to return after a week so your dentist can check your healing progress and to remove the remaining stitches.
As with other treatments, there are wisdom tooth surgery risks. This includes temporary numbness, stiffness, excessive bleeding, and jaw strain. Your dentist will work closely with you to prevent these risks. As you recover, follow the post-surgical extractions given to you to avoid any complications and improve your recovery time.
Dr. Choo-Soon Kua, DDS, FRCDC
Certified Specialist in Oral and Maxillofacial Surgery
Dr. Kua is a Certified Specialist in Oral & Maxillofacial Surgery born and raised in Calgary. He received his Bachelor of Science in Kinesiology from the University of Calgary in 2008. Dr. Kua obtained his Doctor of Dental Surgery from The University of Western Ontario in 2012. Following completion of his doctorate, Dr. Kua practiced general dentistry in Calgary and Bowden Correctional Institution for two years before being accepted into and completing his specialty training in Oral & Maxillofacial
Surgery at Montefiore Medical Center in the Bronx, New York. His residency consisted of rotations in anaesthesia, general surgery, otolaryngology, emergency medicine, internal medicine, and critical care medicine. He is trained in all aspects of IV sedation, complex dentoalveolar surgery, dental implants, bone grafting, oral and maxillofacial pathology, and non-surgical temporomandibular joint disorders.
Dr. Kua is excited to offer a broad range of oral and maxillofacial surgery services to Calgary and surrounding areas.
Contact Us To Book An Appointment
If you are looking for an oral surgeon for complex extractions, our team at Chinook Dental Group can help. We have specialists who have received advanced training and experience to perform safe and smooth surgery.
Book your appointment today to experience premium care for complicated tooth extraction.
