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Preventive Dentistry

A tooth is described as impacted, if it is blocked from erupting into the mouth fully.  Thus it will lie at an angle instead of being upright, remaining tipped against the tooth in front of it. Technically, any tooth can become impacted but it is wisdom teeth that are the most often affected, owing to their late eruption.  Impacted teeth can cause a range of problems or they can cause no problems.

Do I need to have my wisdom teeth removed and if I do, why? This a very good question as almost everyone will be faced with this question at some point in their life. The decision to have your wisdom teeth removed must be individualized for each patient. Your dentist can help you evaluate the specific conditions of your wisdom teeth and the role they play on your total oral health.

 

When a wisdom tooth is problematic symptoms may include:


    1. Pain and swelling of the gum overlying the impaction – this is due either infection of this operculum or trauma from the tooth above hitting into it, or a combination of both. For example, a swelling that arises from infection may make the upper tooth impinge onto the gum – traumatizing it more and causing a vicious cycle.
    2. Bad breath, due to infection and/or debris building up in the area.

    3. A bad taste in the mouth, for the same reasons.

    4. Pus coming out from the swollen gum area.

    5. Aches when you open your mouth, as you are stretching the inflamed tissues.

    6. Difficulty on opening your mouth.

    7. Tenderness when chewing or biting as this hurts the swollen gum area.

    8. Pain/ulcers on the inner cheek, where the pointy parts (cusps) of the impacted teeth may be digging into the soft tissues of the cheeks.

    9. Ear-ache, as pain can spread outward from the area.

       

 

Complications if problematic wisdom teeth is left untreated?


    1. Infections that may spread and cause facial swellings, fever, headaces, limited mouth opening and pain
    2. Chronic suppurative osteitis. In which there is a chronic infection within the bone that is causing bone resorption. This may lead to increases incidences of jaw fractures and spread of infection and may also in severe cases lead to bone death (necrosis)

    3. Development of cystic lesions that resorb bone and that will need surgical removal and in some cases, it may develop oral tumors.

    4. Damage to the teeth in front of the wisdom tooth as it is erupting in an angle

 

            

 

 

What to expect?



Before removing a wisdom tooth, your dentist will give you a local anesthetic to numb the area where the tooth will be removed. Conscious Sedation could be used with anxious and fearfull patients. Further,  general anesthesia may be used.Your dentist will probably recommend that you don’t eat or drink after midnight on the night before surgery, so you are prepared or the anesthetic.

To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. Then separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove.

After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.

In most cases, the recovery period lasts only a few days. Take painkillers as prescribed by your dentist or oral surgeon. The following tips will help speed your recovery.


  1. Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. If you still have bleeding 24 hours after your surgery. Call your dentist or oral surgeon
  2. While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.
  3. Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
  4. Try using an ice pack on the outside of your cheek for the first 24 hours. You can use moist heat-such as a washcloth soaked in warm water and wrung out-for the following 2 or 3 days.
  5. Relax after surgery. Physical activity may increase bleeding.
  6. Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
  7. Do not use a straw for the first few days. Sucking on a straw can loosen the blood clotand delay healing.
  8. After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain.
  9. Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. In addition, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.
  10. Avoid rubbing the area with your tongue or touching it with your fingers.
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