Many years ago when I worked in hospital I used to extract a lot of impacted wisdom teeth. Now as a dentist in New Malden I still find impacted wisdom teeth to be a common problem for patients. Up until around 2000 it was common for wisdom teeth that looked like they may cause problems to be extracted. However, new guidance was introduced to the number of wisdom tooth extractions due to the incidence of unwanted nerve damage. There is a nerve running under the bottom of the wisdom teeth that comes out of the bone a bit further forward and supplies feeling to the lower lip. Another nerve running along the inside of the wisdom teeth supplies feeling to the tongue. Incidence of temporary nerve damage after a wisdom tooth extraction is around 5% and the incidence of permanent nerve damage is around 0.5%. Permanent nerve damage can be extremely distressing as it does not always cause complete numbness but the damage can constant extremely painful shooting pains that are very difficult to treat and leave the patient feeling desperate. Patients also report that the numbness can cause difficult eating, making them feel embarrassed to eat in front of others, and difficulty kissing loved ones. However, where problem wisdom teeth are retained, difficult impactions causing stagnation areas can lead to life threatening infections due to sepsis and due to spreading infection causing swelling around the airway. Therefore the risks and benefits of extractions need to be carefully considered.
If you have an impacted tooth you may find that stagnation around it can cause mild infections from time to time. If you want to avoid both the risks of extraction and serious infection it is essential to know how to keep the area clean and how to deal with infection at the first sign.
Firstly as part of your day cleaning routine, make sure you give the impacted wisdom tooth extra attention and care when brushing. If it is particular awkward your dentist of hygienist may recommend a specific brush to use.
At the first sign of any gum tenderness start rinsing twice a day with Corsodyl mouthwash and massage Corsodyl gum around the area with your finger or a small toothbrush, aiming to massage the gel under the gum where possible. If you get in early, in most cases this will stop the infection from progressing.
If you having problem wisdom teeth, the thought of extractions can be worrying. Fortunately, x-rays or 3D scans can, in many cases, reveal that a particular wisdom tooth is a good distance from the nerve canal. Where the root appears to sit in the nerve canal on a 2D x-ray a 3D scan may show that this is not in fact the case. If the root does sit in the nerve canal a coronectomy can be considered. This is where the crown of the tooth is sectioned and removed, leaving the root buried and the bone heals around it.
If you have problems with your wisdom teeth and would like to see a dentist in New Malden for advice, please do get in touch.