Your wisdom teeth, also known as your third molars, are the last teeth to emerge from your gums right at the back of your mouth. You have four wisdom teeth: two at the bottom and two at the top. They usually emerge in your late teens to early twenties and is thus called because it is at the age some people associate with gaining wisdom.
However, contrary to its name, the emergence of your wisdom teeth is rarely accompanied by wisdom, it is usually accompanied with pain.
For some, their wisdom teeth may emerge without incidence. However, it may still cause pain due to decay since it is in a hard-to-reach space. Erupted wisdom teeth are more vulnerable to tooth decay or gum disease compared to other teeth because of their position.
When your wisdom tooth is impacted (no space to emerge/erupt), it may cause them to grow at odd angles and not in the upright direction. This may cause them to push up against neighbouring teeth thus causing some pain.
There are two types of impacted wisdom teeth:
The top of the teeth (crown) can be seen.
The whole tooth is stuck beneath the gums.
| Characteristics | Causes |
|---|---|
| 1. Red or Swollen Gums 2. Tender or Bleeding Gums | 1. Overlying gum swells as your wisdom tooth emerges 2. Partially erupted tooth may cause food, plaque, and bacteria to get trapped, which may lead to tooth decay and a gum infection called pericontis 3.Cyst and cavities |
| 1. Jaw Pain 2. Swelling Around Jaw 3. Difficulty in Opening Mouth | 1. Erupting or impacted wisdom teeth presses up against neighbouring teeth, causing them to move, resulting in stiff jaws and difficulty in moving your jaw 2. Misalignment of wisdom teeth |
| 1. Bad Breath 2. Unpleasant Taste in Mouth | 1.Trapped food, plaque, bacteria, and other particles resulting in tooth decay and cavities |
When you present to your oral surgeon with symptoms of wisdom tooth pain, your surgeon will examine your mouth and teeth to determine if the pain is caused by your wisdom teeth or if something else is causing your symptoms.
Dental x-rays are then taken to see where your wisdom teeth are and if they are impacted. X-rays are also used to check for any signs of damage to your teeth or bone.
If your wisdom teeth emerged without incidence, you can take the conservative approach and monitor it. However, patients are usually encouraged to remove them as the tooth/teeth might cause problems in the future such as decay, cavities, gum disease, or cyst. Extraction and healing are also easier with less complications in younger patients.
If your wisdom teeth are impacted and causing you pain, they will either be removed under local anaesthesia (extraction) or general anaesthesia if surgery is required.
| Local Anaesthesia (Extraction) | General Anaesthesia (Surgery) | |
|---|---|---|
| How it works | 1. Tooth is loosened by a tool called an elevator. 2. Once loosened, tooth is removed with forceps. | 1. Small incision is made in the gums to expose the tooth. 2. Depending on the tooth, it is either removed like an extraction or may be divided and removed in parts |
| Patient | Emerged/fully erupted wisdom teeth | Partially/fully impacted wisdom teeth |
Removal of your wisdom tooth is claimable from Medisave, only if it is removed during surgery.
| Wisdom Teeth Surgery Procedure | Medisave Claimable |
|---|---|
| Without tooth division (breaking tooth into pieces) | Up to $350 |
| With tooth division | Up to $950 |
| Deep and with tooth division | Up to $1,250 |
After extraction or surgery, you will experience some discomfort such as pain, bleeding, and swelling. Your oral surgeon will provide you with antibiotics, pain medications, and instructions on how to care for your wound.
Aftercare for your wisdom tooth removal
Dr Seah Tian Ee is an Oral & Maxillofacial Surgeon with a special interest in facial aesthetic procedures and the correction of jaw anomalies.
He was the scholarship recipient of the Health Manpower Development Programme in 2009 and trained in the United Kingdom for facial aesthetic surgery.
Dr Seah is the course director for the “Botulinum Toxin Injection Workshop” for the Association of Oral & Maxillofacial Surgeons, Singapore; and is a lecturer and instructor at the annual “International Cadaver Workshop on Facial Contouring & Maxillofacial Aesthetic Surgery” in Korea.
His clinical interests are in the areas of combined rhinoplasty and orthognathic surgery, non-surgical and surgical facial aesthetic procedures, treatment of temporomandibular joint disorders and oral-maxillofacial pathology. He also does routine oral surgery such as wisdom teeth removal, dental implants etc.
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