What is minor oral surgery?
Dentists can do a large number of surgical interventions in the mouth. The term “Minor oral surgery” refers to smaller operations and include removing wisdom teeth, impacted teeth, and severely broken-down teeth, as well as apicectomies, biopsies and other procedures.
At Wellington Cosmetic, oral surgery is largely carried out by Dental Surgeons, with an interest in Oral Surgery.
The Clinic also provides a range of oral surgical procedures for patients referred by their general medical practitioner.
Patients are usually referred for the removal of teeth which the referring practitioner is unhappy to remove themselves.
How is oral surgery carried out?
Procedures are usually carried out using routine local anaesthetic (injections) although sometimes sedation can be provided if necessary.
Our service cannot provide minor oral surgery treatment under general anaesthetic. Patients requiring this form of treatment must be referred to the Oral and Maxillofacial Surgery Department at the relevant hospital. Your dentist is able to make this referral if appropriate.
Removal of impacted Wisdom Teeth
Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.
If a wisdom tooth doesn’t have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, you’ll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon. Some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren’t causing problems, as a preventive measure against potential future problems.
Why it’s done
Problems with impacted wisdom teeth
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.
Many people, however, develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or grow normally. Impacted wisdom teeth may erupt only partially or not at all.
An impacted wisdom tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
You’ll likely need your impacted wisdom teeth removed if they result in problems such as:
- Damage to an adjacent tooth
- Development of a fluid-filled sac (cyst) around the wisdom tooth
- Damage to surrounding bone
- Complications with orthodontic treatments to straighten other teeth
Questions to ask your Dental Surgeon
Your Dental Surgeon may perform the procedure in the office. However, if your tooth is deeply impacted or if the extraction is expected to be difficult, your dentist may suggest you see an oral surgeon. Questions you may want to ask your dentist or oral surgeon include:
- How many wisdom teeth need to be removed?
- Will I need local anesthesia (which numbs your mouth and jaw) or sedation anesthesia (which makes you unaware of the procedure)?
- How complicated do you expect the procedure to be?
- How long is the procedure likely to last?
- Have the impacted wisdom teeth caused damage to other teeth?
- Is there a risk that I might have nerve damage?
- What other dental treatments might I need at a later date?
- How long does it take to completely heal and return to normal activity?
Your Dental surgeon may use one of two types of anesthesia. The appropriate anesthesia for you depends on the expected complexity of the wisdom tooth extraction and your own comfort level. Your options include:
- Local anesthesia.Your doctor or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to the gums that numbs the site. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.
- Sedation anesthesia.Your dental or oral surgeon usually gives you sedation anesthesia through tablets given an hour before treatment. Sedation anesthesia suppresses your consciousness during the procedure and you don’t feel any pain. You will also receive local anesthesia to numb your gums.
After the procedure
As you heal from your surgery, follow your doctor’s instructions on:
- After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in dislodging the blood clot from the socket.
- Drink lots of water after the surgery. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
- Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
- Pain management.You may be able to manage pain with a prescription pain medication — given by your dental or oral surgeon — or an over-the-counter pain reliever, such as maxigesic. Holding a cold pack against your jaw also may relieve pain.
- Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
- Swelling and bruising.Swelling and bruising of your cheeks usually improves in two or three days. Use an ice pack as directed by your dentist or surgeon.
- Cleaning your mouth.Don’t brush your teeth, rinse your mouth, spit or use a mouthwash during the first 24 hours after the surgery. After that time, gently rinse your mouth with warm salt water every two hours and after meals for a week after your surgery. Mix 1/2 teaspoon of table salt in a small glass of water. After the first 24 hours, resume brushing your teeth, being particularly gentle near the surgical wound to avoid disrupting any stitches.
- Tobacco use.If you smoke, don’t do so for at least 24 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
- You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.
Most wisdom tooth extractions don’t result in long-term complications. Problems that can occur include:
- Dry socket, or exposure of bone when the post-surgical blood clot is dislodged from the site of the surgical wound (socket) — a complication that delays healing and causes pain
- Infection in the socket from bacteria or trapped food particles
- Damage to sinuses near the upper wisdom teeth
- Weakening of the lower jawbone
- Damage to nerves that results in altered sensation in the lower lip, tongue or chin
When to call your dental or oral surgeon
Call us if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:
- Swelling that worsens after two or three days
- Severe pain not relieved by prescribed pain medications
- A bad taste in your mouth not removed with saltwater rinsing
- Pus in or oozing from the socket
- Blood in nasal discharge
- Persistent numbness or loss of feeling