Where should I get my wisdom teeth removed in Adelaide?

Understanding Impacted Wisdom Teeth

Wisdom teeth, also known as third molars, are the last teeth to develop at the back of the mouth. They usually begin to appear during the late teenage years or early adulthood.

Sometimes there is not enough space for a wisdom tooth to erupt normally. The tooth may remain partly or completely covered by gum or bone. This is known as an impacted wisdom tooth.

Impacted wisdom teeth are common and do not always require removal. Whether a wisdom tooth should be monitored or removed depends on its position, symptoms, the condition of the surrounding teeth and gums, and whether there is evidence of disease or other complications.

What Does an Impacted Wisdom Tooth Look Like?

The position of an impacted wisdom tooth can vary considerably. An X-ray is usually required to determine the position of the tooth and assess the surrounding structures.

Common types of wisdom tooth impaction include:

Mesial Impaction: A mesially impacted wisdom tooth is angled forward towards the second molar. This is one of the more common positions seen with lower wisdom teeth.

Depending on its position, the tooth may create an area where food and bacteria become trapped between the wisdom tooth and the neighbouring molar.

Distal Impaction: A distally impacted wisdom tooth is angled backwards towards the back of the jaw.

Vertical Impaction: A vertically impacted wisdom tooth is positioned relatively upright but may be unable to erupt because there is insufficient space or because it remains covered by gum or bone.

Horizontal Impaction: A horizontally impacted wisdom tooth is positioned almost completely on its side. It may lie against the neighbouring second molar and can sometimes make cleaning the area difficult.

The clinical significance of an impacted tooth depends on its individual position rather than simply the type of impaction.

What Causes Wisdom Teeth to Become Impacted?

Wisdom teeth can become impacted when there is insufficient room in the jaw for them to erupt into a functional position.

Other factors can influence how a wisdom tooth develops and erupts, including:

• The size and shape of the jaw

• The position and angulation of the developing tooth

• The position of the neighbouring second molar

• The amount of available space at the back of the mouth

• The development and eruption pattern of the individual tooth

An impacted wisdom tooth may remain completely covered by bone and gum, partially erupt, or become trapped against the neighbouring tooth.

Can an Impacted Wisdom Tooth Cause Problems?

Some impacted wisdom teeth remain symptom-free and can be monitored. Others can contribute to dental or gum problems. Potential complications include:

1. Pericoronitis: A partially erupted wisdom tooth can develop inflammation and infection of the surrounding gum tissue. This is known as pericoronitis. Symptoms can include pain, swelling, difficulty opening the mouth, an unpleasant taste and tenderness around the back of the jaw.

2. Tooth Decay: The position of an impacted or partially erupted wisdom tooth can make the area difficult to clean. Food and plaque may accumulate around the tooth, increasing the risk of decay. The neighbouring second molar can also be affected.

3. Damage to the Adjacent Tooth: An impacted wisdom tooth can sometimes be positioned against the second molar. In some cases, this may contribute to decay, periodontal problems or damage to the neighbouring tooth.

4. Gum and Periodontal Problems: Partially erupted wisdom teeth can create areas that are difficult to clean. This can contribute to localised inflammation and periodontal problems around the wisdom tooth or adjacent molar.

5. Cysts and Other Changes: In some cases, tissue surrounding an impacted tooth can develop a cyst or other pathological change. These findings are usually identified through clinical examination and dental imaging.

Not every impacted wisdom tooth will develop these complications, which is why individual assessment is important.

Does Every Impacted Wisdom Tooth Need to Be Removed?

An impacted wisdom tooth that is healthy, symptom-free and not causing damage may sometimes be monitored rather than removed.

The decision to remove a wisdom tooth should be based on an individual clinical assessment.

Factors that may be considered include:

• Pain or recurrent swelling

• Episodes of pericoronitis

• Tooth decay

• Gum disease around the wisdom tooth or neighbouring tooth

• Damage or potential damage to the adjacent second molar

• The position and depth of the wisdom tooth

• Evidence of cystic or other pathological changes

• Whether the tooth can be adequately cleaned

• The relationship of the tooth to important anatomical structures

Your dentist or dental surgeon can discuss the advantages and disadvantages of monitoring or removing the tooth based on your individual circumstances.

How Are Impacted Wisdom Teeth Assessed?

Assessment generally starts with a clinical examination.

Dental imaging can then be used to determine the position of the wisdom tooth and assess the surrounding structures. A panoramic X-ray (OPG) is commonly used as an initial assessment.

In selected cases, 3D imaging such as CBCT may be recommended when more detailed information is required, particularly when assessing the relationship between a lower wisdom tooth and the inferior alveolar nerve.

The need for additional imaging depends on the individual case.

Wisdom Teeth Removal Options

If removal is recommended, the appropriate method depends on the position and complexity of the tooth as well as the patient's medical history, anxiety levels and preferences.

Local Anaesthetic: Some wisdom teeth can be removed in the dental chair using local anaesthetic. The area around the tooth is numbed before treatment.

Intravenous Sedation: For suitable patients, intravenous sedation may be available to help reduce anxiety and improve comfort during treatment. Suitability for sedation is assessed individually. Hospital-based treatment.

General Anaesthetic: Some patients may require or prefer treatment under general anaesthetic. Hospital-based treatment may be considered for selected cases, including more complex surgical procedures or patients for whom treatment under local anaesthetic or sedation is not appropriate.

The appropriate option will be discussed following your assessment.

What Happens at a Wisdom Teeth Consultation?

An assessment allows the dental surgeon to review your symptoms, medical history, dental history and imaging before recommending a treatment approach.

Your consultation may include:

1. Discussion of your symptoms and concerns

2. Clinical examination

3. Review of existing dental X-rays or new imaging where required

4. Assessment of the wisdom tooth position

5. Assessment of nearby teeth and anatomical structures

6. Discussion of treatment options

7. Discussion of potential risks and benefits

8. An individualised treatment plan where treatment is recommended

You will have the opportunity to ask questions before deciding whether to proceed.

Wisdom Teeth Removal and Nerve Position

Lower wisdom teeth can sometimes be located close to the inferior alveolar nerve, which supplies sensation to the lower lip, chin and lower teeth.

Dental imaging can help assess the relationship between the tooth and the nerve.

Where the roots of a wisdom tooth are considered to have a close relationship with the nerve, your dental surgeon may discuss additional imaging or alternative treatment approaches, such as coronectomy, where clinically appropriate.

The risks and benefits of the available options should be discussed as part of your individual treatment planning.

Wisdom Teeth Removal Costs and Health Funds

The cost of wisdom teeth treatment can vary depending on:

• The number of teeth being removed

• The complexity of the surgery

• Whether treatment is performed in the dental chair or hospital

• The type of anaesthesia or sedation required

• Imaging requirements

• Hospital or day-surgery fees

• Anaesthetic fees

• Your individual health fund policy

Before treatment, patients should receive information about the proposed treatment and associated fees.

Where applicable, private health insurance claims can be processed using HICAPS. Your individual health fund should be contacted to confirm your level of cover and applicable benefits.

When Should You Seek an Assessment?

Consider arranging an assessment if you have:

• Recurrent pain at the back of your mouth

• Swelling around a wisdom tooth

• Repeated episodes of gum infection

• Difficulty opening your mouth

• An unpleasant taste or discharge around a wisdom tooth

• Food regularly becoming trapped around a wisdom tooth

• A wisdom tooth that appears to be growing into the neighbouring tooth

• A dentist has identified an impacted wisdom tooth on an X-ray

If you develop significant facial swelling, difficulty breathing or swallowing, rapidly worsening symptoms or other signs of a serious infection, seek urgent medical or dental care.

Book an Impacted Wisdom Teeth Assessment

If you have an impacted wisdom tooth or have been advised that your wisdom teeth may require treatment, an assessment can help determine whether monitoring or removal is appropriate.

At your appointment, your dental surgeon can review your clinical situation and imaging, explain the available options and discuss the expected costs before treatment proceeds.

Book an appointment for an impacted wisdom teeth assessment today.

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