“Wisdom Teeth” (Wisdom Teeth) are the last molars (the 3rd molars) that usually emerge in late adolescence to early 20s. Normally, most people have a total of 4 wisdom teeth (upper left, upper right, lower left, and lower right).
What is the difference between wisdom tooth extraction and wisdom tooth surgery?
Wisdom teeth can cause inflammation or infection of the gums and surrounding tissues, which leads to wisdom tooth pain. If the jaw does not have enough space for the wisdom teeth to emerge normally, or if the wisdom teeth grow in positions and angles that push against other teeth, problems can arise. Additionally, wisdom teeth are difficult to clean, so dentists often recommend surgery or extraction of wisdom teeth even if there is no pain. These procedures differ in difficulty, cost, and possible side effects.
|
Wisdom Tooth Extraction |
Wisdom Tooth Surgery |
| Treatment for wisdom teeth that have fully erupted | Treatment for wisdom teeth that are still under the gums or partially erupted |
| Takes less time | More complex, takes longer |
| Lower cost | Higher cost |
| No stitches required | Wound is stitched and requires suture removal as scheduled by the dentist |
Causes of Wisdom Teeth
Due to the evolution of the chewing system to better process food, the size of the jawbone has gradually decreased, leaving insufficient space for the wisdom teeth, which are the largest molars, to emerge normally. This is why wisdom tooth surgery is commonly needed nowadays.
Types of Wisdom Teeth Eruption
Wisdom teeth have various types depending on the position and angle relative to adjacent teeth, which can be divided into 4 types as follows:
|
Type |
Wisdom Tooth Characteristics |
|
Mesial impaction |
Characterized by an angled position pushing the adjacent molar from the front. Also called Angular or Mesioangular impaction. This type of wisdom tooth is the most common and often partially erupted. |
|
Distal impaction |
This type is less common and positioned opposite to Mesial impaction. The wisdom tooth tilts backward where there is no tooth. If the tooth is in a position and angle that is not severely tilted, it may erupt without causing inflammation and may not require surgery or extraction. In some cases, the dentist may monitor for 1-2 years before deciding on surgery. |
|
Vertical impaction |
Upright in a normal angle without pushing adjacent teeth. This type has a good prognosis because it has a high chance of erupting normally without surgery or extraction. |
|
Horizontal impaction |
The wisdom tooth lies horizontally. It is the most difficult type to remove and requires the longest treatment and recovery time. Therefore, treatment should be performed by a specialist oral surgeon only. |
What Symptoms of Wisdom Teeth Indicate the Need for Surgery?
Most wisdom teeth emerge in late adolescence to early adulthood. Some patients may have no symptoms, while others may experience the following:
- Pain, swelling, and possible bleeding in the gums due to periodontal disease
- Swollen gums, sometimes extending to the cheeks or jaw, caused by inflammation or infection
- Jaw pain
- Tooth decay due to difficulty in brushing and flossing
- Altered taste and bad breath caused by food debris trapped in hard-to-clean areas
- Difficulty opening the mouth and pain when opening, especially if swelling and inflammation spread outside the mouth
If you have these symptoms, wisdom tooth surgery may be necessary promptly to prevent worsening problems. You can consult the Dental Center at Phyathai 1 Hospital by calling 02-201-4600 ext. 3415, 02-245-9627, or 02-245-9610.
Is It Necessary to Have Wisdom Tooth Surgery?
You do not need to have all wisdom teeth surgically removed. The main reason dentists recommend surgery is when the wisdom tooth is difficult to clean and at risk of inflammation and infection later. Surgery between ages 18-25 is easier, heals faster, and has fewer complications, so it is advisable not to delay. However, if wisdom teeth show symptoms after age 26-50, the decision depends on the dentist’s judgment.
Important Indications for Wisdom Tooth Extraction or Surgery Recommended by Dentists
- Wisdom tooth partially erupted, not fully visible
- Wisdom tooth has caused or is causing inflammation or infection
- Abnormal alignment of wisdom tooth
- Wisdom tooth has no opposing tooth or causes abnormal bite
Why Should Wisdom Teeth Be Surgically Removed?
- Gum inflammation: Food debris easily gets trapped around wisdom teeth, causing inflammation
- Tooth decay: Difficulty cleaning leads to easy decay of wisdom teeth
- Cyst formation around wisdom teeth, which can damage nearby gums and bone
Is Wisdom Tooth Surgery Scary or Dangerous?
The risk from wisdom tooth surgery is low. If the wisdom tooth is in an abnormal position, deeply embedded, or infected, the surgery becomes more complex, takes longer, and may increase the chance of side effects.
If your dentist recommends surgery, it means the benefits outweigh the risks. Even if side effects occur, most can be managed and are temporary. Possible complications include bleeding, dry socket, infection, and nerve injury, with treatment depending on the specialist dentist’s judgment.
What Happens If You Choose Not to Have Wisdom Tooth Surgery?
- Tooth decay: Wisdom teeth and second molars are close together abnormally, making cleaning difficult and causing decay in both teeth
- Bad breath: Inflamed gums, tooth decay, and trapped food debris can cause bad breath. Wisdom teeth are a major cause of bad breath, affecting your appearance
- Inflamed gums covering wisdom teeth: Partially erupted wisdom teeth trap food debris easily but are hard to clean, leading to bacterial buildup, gum inflammation, pain, swelling, and pus. If untreated, inflammation can spread under the chin or tongue, affecting breathing and potentially causing life-threatening conditions
- Cyst formation: Wisdom teeth can cause cysts that enlarge and damage adjacent teeth and surrounding bone
- Bone resorption: Pressure from erupting teeth can destroy bone around adjacent tooth roots
Is Wisdom Tooth Surgery Painful and How Long Does It Take to Heal?
In reality, most patients say wisdom tooth surgery is not as painful as expected. Before surgery, there is slight pain when the dentist administers anesthesia. After that, you will only feel slight tightness, which is less painful compared to the pain and complications that may occur if the wisdom tooth is problematic.
Wisdom tooth surgery is performed by experienced specialists. Symptoms usually improve within 1 week. During the first 2-3 days, the gums will swell, causing pain and difficulty eating. Dentists recommend resting at home. As eating improves and the wound heals, symptoms gradually improve. If stitches are placed, do not forget to return for suture removal about 7-10 days after surgery.
Is Wisdom Tooth Surgery Expensive?
The cost of wisdom tooth surgery depends on several factors, including:
- Position of the wisdom tooth: Deeply embedded wisdom teeth require longer and more complex surgery
- Orientation of the wisdom tooth: Upside-down or close to other molars requires extra caution during treatment
- Complications: Inflamed gums or cysts may require additional treatment with medication or other procedures, increasing costs
- Treating dentist: Complex cases or difficult positions referred to specialist oral surgeons may have higher costs
- Dental center: Costs vary by facility. Public hospitals are cheaper but have longer wait times. If you have social security insurance, you can claim 900 Baht and pay the difference at private hospitals, which is another option. You can inquire about costs at the Dental Center, Phyathai 1 Hospital.
Preparation Before Wisdom Tooth Surgery
- Take leave from work or school in advance After surgery, you may still feel pain and swelling, and anesthesia effects may last 12-24 hours. Therefore, rest at home for at least 1-2 days to recover.
- Arrange transportation or someone to accompany you After surgery, you may feel tightness and need rest. It is not advisable to drive yourself home. Dentists recommend having someone drive you or using a taxi.
- Take medications as instructed Before surgery, follow your doctor’s advice strictly regarding stopping or taking certain medications. Inform your dentist of all medications you are taking, especially blood thinners.
- Prepare soft foods Pain and tightness after surgery usually last 1-2 days, and you may not want to go out. It is better to prepare soft foods that require little chewing, such as rice porridge, pudding, soup, or yogurt.
- Additional recommendations before surgery
- Get enough rest, at least 8 hours before surgery
- Wear comfortable, loose clothing. If you have long hair, dentists recommend tying it back neatly
- Avoid wearing jewelry, makeup, or lipstick
What is the Procedure for Wisdom Tooth Surgery and How Long Does It Take?
The simple and straightforward steps for wisdom tooth surgery include:
- Blood pressure measurement If you have underlying diseases or are older, the dentist will check your blood pressure before surgery or extraction. Very high blood pressure can cause excessive bleeding and be dangerous. If detected, the dentist may postpone your surgery until your blood pressure is controlled.
- Local anesthesia injection Before extraction or surgery, the dentist will inject anesthesia and confirm it is effective before proceeding. After this, you will only feel slight tightness. The dentist will assess this every time.
- Incision on the gum To access wisdom teeth that are not fully erupted, the dentist will make an incision on the gum to carefully reach the tooth.
- Removal of the wisdom tooth The dentist may need to remove some bone and cut the tooth into smaller pieces for easier removal. You will feel slight tightness as the dentist creates space to extract the tooth effectively.
- Wound cleaning and suturing After the tooth is completely removed, the dentist will clean the wound, stitch it closed, and check for bleeding. Then, you will receive further instructions and medication. You will have a follow-up appointment for suture removal in 7-10 days.
Wisdom tooth surgery usually takes about 20-45 minutes depending on difficulty. However, surgeries lasting hours can occur because even if the dentist assesses the case as uncomplicated from oral examination and X-rays, hidden complexities may arise during treatment.
Taking care of your teeth is like taking care of your overall health. If wisdom teeth are found, whether symptomatic or not, they should not be left untreated to avoid complications later.
The best and most important thing is to consult and receive treatment from an experienced specialist dentist who will plan personalized treatment considering safety and suitability to achieve the best results.
