Impacted teeth & Surgical removal of complex teeth

WISDOM TEETH

WHAT EXACTLY ARE WISDOM TEETH?
Wisdom teeth or third molars are the last teeth to erupt, usual y between the ages of 17 and 25 years. Most people have four wisdom teeth, but it is possible to have fewer or more. It is generally accepted that teeth which remain completely buried or unerupted in a normal position wil have to be assessed for their potential to cause harm.

WHAT DOES IT MEAN IF YOUR WISDOM TEETH ARE IMPACTED?
Teeth become impacted due to a lack of space in the dental arch. Their eruption is therefore prevented by gum, bone, another tooth or all three. When teeth are impacted it is best to remove them as they can cause problems e.g. tooth crowding, infections and pain.

WHAT ARE THE RISKS INVOLVED IN REMOVING WISDOM TEETH?
Sometimes the roots of the teeth are lying across one of the facial nerves and care should be taken in removing the roots without damaging the nerve. Should the wisdom teeth in the upper jaw lie very high up, the sinus floor could be opened when they are removed. If this happens during the operation, the surgeon will have to close the sinus by creating a flap out of the gums to close the area. Please adhere to the following instructions as closely as possible, to ensure healing of the sinus: Don’t blow your nose for two weeks; If you have to sneeze, then please sneeze through your mouth and nose simultaneously – don’t block your nose to suppress your sneeze! Avoid snif ing very hard. Only use your nasal spray if your nose feels blocked. If you use it every 4 to 6 hours as advised on the package insert, it wil only be effective for 5 days.

INSTRUCTIONS TO ADHERE TO BEFORE UNDERGOING GENERAL ANAESTHESIA
• Please confirm your date and time of admission at the clinic or hospital to avoid late admissions or missed appointments.
• You are not allowed to drive a motor vehicle for at least 24 hours after undergoing general anaesthesia. Please arrange for someone to drop you off and pick you up again!
• If you need authorization from your medical aid before undergoing the procedure, you should arrange for the authorization number timeously. Most hospitals require a pre-admission fee before admission for general anaesthesia, if you do not have your authorization number.
• If you contract a cold or influenza before your operation date, you should please bring it under our attention, in order to arrange for an alternative date when you have recuperated.
• If you are a smoker, I urge you strongly to stop smoking for at least 48 hours before the operation, to minimize the risk for lung complications. Please inform nursing staff if you suffer from any serious diseases, and of all allergies, should you have any.
• You are not allowed to eat or drink anything for at least 8 hours before your operation. This also applies to your early morning cup of coffee! If you are a diabetic, then special precautions wil have to be taken to keep your blood sugar at an acceptable level.
• The hospital wil supply you with a gown and underwear to wear during the operation.
• Avoid taking Aspirin containing analgesics, as this might lead to excessive bleeding and bruising. If you are taking Aspirin to prevent thrombosis, you should carry on taking it, but please inform your physician of your condition. If you are younger than 18 years, then your parent / legal guardian / spouse should accompany you to sign for your operation.

HOW MUCH PAIN WILL I HAVE AFTER THE OPERATION?
Swelling and pain can be expected for about five days and varies from person to person, with the second day usually being the worst. If the swelling, bruising and pain continue for more than five days it is best to book a follow-up appointment.

POST OPERATIVE CARE?
• An antibiotic, painkil er and an anti-inflammatory will be prescribed by the doctor after the operation to ease pain (please inform the doctor if you are allergic to penicil in). Don’t wait until the pain becomes unbearable before taking your pain medication, because then you might need larger dosages to control your pain.
• Finish your course of antibiotics and avoid consuming any alcohol while taking medication.
• Avoid lying flat on your back, as this might lead to facial swelling.
• It is advised to put an ice pack on the side of your mouth to prevent excessive swelling. This should be done at twenty minute intervals for the first day after the operation.
• Rinse twice daily with the prescribed mouth wash. You may rinse with warm salt water as often as your wish, but do not spit as this promotes bleeding and may dislodge the blood clot, which may result in a dry socket. (A dry socket is when the blood clot formed at the extraction site is dislodged and results in irritation and pain).
• The stitches wil dissolve by themselves any time between 5 and 15 days. Brush your teeth thoroughly to prevent infection.
• Should your wound bleed more than expected, place a damp unused tea bag (black English tea) on the wound and bite onto it. The tannin in the tea and the pressure will aid in blood clotting.

Surgical removal of teeth

• You are not allowed to eat or drink anything for at least 8 hours before your operation if undergoing general anaesthetic.
• No fluids for at least 1 hour after the operation. Take pain medication immediately.
• For 3 hours after the operation no warm fluids or any other food.
• Should the wound start bleeding again, take a teabag (black English Tea), wet it under the tap and bite lightly onto it – the pressure of the bite and the tannin in the tea will stop the bleeding by helping the blood to coagulate.
• After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. It will help towards a speedy recovery and lead to less bone loss.
• The blood clot will have a greyish-brown colour after a day or two – this should not be removed or sucked out with the tongue as this will cause a dry socket. That is when the blood clot formed at the extraction site is dislodged and results in irritation and extreme pain.
• An antibiotic, painkiller and an anti-inflammatory will be prescribed by the doctor after the operation to ease pain (please inform the doctor if you are allergic to penicillin). Don’t wait until the pain becomes unbearable before taking your pain medication, because then you might need larger dosages to control your pain.
• Finish your course of antibiotics and avoid consuming any alcohol while taking medication.
• It is advised to put an ice pack, covered in a cloth, on the side of your mouth to prevent excessive swelling. This should be done at twenty minute intervals for the first day after the operation.
• Avoid lying flat on your back, as this might lead to facial swelling. Sleep on 3 pillows for the first 48 hours. This will reduce swelling and bruising.
• Do not smoke for at least 48 hours after the operation as it promotes bleeding and interferes with the healing process.
• Only consume soft or liquid foods for the first three days, avoid popcorn or any other food with pips, seeds or peels for a period of 3 weeks.
• It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.
• Rinse twice daily with the prescribed mouth wash. You should rinse with warm salt water (1 teaspoon of salt and ½ teaspoon of bicarbonate of soda dissolved in 250ml of water) as often as your wish or at least after every meal, but do not spit as this promotes bleeding and may dislodge the blood clot, which may result in a dry socket.