Oral surgery is the surgical side of dentistry: the removal of teeth that cannot simply be pulled, and operations on the gum and jawbone. Our oral surgeons carry out complex extractions, the removal of impacted wisdom teeth and dental cysts, and other surgical procedures on site, so that you do not have to be referred to a hospital. Every case is planned in advance, with 3D imaging where it is appropriate.
What we do
- Wisdom teeth that are impacted, partly through the gum, decayed or causing repeated infection
- Difficult extractions: broken teeth, retained roots, teeth with curved roots or close to a nerve or the sinus
- Extractions before braces or dentures
- Apicectomy: removing the infected tip of a root when root canal treatment alone has not cleared the infection
- Cysts and small lumps in the mouth, with a sample sent for laboratory examination
- Exposing a buried tooth so that it can be brought into line with braces
- Preparing the jaw for implants: see dentures, implants and bridges
Planning
At the consultation the surgeon examines your mouth and studies your X-rays. For a wisdom tooth lying close to the nerve that gives feeling to the lip and chin, or an upper tooth close to the sinus, a 3D scan shows exactly where each structure lies. You are told what the operation involves, the risks that apply to your tooth, the alternatives, including leaving it alone, and what recovery will be like. Not every wisdom tooth needs to come out: one that is buried and causing no trouble is often better left and watched.
The procedure
Most oral surgery is done under local anaesthetic. You are awake and feel pressure and movement, but not pain. If you are anxious, or the operation is a long one, it can be combined with sedation. A typical wisdom tooth takes between twenty minutes and an hour. Dissolving stitches are usually used.
Recovery
Swelling and stiffness of the jaw peak on the second or third day and settle over a week. You are given written instructions; the essentials are:
- Bite on the gauze for the time advised, and do not rinse on the first day
- From the second day, rinse gently with warm salt water after meals
- Soft food, plenty of fluids, and painkillers as advised, taken before the numbness wears off
- No smoking and no alcohol for several days: smoking is the main cause of dry socket, a painful delay in healing
- No strenuous exercise for two or three days
Contact us if bleeding does not stop with firm pressure, if pain gets worse after the third day, or if you develop a fever, a bad taste or increasing swelling. Lasting numbness of the lip, chin or tongue is uncommon and is discussed with you beforehand where your tooth carries that risk.
Before your operation
Tell us about every medicine you take, especially blood thinners, medicines for osteoporosis, steroids and anything that affects your immune system, and about heart conditions, diabetes and pregnancy.
Common questions
How long will I need off work? Often a day or two; longer after several teeth or a difficult extraction.
Can all four wisdom teeth be removed together? Yes, where that suits you. Sedation makes it easier.
I am in pain with a wisdom tooth now. Book an emergency appointment. The infection is settled first and the surgery planned afterwards.
