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Bone regeneration after wisdom tooth removal

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. It is possible for them to erupt and become useful, healthy teeth, but usually they become impacted and need to be removed.

1. When is Bone Regeneration needed?

Wisdom teeth that have erupted or are erupting, require the same care and attention that the rest of your teeth need. Daily flossing and brushing is essential to preventing the from getting decay and gum disease.

Wisdom teeth are right at the back of your mouth, and can be difficult to reach with normal brushing and flossing. Partially closing your mouth makes it easier to reach their outer surfaces and gives you a better ability to clean them.  

 

2. What is a Bone Graft made of?

The term “impacted" is used when the wisdom teeth are unable to fully erupt into the mouth.  This happens if there is not enough space for them to come through, or if they are growing on an angle that stops them from erupting.

An impacted tooth can stay painless for a long time, and you may not even realize it's there. It is only when it begins to hurt, or if it is picked up in a dental exam, will you know it's there. 

A wisdom tooth that has only erupted part of the way, creates a small opening that allows bacteria and food to gather around it. This can make the flap of gum sitting over your wisdom tooth become red and swollen.

This can hurt, you might feel pain in nearby teeth, or in the ear on that side of your face. An impacted tooth can lead to an infection called pericoronitis, which if left untreated, can spread to the throat or neck.

An impacted tooth can push on the neighbouring molar tooth, which can lead to decay or gum disease. It also can change the way your teeth come together. Rarely, impacted teeth can cause cysts or other growths in the jaw.

3. What are the symptoms of impacted Wisdom Teeth?

Impacted wisdom teeth often go unnoticed for many years because they aren't painful to start. Decay doesn't become a toothache until it is quite severe, which is why we recommend early assessment of your wisdom teeth.

As wisdom teeth are erupting, they become exposed to the same food and bacteria that the rest of your teeth are. They are just as susceptible to decay as the rest of the teeth, and even more so if they are difficult to clean.

There only needs to be a small gap in the gum behind the back tooth to expose the wisdom teeth to the bacteria that becomes plaque. Once plaque gets under the gum over an erupting wisdom tooth, it is difficult to remove.

Normal tooth brushing won't be able to get rid of this bacteria, and can make your gum really inflamed. This gum can become so swollen that when you chew, your upper teeth bites into the gum, a condition called pericoronitis.

Plaque may cause the wisdom tooth to get decay, which can become a toothache, or an infection that causes further pain and swelling. You may have difficulty opening your jaw, an unpleasant taste, and swollen lymph nodes.

The molars in front of wisdom teeth can also be affected. Plaque in the tight space between the wisdom teeth and molars, can produce decay that may mean you lose the neighbouring molars as well as the wisdom tooth.

The symptoms of impacted Wisdom Teeth are...

  1. Pain or aching
  2. Swollen & bleeding gums
  3. Swelling around the jaw
  4. Bad breath or unpleasant taste
  5. Headache or jaw tenderness
  6. Stiffness of the neck
  7. Swollen lymph glands

4. Do my Wisdom Teeth require extraction?

Wisdom teeth should be assessed by your general dentist as part of your routine check-up, and if you are unsure then just ask them. 

We will recommend the removal of your Wisdom Teeth if they have the potential to affect your health. Wisdom Teeth do not need to be painful for them to be causing problems. 

Wisdom Teeth that are impacted can develop cysts, an infection that is growing around the Wisdom Tooth.  These will usually not cause any symptoms and can only be detected with an x-ray.

An impacted Wisdom Tooth is often painless and may show no symptoms. When it becomes infected or starts damaging teeth next to it, is when you may finally experience some pain. 

Your wisdom teeth may not need removal if they are...

  1. Fully erupted into your mouth
  2. Able to be kept clean and healthy
  3. A functional part of your bite
  4. Not causing damage to your other teeth

5. Why do we advise preventative Wisdom Teeth removal?

If you have wisdom teeth that are impacted, or look like they will become impacted, we recommend that these be removed as a preventative measure, and at the earliest possible time.

Your wisdom teeth are assessed using an OPG, a full mouth X-ray like those on this page. This should be part of your regular dental check-ups, and you should be advised to have your wisdom teeth removed if they are likely to...

  1. Not fully erupt into your mouth
  2. Cause damage to your other teeth
  3. Become pathology such as a cyst
  4. Increase the risk of jaw fracture

The earlier you have impacted wisdom teeth out, the better. If it looks like your wisdom teeth are going to cause trouble, then it is more or less likely they will.

The ideal time to remove impacted wisdom teeth is in your mid to late teens. There are a number of reasons for this, which are...

  1. The roots securing your wisdom teeth to your jaws have only just started to grow. Wisdom teeth that have little in the way of root formation, are easier to remove, and is a more conservative operation.
  2. The bone in a young person is softer that that of someone older. Less bone needs to be removed to gain access to wisdom teeth, and the increased flexibility in the bone makes them easier to remove.
  3. Severely impacted wisdom teeth, may prevent the normal growth of bone around the molar teeth in front. Removing such wisdom teeth can leave large defects around these molars, which will fill in with bone if you are young enough. If not, you will need additional bone grafting to ensure the longevity of the 2nd molar teeth.

6. Do I need Bone Grafting when I get my Wisdom Teeth out?

A wisdom tooth that is heavily impacted against the molar tooth in front, can destroy a substantial amount of the bone around the back part of this tooth.

Removing a wisdom tooth like this, leaves the back portion of the next molar without the gum and bone covering it to protect it from decay and gum disease.

This can be overcome through bone grafting, which rebuilds the bone around the back of the next molar that was destroyed by the impacted wisdom tooth.

The bone graft material is a product called BioOss, which is a natural bone substitute derived from the mineral portion of bovine, or cow bone.

7. Will I need to go under a general anaesthetic?

Not all wisdom teeth extractions are complicated or extremely difficult. Many wisdom teeth can be removed in our dental surgery under local anaesthesia. Other forms of sedation are available to relieve anxiety about the procedure. 

If you feel that you are anxious about the procedure and would prefer not to remember it, you may choose to have your wisdom teeth removed under general anaesthesia in a private hospital setting.

It is important to remember that having a general anaesthetic is a medical procedure that has its own recovery period. Most people that undergo general anaesthesia will feel the after effects for a few days after surgery.

Your decision should be made based on how well you tolerate other dental procedures. Wisdom teeth removed by a specialist is a relatively quick and painless process that can be completed in the chair under local.

If you experience high levels of anxiety during standard dental or other medical procedures, then it may be advisable to have the operation performed in a hospital setting under a general anaesthetic.

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