Dental Surgery

Wisdom Tooth Extraction

Wisdom teeth are the third molars located at the very back of the dental arch. They are often impacted within the jawbone, grow at an angle, or sometimes horizontally. In some cases, the roots may be abnormally curved or enlarged. Therefore, extracting wisdom teeth differs from regular tooth extraction and requires specialized skills. The surgery is performed with caution, but noticeable pain and swelling after the procedure are inevitable, so proper care is necessary.

Wisdom Tooth Extraction Procedure

  1. Local Anesthesia → Numb the surgical area.

  2. Incision in Gum Tissue → Only if the tooth is covered by soft tissue.

  3. Bone Removal → Remove part of the jawbone if necessary to access the tooth.

  4. Tooth Sectioning → Divide the wisdom tooth into smaller pieces.

  5. Crown Removal → Extract the tooth crown first.

  6. Root Extraction → Remove the remaining tooth roots.

  7. Cleaning and Suturing → Clear out any fragments, clean the socket, and place 4–5 stitches.

  8. Hemostasis → Bite down on gauze to stop bleeding.

When Wisdom Teeth Need to Be Extracted

  1. Impacted or Misaligned Wisdom Teeth – Wisdom teeth grow at an angle, sideways, or partially remain trapped in the jawbone.

  2. Food Impaction and Decay Risk – A wedge-shaped angle between the second molar and the wisdom tooth traps food, making it difficult to clean. Over time, this can cause cavities in both teeth, pulp inflammation, and may endanger the second molar. Teeth with severe pulpitis may need root canal treatment, crowns, or even extraction of the second molar.

  3. Pericoronitis Risk – Limited space at the back of the mouth and gum covering over the wisdom tooth creates a pocket where food and bacteria accumulate, leading to inflammation around the crown.

  4. Spread of Infection – Pericoronitis can lead to abscesses in adjacent teeth, infections in nearby spaces, and eventual absorption of alveolar bone or tooth roots.

  5. Impact on Orthodontic Treatment – Wisdom teeth tilted forward can block tooth movement during braces and, if left after treatment, may push front teeth out of alignment.

  6. Interference with Prosthetic Treatments – Erupting wisdom teeth may obstruct crown or bridge placement on the second molars, reducing the longevity of dental prosthetics.

  7. Jaw Function Issues – A single erupting wisdom tooth without a corresponding tooth on the opposite side may over-erupt, causing bite problems and potentially contributing to temporomandibular joint (TMJ) issues.

Apicoectomy and Gum Surgery

Root or gum surgery procedure

Step 1: Take X-RAY

Step 2: Local anesthesia

Step 3: Incise and flap the gum

Step 4: Clean and disinfect the root or inflamed areas around the root

Step 5: Suture and allow the wound to heal

Situations that require root-end resection or gum surgery

  • Abscess

  • Persistent discomfort or pain after root canal treatment

  • X-ray shows a large area of radiolucency around the tooth root

Teeth suitable for apicoectomy or periodontal surgery

  • Upper jaw (maxilla): both sides, from front teeth to molars
  • Lower jaw (mandible): both sides, from front teeth to first molar

Situations not suitable for gum or root-end surgery

  1. Extensive inflammation

  2. Signs of a fractured tooth root

  3. Severe periodontitis with significant alveolar bone loss

  4. Tooth root close to or inside the maxillary sinus

  5. Presence of serious complications

Is there a possibility of recurrence?

There is a possibility of recurrence. If the inflammation continues to worsen, the doctor will recommend tooth extraction.