Wisdom Teeth Surgery

Wisdom Teeth

Wisdom teeth, or third molars, are the last teeth to develop, usually appearing in your late teens or early twenties. Often, there isn't enough room for them, causing them to become "impacted" – trapped below the gum or partially emerged.

Why are impacted wisdom teeth a problem?

Even when they're not causing immediate pain, impacted wisdom teeth can set the stage for:

  • Infection: Partially erupted teeth create hiding spots for food and bacteria, leading to infections and gum disease.

  • Cysts and Tumours: Impacted teeth can stimulate the formation of fluid-filled sacs (cysts) that damage the surrounding jawbone and teeth. Rarely, tumours can also develop.

  • Damage to Adjacent Teeth: As impacted wisdom teeth try to erupt, they can push on existing teeth, causing crowding, shifting, and even damage to their roots.

  • Pain and Discomfort: Impacted wisdom teeth are a common source of recurring pain, swelling, and jaw stiffness.

What to expect with Wisdom Tooth Surgery

The modern standard of care for wisdom teeth removal typically involves a general anaesthetic in a hospital setting. This ensures a comfortable, minimally invasive procedure, performed while you are asleep, allowing for a quicker recovery. However, in select cases, your surgeon may determine that a local anaesthetic procedure in a clinic setting is suitable. Your surgeon will discuss your specific situation and recommend the best approach for you.

General Anaesthetic Procedure (Hospital Setting):

  • Fasting: You will need to fast for 6 hours prior to your procedure. This usually means no food or drink after midnight for a morning operation, or from early morning for an afternoon operation.

  • Hospital Arrival: You will typically arrive at the hospital 1-2 hours before your scheduled procedure.

  • Hospital Admission: You will be checked in by hospital admission staff. Completing the hospital admission paperwork online beforehand can streamline this process.

  • Day Procedure: Wisdom tooth surgery is usually a day procedure, meaning you will return home on the same day.

  • Procedure and Recovery: After the procedure, you will spend approximately 1.5-2 hours in the recovery room before being discharged.

  • Discharge: You must have a responsible adult pick you up from the hospital (not a taxi or ride-share service) and stay with you overnight.

  • Medications and Instructions: We will provide you with prescriptions for antibiotics (when required), pain medication, and an antibacterial mouthwash on the day of your surgery. You will also receive written post-operative care instructions.

  • Follow-up: Our team will contact you within two weeks of the procedure to monitor your recovery. You can also contact your surgeon or the clinic with any concerns.

Local Anaesthetic Procedure (Clinic Setting):

  • Pre-Procedure Meal: There is no need to fast for a local anaesthetic procedure. In fact, we encourage you to have a light meal beforehand to prevent faintness during the procedure.

  • Arrival: Please arrive at least 20 minutes before your scheduled procedure.

  • Local Anaesthetic Administration: You will receive local anaesthetic injections (similar to those given by a dentist). You will then rest for 10 minutes while the anaesthetic takes effect. During this time, we will provide you with both verbal and written post-operative care instructions.

  • Procedure and Discharge: The procedure itself usually takes 30-45 minutes. You will be ready to leave within 15 minutes of the procedure’s completion.

  • Medications and Instructions: We will provide you with prescriptions for antibiotics, pain medication, and an antibacterial mouthwash on the day of your surgery.

  • Follow-up: Our team will contact you within two weeks of the procedure to monitor your recovery. You can also contact your surgeon or the clinic with any concerns.

Risks

Wisdom teeth surgery is an incredibly safe and common procedure, especially when performed by a specialist oral and maxillofacial surgeon. While complications are very rare, it's essential to be aware of the potential risks before making a decision. This information aims to outline those potential risks.

General Risks Associated with All Wisdom Teeth Removal:

  • Pain and Swelling: Some pain and swelling are expected after surgery. This is usually managed with pain medication and cold compresses.

  • Bleeding: Some bleeding is normal in the immediate post-operative period. You will be given instructions on how to manage this.

  • Dry Socket (Alveolar Osteitis): This occurs when the blood clot in the extraction site is dislodged, causing intense pain. It usually requires a dressing and pain relief from your surgeon.

  • Infection: Although rare, infections can occur. Antibiotics may be prescribed if this happens.

  • Temporary Limited Mouth Opening (Trismus): This is due to muscle soreness and usually resolves within a few days.

Specific Risks Associated with Upper Wisdom Teeth Removal:

  • Oral Antral Communication (OAC): This is a connection between the mouth and the maxillary sinus (air-filled space in the cheekbone). If this occurs, it may require further treatment, including closure with stitches or a small flap of tissue.

  • Displacement of Roots into the Sinus or Other Facial Spaces: In rare cases, a root tip may be displaced into the sinus or other facial spaces. This may require further surgery to retrieve it, potentially including sinus surgery.

  • Need for Further Surgery: As mentioned above, OAC and root displacement may require further surgical intervention, including sinus surgery and repair.

Specific Risks Associated with Lower Wisdom Teeth Removal:

  • Inferior Alveolar Nerve Injury: This nerve supplies sensation to the lower lip, chin, and teeth. Damage to this nerve can result in numbness, tingling, or altered sensation (dysaesthesia) in these areas. In most cases, this is temporary, but in rare instances, it can be permanent.

  • Lingual Nerve Injury: This nerve supplies sensation to the tongue and taste. Damage to this nerve can result in numbness, tingling, or altered taste sensation. Similar to inferior alveolar nerve damage, this is usually temporary, but can be permanent in rare cases.

  • Altered Sensation (Dysaesthesia): This can include burning, tingling, or other unpleasant sensations in the affected area.

Rare but Serious Risks:

  • Mandible Fracture: In very rare cases, the jawbone can fracture during or after surgery, particularly in older patients or those with weakened bones.

  • Osteomyelitis: This is a rare bone infection that may require prolonged antibiotic treatment.

Osteonecrosis of the Jaws (ONJ):

This is a rare but serious condition in which the jawbone fails to heal after minor trauma, such as a tooth extraction. The risk of ONJ is increased in patients who:

  • Have received radiation therapy to the jaws.

  • Are taking bisphosphonate medications (e.g., Actonel, Fosamax, Zometa) for osteoporosis or other bone conditions.

  • Are undergoing chemotherapy.

  • Are taking Denosumab (Prolia).

If you are taking any of these medications, it is crucial to inform your surgeon before surgery.

Important Considerations:

  • The likelihood of these complications varies depending on factors such as the position of your wisdom teeth, your age, and your overall health.

  • Your surgeon will discuss your specific risks with you before surgery.

  • It is important to follow your surgeon’s post-operative instructions carefully to minimise the risk of complications.

Fees

Understanding the fees associated with wisdom tooth removal can feel like navigating a maze. Let's break it down:

Hospital Setting:

When your procedure is performed in a hospital under general anaesthetic, three main fees apply:

  • Surgical Fee: This covers the surgeon's expertise. It's often lower for hospital procedures due to efficiency. Typically, removing four wisdom teeth costs $2,800 but can be as low as $2,400. Your private health insurance "extras" cover will provide a rebate for this as a major dental procedure.

  • Hospital Fee: This covers the hospital's facilities and resources. Good news! This is usually covered by your private health insurance "hospital cover," with the out-of-pocket expense limited to your policy's excess (typically $0-$500). If you've already paid your excess this year for another admission, you likely won't have further hospital fees.

  • Anaesthetic Fee: This covers the anaesthetist's services. It ranges from $500-$800, with partial coverage from both private health insurance and Medicare. Your out-of-pocket expense is usually around $100-$350.

Clinic Setting (Local Anaesthetic):

If your case is suitable for removal under local anaesthetic in our clinic, you'll only have the surgical fee. While there are no hospital or anaesthetic fees, the surgical fee may be slightly higher than for a general anaesthetic procedure.

Get an Accurate Estimate:

We'll provide you with the item codes for your specific procedure. We strongly recommend contacting your private health fund with these codes (typically the codes are 322 or 324 per tooth) to confirm your exact out-of-pocket expenses for the surgical, hospital, and anaesthetic fees. This will give you a clear picture of the overall cost before proceeding.