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Wisdom Tooth Extraction and Surgery

What Are Wisdom Teeth?

Wisdom teeth, also known as third molars, are teeth that grow at the back of the mouth.

They are the last teeth to appear, and will typically appear between ages 18 to 25. Each individual will have a total of 4 wisdom teeth – 2 in the lower jaw and 2 in the upper jaw. Once they start to erupt, it can take several months to a couple of years for them to fully emerge. 

However, certain factors can influence this timeline. For instance, if a wisdom tooth is impacted, it might never fully emerge or take longer to do so. Hence, regular dental check-ups are essential during the time when your wisdom teeth typically emerge to ensure they are coming in correctly or to determine if removal is necessary.

Wisdom teeth removal is a common dental procedure but not everyone necessarily needs to have them extracted. 

Signs That Indicate You Should Consider Removal

If you notice any of these signs, you should consult a dentist who can give you advice on the best course of action:

  • Bad breath: Chronic bad breath or an ongoing unpleasant taste in the mouth can be due to an infection or decay related to a wisdom tooth.
  • Difficulty opening your mouth: If there is inflammation or infection around a wisdom tooth, it might become challenging to open your mouth fully.
  • Pain and tenderness: Experiencing pain or tenderness in the back of your mouth, particularly behind the molars.
  • Swollen or bleeding gums: Inflammation or bleeding of the gums near the rear of the mouth can be indicative of problems with the emerging wisdom tooth.
  • Swelling: Swelling around the jaw or the side of the face might suggest an impacted wisdom tooth or an infection associated with it.

Patients are generally advised to remove impacted wisdom teeth if they are present. Impacted wisdom teeth are teeth that have partially erupted through the gum or can be completely buried in the soft tissue or jawbone.

If not removed, they may cause the following issues:

  • Tooth Decay

    Wisdom teeth grow at the back of the mouth, making them hard to clean which may accumulate food particles and cause plaque buildup.

    Leaving this untreated can lead to the decaying of the wisdom tooth and surrounding teeth. Thus, it is best to remove your wisdom teeth as soon as possible to prevent this.

  • Gum Disease

    Impacted wisdom teeth may impede oral hygiene, causing gum disease.

    Symptoms can include aching gums and teeth, swollen gums and persistent bad breath. In such cases, you will need to seek gum treatment.

  • Teeth Crowding

    At times, your wisdom tooth may be misaligned which can push your existing teeth and cause them to become crooked.

    This negatively affects your appearance, bite and oral hygiene. If you have had any orthodontic treatment done, your teeth may become misaligned again.

  • Jaw damage

    In rare cases, cysts can form around the wisdom teeth. If left untreated, they can damage the jaw bone and infect surrounding teeth.

    When this happens, you will need to undergo a complex and comprehensive treatment.

Your wisdom tooth will be extracted either by a simple extraction or surgery. This depends on the state of your wisdom teeth.

Simple Extraction

A simple wisdom tooth extraction is mostly used to remove upper and lower wisdom teeth that are visible but not impacted.

During this procedure, local anaesthetic will be administered so that you will not feel any pain. Thereafter, the dentist will loosen the tooth and extract it.

Surgery

Wisdom tooth surgery (or surgical extraction) is required when your tooth has partially erupted, has not fully erupted and/or is impacted.

During the surgery, you will receive

  • Local anaesthetic

Local anaesthetic is injected to numb the area, preventing you from feeling pain during the procedure.

  • IV sedation

You might also be given IV sedation during the surgery. Patients given an IV sedation will be semi-unconscious.

This means that you will not feel any pain and will not be aware of what is going on during the procedure.

Simple wisdom tooth extractions and surgeries are done as outpatient procedures, so patients can head home on the same day after it is done.

To prepare for the procedure, your dentist should give you tailored advice on what to do but here are some general guidelines to follow:

1. Eat well before the procedure

After the procedure, your jaw will be numb for about 2 to 3 hours and it will be challenging to eat or drink. Hence, you are advised to have a light meal 1 to 2 hours before your appointment.

Your dentist will be able to advise on eating and drinking before the procedure, depending on the sedation used.

2. Brush and clean your teeth thoroughly

Cleaning your teeth thoroughly will ensure that all plaque is removed, decreasing any risks of an infection after the extraction.

3. Wear loose and comfortable clothes

You will not be changing into any surgical attire for the procedure, so it is best to wear loose and comfortable clothes.

4. Arrange for someone to bring you home after the procedure

You may feel groggy after the extraction procedure if it involves IV sedation. To ensure your safety, please arrange for someone to bring you home.

Part 1: Consultation

  • Understanding Concerns

    During your consultation, our dentist will have a chat with you to learn about your concerns, lifestyle habits and dental condition.

  • Dental Check Up

    Next, a dental check up will be conducted to check on the condition of your teeth and gums.

    This usually includes X-rays, if necessary, to locate the position of your wisdom teeth.

  • Customised Treatment Plan

    Once the check-up is complete, our dentist will advise whether a simple extraction or surgery is required and explain the entire procedure to you.

    They will also brief you on how to prepare for the procedure and answer any of your questions.

Part 2: Wisdom Tooth Extraction

  • Administration of Anaesthetic

    To ensure that you do not feel any pain, the area around the wisdom tooth will be injected with local anaesthetic to numb it.

    General anaesthesia or IV sedation may also be used if required, based on your treatment plan.

  • Wisdom Tooth Extraction

    The dentist will then cut your surrounding gum, exposing the tooth and bone to gain access to your wisdom tooth. Thereafter, the tooth will be extracted.

    It is normal to feel some pressure and hear cracking noises, but you should not feel any pain.

  • Stitching of Gums

    After your tooth has been extracted, the dentist will clean the area and use stitches to close the extraction hole.

    These stitches aid in the formation of blood clots to promote healing. They should be removed 1 to 2 weeks later.

If you have been given general anaesthesia or IV sedation, you may be taken to a recovery room where the staff will monitor you as the effects of the anaesthesia wear off. However, if you have been given local anaesthesia, most of the recovery process takes place right in the dental chair. There is no need for monitoring.

For the first few days after the extraction, it is normal to experience the following symptoms:

  • Bleeding

    Some light bleeding from the wound may occur. Ensure that you avoid rinsing your mouth or gargling vigorously and prevent chewing on the extraction site. You should also replace the gauze on the extraction site as instructed by your dentist.

  • Pain and Stiffness

    Typically, the pain will peak about 6 hours after your procedure. You may feel pain and stiffness in your jaw for up to 10 days, depending on how complicated the extraction was. Your dentist may prescribe pain relievers to help you manage this discomfort.

  • Swelling in Face or Cheeks

    In the next 2 to 3 days after the procedure, you may notice some swelling in your face or cheeks. Using a cold pack can help reduce this swelling.

  • Bruising on Face

    Other than swelling, there may be bruising which is part of the healing process. This should subside after 1 week.

These symptoms should wear off after 1 to 2 weeks. However, if they persist, do consult our dentists immediately.

Recovery Tips After Extracting Wisdom Teeth

After removing your wisdom tooth, you may take up to 2 weeks to fully recover. Here are some recovery tips as pointed out by our dentist, Dr. Pua.

  • Do’s
    • Go about your daily activities after the procedure.
    • Use the gauze pads provided to stop the wound from bleeding.
    • Use mouthwash as instructed to ensure the mouth and wound are kept clean.
    • Apply cold compress during the first 24 hours to reduce swelling.
    • Brush your teeth as per normal while avoiding the area around the extraction.
    • Have a soft food diet.
    • Take the prescribed medication, if any.
    • Use wisdom tooth pain relief methods recommended by dentists.
  • Don’ts
    • Avoid strenuous activity for the next couple of days.
    • Do not swish when cleansing your mouth as this can dislodge blood clots.
    • Avoid spicy food.
    • Avoid hot, caffeinated, carbonated and alcohol beverages.
    • Avoid smoking for at least 48 hours to prevent infection in the wound.
    • Rinse and spit excessively.
    • Suck liquids through a straw.

Managing Pain After Wisdom Tooth Removal

It is normal to experience pain after wisdom tooth removal. Here are some ways which you can relief the discomfort:

  • Maintain good oral hygiene: Use a soft toothbrush to clean all areas of your mouth (except the surgical site) and rinse your mouth with antibacterial mouthwash or warm salt water regularly. This can help to prevent infections.
  • Using an ice pack: Applying a cold pack or ice wrapped in a cloth to the cheek can help reduce swelling and numb the area, providing relief from pain. Use the cold compress in 5-minute intervals in the first 18 hours following your procedure.
  • Using pain medication: Your dentist might prescribe painkillers. Ensure you take them as directed and be aware of potential side effects.

Always follow the specific post-operative instructions provided by your dentist. If your pain is unmanageable or you have concerns about your recovery, seek professional advice from your dentist.

Risks of Wisdom Tooth Extraction

As with any type of procedure, wisdom tooth extraction comes with some risks. However, the risks are usually small and rare. Some of them include:

  • Dental Trismus

    Trismus is a temporary dental condition characterised by pain and restricted mouth movement. This can happen due to trauma to the jaw from dental surgery.

    If you experience this, avoid forcing your mouth open and stick to a soft food or liquid diet to facilitate recovery.

  • Dry Socket

    Dry socket is a dental condition that occurs when the blood clot at the extraction fails to develop, dissolves or dislodges. Some tell-tale signs of a dry socket are dull, throbbing pain in your jaw, bad breath and an unpleasant taste in your mouth.

    Speak to your dentist if the pain worsens in the days after the surgery or if you suspect that you have a dry socket.

  • Nerve Damage

    Wisdom tooth extraction may potentially cause damage to your inferior alveolar nerve and the lingual nerve. These nerves are in charge of supplying sensation to your lower teeth and tongue.

    Fortunately, the risk of nerve damage is relatively low and the effects of these damages are seldom permanent.

  • Infection

    After a tooth is extracted, it leaves behind an open socket. This socket is exposed to the bacteria-rich environment of the mouth, making it susceptible to infections. If you experience continuous swelling, pain or tenderness, you may have an infection. It is essential to see your dentist and get it treated promptly.

  • Tooth Root Fracture

    If the roots of your wisdom tooth fractures during extraction, your dentist might opt to leave them in place. This decision is when no disease is detected or if removing the root fragments could lead to additional complications.

Here’s a breakdown of the cost of wisdom tooth extraction at i.Dental (prices are inclusive of GST):

Cost Claimable by MediSave? Eligible for CHAS subsidy?
Consultation*$21.80 - $54.50NoNo
Simple extractions $196.20 - $272.50 (per tooth)NoYes, for CHAS blue card only
Surgeries $708.50 - $1689.50 (per tooth)Yes, you can use MediSave to cover a portion of the costNo

*This includes a basic oral examination. X-rays or orthopantomogram X-rays will be charged separately if necessary.

While MediSave cannot be used for simple extractions, you may enjoy subsidies if you have a CHAS blue card. Find out more about how much subsidies you are eligible for if you hold a CHAS, Pioneer Generation or Merdeka Generation card.

MediSave can be used to pay for the partial cost of your wisdom tooth surgery. You can claim up to $1,550 per tooth and this amount depends on the complexity of your treatment.

 

Number of Teeth Claim Amount
Single ToothUp to $1,550
2 or 3 TeethUp to $2,150

 

How To Use MediSave to Pay for Wisdom Tooth Surgery in Singapore

To claim from your MediSave account, you will need to be a Singapore citizen or permanent resident and have sufficient funds in your account. Here is how you can use MediSave to pay for your wisdom tooth surgery.

Patients with at least $2,000 in their MediSave accounts

You will only be required to pay the difference between the total amount payable and the amount you can claim from MediSave. 

Here is an example of how the payment scheme will work:

Cost of surgery$2,000
Amount claimable from MediSave $1,900 ($950 per tooth)
Amount you need to pay $100

Patients with Less than $2,000 in their MediSave Accounts

If you have less than $2,000 in your MediSave account, the full sum of the procedure will be collected. Thereafter, your MediSave claim will be processed and a cheque made payable to you will be issued. This process will take approximately 2 months.

Patients with No MediSave Accounts

If you do not have a MediSave account, you have 2 options:

  • Option 1: Pay using an interest-free credit card instalment plan. Payment will be spread out over 12 months.
  • Option 2: Use your immediate family’s MediSave account to pay for your surgery. This includes your siblings, parents, grandparents, spouse, or children.
  • Decades of Experience

    With over 30 years of experience, our team of qualified dentists have accumulated the expertise and knowledge required to provide you with quality treatment.

  • Our Technology

    Planmeca Cone Beam CT Scan (CBCT): With this 3D x-ray system, it allows for informed treatment planning, avoiding vital structures like nerves.

FAQs

It is recommended if the wisdom tooth is decayed or impacted. If not removed, they could cause gum infection, gum disease and also, decay on adjacent teeth.

Aside from that, if you experience the following recurring issues, it is advised to get your teeth checked.

  • Recurring gum pain (aka pericoronitis)
  • Regular food trap
  • Improper hygiene potentially leading to decay of both the wisdom teeth and their neighbouring teeth

It is generally recommended to remove your wisdom teeth when you are between the ages of 18 and the early 20s. However, your dentist may advise you to remove them earlier depending on the structure of your teeth.

While this is possible, your oral health and medical history will need to be taken into account. If you do not have any medical complications and only require simple extractions, your dentist may recommend you to remove all your wisdom teeth at one go. You may also opt to remove 2 of your wisdom teeth on one side first, followed by the other side.

As each individual’s case is different, consult with your dentist to find out which is the most suitable option for you.

Yes, you do! Delaying the procedure may lead to further complications, especially if your wisdom tooth is impacted.

If you are prone to dental anxiety, an IV sedation can be administered via an intravenous line in your arm. Furthermore, your dentist will inject a local anaesthetic to numb the area where the tooth will be removed. Hence, it is unlikely that you will feel any pain during the procedure.

  • If wisdom tooth erupts during orthodontic treatment

You can have your wisdom teeth extracted during orthodontic treatment if necessary.

For braces: wisdom teeth removal will not affect the braces treatment and braces will not affect your recovery from the removal.

For Invisalign: your dentist may advise you to stop wearing aligners for a while during healing. However, this should not affect your progress.

Each case is unique so it’s best to consult the dentist who planned your treatment, before removing your wisdom teeth.

  • If wisdom tooth erupts after orthodontic treatment has completed

According to Dr. Pua, to maintain your results, it is important to wear retainers. A fully erupted wisdom tooth is usually less troublesome than an impacted wisdom tooth which can potentially pose a problem after your treatment.

Working closely with your dentist can help to reduce the severity of the problems resulting from your wisdom tooth.

A simple wisdom tooth extraction will typically take below 30 minutes to complete.

A wisdom tooth surgery, on the other hand, will generally take between 30 – 60 minutes.

Simple wisdom tooth extraction:
You will not be allowed to use your MediSave for this procedure as it is non-surgical.

However, you may use your CHAS, Merdeka Generation or Pioneer Generation cards to get subsidies for simple extractions.

Wisdom tooth surgery:
MediSave can be used to pay for the partial cost of the procedure. You are allowed to claim up to $1,550 per tooth and this amount depends on the complexity of your surgery.

FAQs

You will be given 1 – 2 days of MC for a simple extraction.

Depending on your dentist, you will typically be given 5 days of MC after surgery.

It can take up to 2 weeks for you to fully recover from your wisdom tooth extraction.

Bleeding is normal after surgery and may last for another 24 – 48 hours. But in general, it should stop before you leave the clinic.

You may control bleeding by trying the following:

  • Place a clean gauze pad over the wound and bite for 10 minutes. Repeat this as required.
  • Avoid chewing on the gauze as it might increase bleeding.

24 – 72 hours.

Pain control medication should be taken as prescribed not only after feeling the pain. Note that the medication may cause drowsiness, so do not partake in activities such as driving or machinery work.

It is essential to keep up with your oral hygiene and dental health to prevent complications.

You are advised to

  • Brush your teeth with a soft-bristled toothbrush
  • Avoid the wound when brushing
  • Cleanse your mouth with warm salt water or an antibacterial mouthwash

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