Wisdom Teeth and Dento-alveolar Surgery

Surgical Removal of (Erupted) Teeth

The removal of teeth is a routine specialist procedure. However, there are many reasons why the surgical removal of a tooth may be necessary, prompting referral to an Oral and Maxillofacial Surgeon. Most teeth are removed because of extensive dental decay, or failure of previous treatments to save the tooth, such as root canal treatment. These conditions destroy and weaken the remaining tooth crown thus requiring surgical removal. The pattern of root growth, for example a curved root, may increase the risk of complications in removal, if the tooth is not surgically removed.

Removal of Impacted Teeth

Impacted teeth have insufficient space to erupt into the mouth. The most common teeth to be impacted are the third molar teeth (‘wisdom teeth’) and canine (‘eye’) teeth. These teeth often require removal due to problems with pain and infection of the surrounding gum tissue and decay of adjacent teeth, necessitating referral to an Oral and Maxillofacial Surgeon for assessment and treatment. Due to the frequency of problems associated with impacted teeth, these are often removed to prevent future problems of pain, infection, decay and other pathology e.g. Cyst development.

Exposure of Impacted Teeth (surgery to assist Orthodontic Treatment)

Some impacted teeth may be able to be orthodontically positioned by creating space. This may require the extraction of other teeth such as, deciduous (‘baby’) teeth or premolar teeth. Surgery is be undertaken to remove some of the overlying soft tissue and bone to allow an orthodontic appliance to be glued to the surface of the tooth, at the time of surgery or after a period of healing, This allows the orthodontist to move the tooth into its correct position during a course of braces treatment. This positioning of impacted teeth is best undertaken by a registered Specialist Orthodontist.

Apical Surgery

Some infections in the gums and jaw are related to teeth that have previously undergone root canal treatment. Surgery may sometimes be required to treat the residual infection around the apices of the roots of these teeth.

Management of Jaw Cysts

Cysts of the jaws are fluid-filled cavities replacing bone within the jaws, which may be asymptomatic in the jaw. Jaw cysts commonly arise from infections around the apices of teeth, the soft tissue around the developing tooth, or from the cells from which teeth and their surrounding structures develop. The majority of jaw cysts are benign and are usually managed with surgery. The treatment however, will depend upon the type of cyst present. Some cysts may require adjacent teeth to be removed as part of the treatment (also see below).

Preprosthetic Surgery

In order to have a denture constructed that is comfortable, with or without the use of dental implants, it may be necessary to alter the shape or size of the jaw or soft tissues that the denture will rest upon. Removal of excess mucosa (‘gum’) that has developed under an old, poorly fitting denture may be required, before the new denture is made. Similarly bony projections may need to be contoured to facilitate a new denture.