We all agree that wisdom tooth pain is probably one of the most painful experiences we can have. What we can do is to remove them, either through a simple extraction or surgery.
Why do some of us need to remove our wisdom tooth, what are the benefits of wisdom tooth removal, and what is the procedure like? These are some of the questions we will be answering in this pocket guide, and tell you all you need to know about wisdom tooth removal in Singapore.
What are Wisdom Teeth?
Your wisdom teeth are your third permanent molars1. In this X-ray diagram below, you can see that they are the very last teeth at the back of your mouth, with one at each end of the row of teeth. Most adults will have a total of 4 wisdom teeth – 2 at the top and 2 below. They usually appear or erupt much later than any other teeth at about 17-25 years old.
What Purpose Do Wisdom Teeth Serve?
So, why do we need wisdom teeth? From an evolutionary perspective, anthropologists have revealed that the last set of molars, called wisdom teeth, were necessary for our ancestors to help them chew very coarse, tough or hard foods like nuts, roots, leaves and meats.
But it doesn’t take a scientist for us to know that our wisdom teeth now no longer serve their original purpose – we have soft, cooked food and modern tools like knives, forks and spoons to help us when we’re eating.
What’s the Development Process of Our Teeth?
As expected, teeth grow very systematically - from the temporary or milk teeth to permanent teeth followed by the wisdom teeth. The first and second sets of molar teeth form at ages 6 and 12. Wisdom teeth start to develop around 10 years old but do not erupt until you are 17-25 years old. This is why children are encouraged to see a dentist early because the dentist can spot wisdom teeth growth and monitor their progression to prevent problems.
Not everyone develops wisdom teeth, but for those who do, they generally have about 1 to 4 of them, or even more in some cases. Scientists haven’t found a reason for why there are inconsistencies in the number of wisdom teeth appearing for each person.
Similarly, not everyone will experience issues with their wisdom teeth or experience wisdom teeth pain. But if they do, there will likely be a series of dental problems until they have been extracted.
What causes Wisdom Tooth Pain?
When our wisdom teeth hurt, it is likely a result of the following reasons:
Growth
If your wisdom teeth hurt, it could simply be because they are growing in. The process of breaking through the gums might cause slight pain, tenderness and swelling.
Impacted Wisdom Teeth
This is the case where wisdom teeth are impacted because they don’t have enough room to erupt as per normal. The various types of impacted wisdom teeth are as follows2:
Mesial Impaction
- Most common
- Partially erupted
- Angled towards the front of the mouth
- May or may not cause any issue
Vertical Impaction
- Full impaction
- Tooth is in the correct position but is below the gums
- Extraction rarely needed
Horizontal Impaction
- Full impaction
- Tooth is lying horizontally under the gums and moves sideways
- Most painful type
- Must be surgically removed
Distal Impaction
- Rarest
- Angled towards the back of the mouth
- Partially or fully impacted
- May or may not need extraction
Cavity
Because it is so cramped at the back of the mouth, wisdom teeth often grow very close to other teeth. The lack of space makes it hard to clean, which means cavities could appear and cause pain.
Cyst Development
When a wisdom tooth is impacted, a cyst may form at the impacted tooth’s follicle, causing pain in the tooth and jawbone.
Gum Disease
Gum disease can be a result of wisdom teeth formation because their location makes it harder to clean.
How do I relieve Wisdom Tooth Pain?
Wisdom Teeth Removal
Removing your wisdom teeth is the most straightforward way to solve wisdom teeth-related issues and prevent future problems. Most people tend to resort to methods like a cold compress and painkillers. However, these are only temporary methods to relieve immediate pain and you will not be able to solve the root of the problem. The best long-term solution is still to remove your wisdom teeth.
Why should I remove my Wisdom Tooth?
When wisdom teeth fail to erupt completely and stay receded, oral issues occur and this includes overcrowding or dislocation of permanent teeth. Some other oral issues that could occur include3:
Tooth Decay
Since your wisdom teeth are located further behind in your mouth, it is often hard to keep them clean. They may accumulate plaque and food particles, which can lead to the decay of both your wisdom teeth and other surrounding teeth.
Gum Disease
If your wisdom teeth do not form properly, food debris might accumulate in the gums, leading to bacterial growth and even infection. The gums may become inflamed, causing pain, bad breath and swelling. In severe cases, gum diseases like gingivitis and periodontitis could occur.
Teeth Crowding
If your wisdom teeth are not aligned when they erupt, they could push your other teeth into a state of disarray. Malpositioning of the teeth may affect not just the way you eat, but also other important aspects such as your appearance, speech and oral hygiene.
Cysts
In rare cases, a cyst may develop in the soft tissues of the affected area. The cyst may cause the jaw to expand or damage the surrounding bone and teeth. Tumours could also form in the cyst, causing the jaw to break if they grow bigger.
As mentioned earlier, not everyone will have problems with their wisdom teeth. Some may find that they do serve their purpose of chewing tough foods well. It really depends on the individual situation and the condition of your teeth.
How do I know if I have Impacted Wisdom Teeth?
How do I know if my wisdom teeth are causing me problems? What if it’s just the normal process of wisdom teeth erupting? We’re here to let you know the signs and symptoms you should take note of when your wisdom teeth come in, so you know when it is necessary to get them removed.
Impacted wisdom teeth do not always cause symptoms. However, an impacted wisdom tooth might become infected, damage other teeth or cause other dental problems4, causing signs and symptoms as mentioned below:
Red, swollen or bleeding gums
One of the first signs of the wisdom teeth erupting is any tenderness or discomfort in the back of your mouth. This may occur on either side or both sides of the mouth. There may also be swelling or bleeding of the gums.
Swelling around the jaw and jaw pain
When wisdom teeth erupt, they can push against other teeth and cause them to shift. This may cause pain or discomfort in your jaw such as stiffness and soreness, and difficulty in opening it. This can hence cause swelling of the gums in the back of the mouth or the side of the jaw.
Bad breath
If your wisdom teeth are impacted and cannot erupt cleanly, they can trap food particles and allow bacteria to grow. This may cause bacterial infection that leads to bad breath.
An unpleasant taste in your mouth
If there is an infection or tooth decay going on, they can cause a nasty, bitter taste in your mouth.
Difficulty opening your mouth
Wisdom teeth can cause misalignment that make opening or closing your mouth difficult.
At what age should I have Wisdom Tooth Removal?
If you are considering wisdom tooth removal, we recommend that you carry out the procedure while you’re young. This means between ages 18-24, when the root of the tooth is not yet fully formed. The more developed the tooth, the harder it is to manipulate during surgery. Older patients also tend to face more complications and longer healing periods.
What are the benefits of Wisdom Tooth Removal?
Reduction in headaches
When wisdom teeth emerge, they tend to cause unwanted movement of the teeth, which can cause headaches. Removing your wisdom teeth may relieve your gums of the pressure and soothe the headaches that they cause.
Prevention or Relief from pain
Orofacial pain is pain in the face or mouth that can occur due to wisdom tooth crowding, gum disease or tooth decay. If you want to be free from the shackles of pain, opt for wisdom tooth removal.
Reduced risk of oral disease
With wisdom tooth removal, you can prevent oral diseases like tooth decay and gum disease that may happen because you are unable to properly clean your teeth.
Fewer oral injuries
Wisdom teeth may come in at an angle that can cause you to bite your cheeks while chewing. Or, teeth that point inwards may scratch the sides of the tongue. These issues can be easily prevented with wisdom teeth removal.
Cleaner teeth
You might know that wisdom teeth are notoriously hard to clean. When they are partially erupted, it can be impossible to brush the entire tooth surface. This means that dental plaque and tartar may build up and lead to dental decay. If you remove your wisdom teeth, it will be much easier to clean and floss your teeth and this can prevent any oral problems.
How are wisdom teeth removed?
Wisdom tooth removal can refer to the extraction of wisdom teeth where local anaesthesia is used before extracting the tooth. However, if the tooth is impacted or difficult to extract, the dentist may recommend a wisdom tooth surgery, which can be performed under local anaesthesia or general anaesthesia. Fun fact: 10 million wisdom teeth are extracted from about 5 million people in the United States every year.5
What is the Wisdom Tooth Surgery Procedure like?
Consultation
During the consultation with the dentist, you may discuss your problems regarding your wisdom teeth with your dentist, such as any pain or swelling you may be experiencing.
The dentist will carry out a full dental assessment where X-ray scans may be taken to determine the position of your wisdom teeth. Then, they will come up with a treatment plan tailored specifically for you.
Wisdom Tooth Removal
We want you to be as comfortable as possible, so local or general anaesthesia will be applied to ensure you do not feel any pain or discomfort.
What are the risks of Wisdom Tooth Surgery?
Wisdom tooth surgery is a very safe procedure carried out routinely by dentists and oral surgeons. However, as with any surgery, wisdom tooth surgery carries its own set of complications such as infection. This can be avoided by strictly following the aftercare instructions provided by your dentist or oral surgeon.
Is Wisdom Tooth Surgery painful?
At Smilepoint, we go the extra mile by applying topical anaesthetic gel before any numbing injection, so that you do not feel any pain at all. During the process of wisdom tooth removal, you may feel some pressure or vibrations, or hear some cracking noises, but you should not feel any pain.
Once the tooth is removed, the area will be sterilised and your gums will be stitched back together.
How long does a Wisdom Tooth removal process take?
Normally, wisdom tooth removal surgery takes about 45 minutes. At Smilepoint however, the oral surgeon works fast and can safely do the procedure in just 30 mins. He has more than 20 years of experience for oral surgeries alone.
What should I do after Wisdom Tooth Surgery?
After the procedure, the healing process may take a few days for full recovery. Here are some things you may wish to do or avoid for proper aftercare to aid the recovery process:
- Avoid using straws. Do not suck, spit, or smoke or consume alcohol.
Avoiding these helps to maintain the blood clot that forms over the extraction region. If the clot becomes dislodged, there may be bleeding and pain, as well as a complication that may develop termed as dry sockets.
- Do not eat, drink or talk immediately after your surgery.
- Do not eat solid foods.
You can eat solids only 4-5 hours after the extraction.
- Avoid hard or crunchy foods for at least a week.
Stay away from popcorn and potato chips.
- Do not take hot or carbonated drinks, spicy foods, sodas, etc.
It is best to drink lots of plain water but without using a straw.
- Eat using the other side of your mouth.
Do this to avoid disturbing the gums and allow for healing.
- Do not take aspirin.
It’s a blood thinner and will disrupt clot formation.
- Take your prescribed medicines.
Try not to skip your medicines as it may be hard to soothe the pain later.
- Bite down on the cotton gauze provided.
There may be some minor bleeding from the wound that can be controlled by biting down on a piece of gauze.
- Elevate your head to reduce swelling.
- Use ice packs in the first 24-48 hours to reduce the swelling.
Apply ice packs for 15 minutes with a 15-minute interval for 1-2 hours.
- Stop icing after the first 48 hours after your wisdom teeth extraction.
Instead, apply a hot compress on your jaw to soothe your pain and promote healing.
- Do not poke into the gap created with your tongue, finger, tissue or toothpick.
It may delay your healing or cause bleeding, or worse – cause a dry socket.
- Do not rinse or brush your mouth too vigorously.
If you rinse too harshly, the force could dislodge the blood clot and cause complications. Gargle gently with saltwater instead. You may resume gently brushing your teeth after 24 hours. Avoid brushing the extraction site.
Facial swelling and discolouration of the overlying skin may develop for the first three days and then subside. You may not be able to open your mouth too wide at first. The discomfort after a wisdom tooth removal should dissipate within 3-4 days.
How many days of rest (MC) will I be issued after a wisdom tooth surgery?
For a simple wisdom tooth extraction, you will be given 1-2 days MC. For wisdom tooth surgery, you will be given 5-7 days of MC.
What is the cost of Wisdom Tooth Removal in Singapore?
Wisdom teeth extraction can cost between $250 and $350 depending on where you go to.
Wisdom teeth surgery can cost anywhere from $650 to $1800. Please note - wisdom teeth surgery should only be performed by a specialist.
Impacted wisdom tooth surgery may be Medisave claimable.
The table below shows a summary of the costs of teeth extraction at Smilepoint.
| Regular Extraction | $65 – $190 |
| Wisdom tooth extraction | $250-$350 |
| *Impacted wisdom tooth removal (Surgery) | $650-$1800 per operation site |
Is Wisdom Tooth Removal Medisave-claimable?
Yes, wisdom tooth removal in Singapore can be Medisave-claimable. The actual amount would depend on approval.
Those who are Singaporeans or Permanent Residents can claim up to $350 for wisdom teeth surgery without tooth division, and up to $950 with tooth division. For cases with deep wisdom teeth and tooth division, patients can claim up to $1250.
| Procedures Covered | Medisave Withdrawal Limit (S$) |
|---|---|
| Without tooth division | Up to $650 |
| With tooth division | Up to $1250 |
| Deep & with tooth division | Up to $1550 |
Conclusion
Wisdom teeth can bring about a lot of unnecessary pain and trouble, but this can be resolved with a simple wisdom tooth extraction or surgery. While the risks of a surgical procedure remain, it is a widely-performed procedure that is mostly safe and very effective at preventing future problems. Cost-wise, it is Medisave-claimable so it reduces your burden greatly. Smilepoint is always here to help you with any oral issues, so contact us to book your appointment today.
References
- https://www.healthhub.sg/a-z/diseases-and-conditions/486/oral_maxillofacial_surgery_sdhf
- Jaroń, A., & Trybek, G. (2021). The Pattern of Mandibular Third Molar Impaction and Assessment of Surgery Difficulty: A Retrospective Study of Radiographs in East Baltic Population. International Journal of Environmental Research and Public Health, 18(11), 6016.
- Ghaeminia, H., Nienhuijs, M. E., Toedtling, V., Perry, J., Tummers, M., Hoppenreijs, T. J., Van der Sanden, W. J., & Mettes, T. G. (2020). Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. The Cochrane database of systematic reviews, 5(5), CD003879. https://doi.org/10.1002/14651858.CD003879.pub5
- https://www.mayoclinic.org/tests-procedures/wisdom-tooth-extraction/about/pac-20395268
- Friedman J. W. (2007). The prophylactic extraction of third molars: a public health hazard. American journal of public health, 97(9), 1554–1559. https://doi.org/10.2105/AJPH.2006.100271