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All you need to know about wisdom tooth removal in Singapore

W / Wellness

All you need to know about wisdom tooth removal in Singapore

We speak to a dental expert to get the lowdown on the procedure, costs and recovery process involved

by Balvinder Sandhu   /   April 29, 2022
wisdom tooth

Credit: 123rf

Wisdom teeth are not created equal. Some of us have no issues at all when we get wisdom teeth, as they grow so discreetly and without any symptoms, to the point where we aren’t even aware that we have them. However, wisdom teeth can also cause problems such as pain or difficulty in chewing anytime, even if you didn’t used to face those issues before. In such cases, extracting them is your best option.

Before we go into the costs, procedure and issues involved in wisdom tooth removal, here’s a refresher on what wisdom teeth actually are.

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All you need to know about wisdom tooth removal in Singapore
So… what are wisdom teeth?
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Dr Sabrina Ng Livia, associate consultant, Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, explains that wisdom teeth are also known as the third molars on each side of the upper and lower jaws. They generally erupt between our late teens and early twenties and, because they are the last teeth to erupt, they are referred to as “wisdom teeth”.

“They are part of the adult dentition, but are also the most commonly missing teeth. Most adults have up to four wisdom teeth, although some may be missing one to all of their wisdom teeth,” she says.

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When do we need to remove wisdom teeth?
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Wisdom teeth can provide function – mostly chewing – when they erupt normally. However, they sometimes don’t come through the way they’re meant to, usually due to insufficient space in the mouth. This then means they are “impacted” or stuck. Dr Ng says that impacted wisdom teeth may pose a greater risk of infection and tooth decay due to the difficulty in cleaning around them. In rare cases, they could even pose a risk of cyst formation.

“At times, even though the wisdom tooth is not impacted, its opposing wisdom tooth may be,” she explains. “For example, the lower right wisdom tooth may be impacted but the upper right wisdom tooth may have erupted normally. When this happens, the upper right wisdom tooth may be considered to be non-functional, in that it does not contribute to chewing function, as it does not have another functional tooth to chew against.”

“In such cases, it is recommended to remove both the impacted and non-functional wisdom tooth, as it may continue to grow downwards and potentially cause trauma to the lower gums and even the lining of the cheeks, causing ulceration, pain and infection,” Dr Ng adds.

If you had no idea your wisdom teeth existed until now, take heart. It’s a good idea to consult your dentist during your six-monthly dental appointment, who would be able to advise on the presence or absence of wisdom teeth after clinical examination and dental radiographs, and recommend removing your wisdom teeth prophylactically (in the absence of any signs and symptoms) before they act up. Your dentist can also refer you to a surgeon for removal, if necessary.

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How much does wisdom tooth removal cost?
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The Ministry of Health’s website lists the average fees of dental procedures at public institutions. Impacted wisdom tooth surgery costs between $381 and $998, depending on where you seek treatment. Dr Ng states that the cost of wisdom tooth removal at National Dental Centre Singapore is approximately $910, most of which can be claimed by Medisave. But costs can differ based on complexity and whether the procedure is done by a specialist.

While there’s no best time to remove a wisdom tooth, Dr Ng advises to consider doing it at a younger age if possible, as it could result in a better recovery experience compared to when you’re older.

Also, because X-ray(s) and prescription of antibiotics are required for the diagnosis and management of a wisdom tooth-related infection, it is recommended to remove wisdom teeth which may potentially cause infection before getting pregnant, as taking X-rays during pregnancy may harm the growing foetus.

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The lowdown on wisdom tooth surgery
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Dr Ng takes us through some must-knows about wisdom tooth surgery:

  • The surgery itself usually takes 15 to 30 minutes, or longer in complex cases.
  • The downtime after surgery ranges from a few days to a week. As it’s uncomfortable during this time to open your mouth widely and chew, follow a soft diet.
  • Experiencing numbness right after the surgery is common due to the anaesthetic given. Until the numbness wears off, it is advised to avoid hot and hard foods, as patients may be burnt or injured without realising it.
  • It’s not uncommon to have intermittent bleeding, as well as pain and swelling at the surgical site for a few days after the surgery. There might also be some sensitivity in the surrounding teeth. All these should be resolved in a couple of weeks.
  • Any performed surgery carries the risk of infection, bleeding, and injury to adjacent structures. However, wisdom tooth surgery poses a relatively low risk of such complications.
  • The main risk involved in removal of the lower wisdom tooth is that to the inferior dental nerve and the lingual nerve, which lie close to the tooth. These nerves provide sensation to the lower lip, chin and tongue. Permanent injury may include numbness to these areas, but the risk of permanent injury is generally low.
  • The upper wisdom tooth lies close to the maxillary sinus – one of the four paranasal sinuses (which are small air-filled holes in the bones of the face). During removal of the upper wisdom tooth, it is possible to breach the bridge of bone between the mouth and the sinus, resulting in an oro-antral perforation (puncturing a hole in the sinus). This can usually be resolved with a surgical procedure performed in the same sitting.
  • With all surgeries, there are risks of developing rare complications, so discuss your treatment plan with your surgeon.

 

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Truth time. Just how scary is wisdom tooth surgery?
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As with any surgery, you’ll want to mentally prepare yourself for it. Dr Ng suggests speaking to your surgeon to understand the procedure and the recovery process, as well as discuss pain relief options.

“The physical setting of wisdom tooth surgery is very similar to regular dental procedures except for the sterile surgical drapes we may use to cover your eyes and body for protection and to maintain a sterile surgical field,” Dr Ng says. “For procedures performed under local anaesthesia (done while awake with just the numbing injection), patients can expect to hear some drilling sounds – much like those made by the dental scaler or the dental handpiece which one may be familiar with – and feel some water in the mouth which the surgical assistant will help to suction out.”

She continues: “As the wisdom tooth is in the jaw bone that is connected to the bone where the ear is, all the sounds will be amplified. It is helpful to practise some breathing techniques to help relieve anxiety and to breathe through the nose during the procedure.”

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Tips from a dentist
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If you cringe at the thought of going through a dental procedure, you’re definitely not alone. Discuss the surgical setting for your operation with your specialist.

There are three main surgical setting options for wisdom tooth surgery: local anaesthesia (numbing injection), sedation (the numbing injection with a mild form of sedative to help you tolerate the procedure better) and general anaesthesia (completely asleep). Dr Ng recommends speaking to your surgeon about the suitability of these options, to help relieve some of the anxiety.

You might think plugging into headphones during surgery would help to keep your mind off it but Dr Ng doesn’t recommend this. It’s because some clinicians – herself included – like to play music in the operatories and speak to their patients throughout the procedure, as it can help distract them from the sounds.

“Patients under local anaesthesia may voice out their discomfort during the procedure. Some patients have found it helpful to discuss a ‘safe word/sound’ with their surgeons, which will act as a signal during the procedure,” she shares.

When the deed is done, you may feel some discomfort at the operative site for a few days, especially when you open your mouth wide or bite down hard.

“For pain relief after the procedure, patients will be given sufficient analgesics,” Dr Ng reveals. “For pain relief remedies at home, patients can press a cold compress to the face or – my favourite – eat ice cream as it can serve as a cold compress inside the mouth to relieve pain.”

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