Wisdom teeth may not need to be removed if they are:
•    Healthy
•    Fully erupted
•    Positioned correctly and biting properly with their opposite teeth
•    Able to be cleaned as part of daily hygiene practices

Wisdom teeth — the third molars in the very back of your mouth — don’t have room to grow properly and can cause problems. Erupting wisdom teeth can grow at various angles in the jaw, sometimes even horizontally.
Sometimes wisdom teeth only partially emerge through the gums. Other times, they remain completely hidden. Wisdom teeth that aren’t able to emerge become impacted within your jaw.
If the wisdom teeth emerge partially through the gums, a passageway is created, which can cause problems. Because this area is hard to see and clean, it can become a magnet for bacteria that cause gum disease and oral infection.
Wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as:
•    Pain
•    Repeated infection of soft tissue behind the lower last tooth
•    Cysts (fluid-filled sacs)
•    Tumours
•    Damage to nearby teeth
•    Gum disease
•    Extensive tooth decay
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The decision to remove wisdom teeth isn’t always clear. Talk to your dentist or an oral surgeon about the position and health of your wisdom teeth and what’s best for your situation.

Considerations For Removal Of Wisdom Teeth

When wisdom teeth cause problems, or X-rays show they might down the line, they need to come out. Other good reasons to take them out include:
•    Damage to other teeth: That extra set of molars can push your other teeth around, causing pain and bite problems.
•    Jaw damage: Cysts can form around the new teeth. If they aren’t treated, they can hollow out your jaw and damage nerves.
•    Sinus Issues: Problems with wisdom teeth can lead to sinus pain, pressure, and congestion.
•    Inflamed Gums: Tissue around the area can swell and may be hard to clean.
•    Cavities: Swollen gums can create pockets between teeth that help bacteria grow and cavities form.
•    Alignment: Impacted wisdom teeth can sometimes lead to crowding of the front teeth if there is a space shortage.
Your dentist will look at the shape of your mouth and the position of your teeth to make a decision. Your age plays a role, too.
Still not ready to part with your molars? You can ask your dentist to explain what he sees with your teeth. In many cases, you can wait several months to see if things change before making your decision. But if you have pain or notice swelling or a bad odour near your back teeth, it may be time for a second look.

What happens during wisdom teeth removal?

Your dentist or oral surgeon may use one of three types of anaesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:
•    Local anaesthesia: Your dentist or oral surgeon administers local anaesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.

•    Sedation anaesthesia / conscious sedation: Your dentist or oral surgeon gives you concious sedation through an intravenous (IV) line in your arm. Sedation anaesthesia suppresses your consciousness during the procedure. You don’t feel any pain and will have limited memory of the procedure. You’ll also receive local anaesthesia to numb your gums.

•    General anaesthesia: In special situations, you may be offered general anaesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You’ll experience no pain and have no memory of the procedure. Local anaesthesia is also given to help with postoperative discomfort.

During wisdom tooth extraction, your dentist or oral surgeon:
•    Makes an incision in the gum tissue to expose the tooth and bone
•    Removes bone that blocks access to the tooth root
•    Removes the tooth
•    Cleans the site of the removed tooth of any debris from the tooth or bone
•    Stitches the wound closed to promote healing, though this isn’t always necessary
•    Places gauze over the extraction site to control bleeding and to help a blood clot form

What to do after the procedure?

If you receive conscious sedation or general anaesthesia, you’re taken to a recovery room after the procedure. If you have local anaesthesia or conscious sedation, your brief recovery time is likely in the dental chair.
As you heal from your surgery, follow your dentist’s instructions on:
•    Bleeding: Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
•    Pain management:You may be able to manage pain with an over-the-counter pain reliever or a prescription pain medication from your dentist or oral surgeon. Holding a cold pack against your jaw also may relieve pain.
•    Swelling and bruising: Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
•    Activity: After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.
•    Beverages: Drink lots of water after the surgery. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
•    Food: Eat only soft foods for the first 24 hours. Start eating semi-soft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
•    Cleaning your mouth: Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you’ll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
•    Tobacco use:If you smoke, don’t do so for at least 72 hours after surgery — and wait longer than that if possible. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
•    Stitches: You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.
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•    When to call your dentist or surgeon
•    Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:
•    Difficulty swallowing or breathing
•    Excessive bleeding
•    Fever
•    Severe pain not relieved by prescribed pain medications
•    Swelling that worsens after two or three days
•    A bad taste in your mouth not removed with salt water rinsing
•    Pus in or oozing from the socket
•    Persistent numbness or loss of feeling
•    Blood or pus in nasal discharge