It’s time to get Scrub’d up! Order now. 

by Dr. Rashmira Balasuriya 

THE WISDOM TOOTH – KEEP OR REMOVE?

For years (and years), I’ve been suffering from severe tooth/jaw pain which seems to come on when I get stressed out and unfortunately almost always coinciding with my exams! So throughout medical school and thereafter, it was expected that every time I was even mildly stressed, I would have an annoying and irritating gnawing pain on the base of my jaw which I knew was radiating from my teeth. If you ever had tooth pain you’ll know that it’s the most annoying type of pain!

On visiting my regular dentist, I was told that all 4 of my wisdom teeth (upper and lower, right and left) were trying to come through, but had got impacted – especially my left lower wisdom tooth. Wisdom teeth are the 3rd (and last) set of molar teeth. They usually cause no problem at all, but sometimes can cause pain and swelling, especially if the teeth become impacted on the gum or misaligned (grow in the wrong direction). I actually have no idea why they are named wisdom teeth, but I genuinely do hope that it has no association with my mental abilities.

After many years of denial and ignorance on my part, I finally made an appointment to discuss wisdom tooth extraction. My regular dentist advised me to get my teeth removed only after taking an OPG (Orthopantomogram) X-ray so that the dental surgeon has a better idea of what’s going on. [I received an instagram message telling me that it was a waste of radiation to take an x-ray prior to tooth removal, but in my opinion don’t be stupid – you’d rather the dentist/dental surgeon know which direction your tooth is aligned and how deep it is before trying to take it out. Obviously, do not get an X-ray if you are or maybe pregnant]. I took the OPG X-ray at the hospital where I worked and for my luck, the hospital dentist was available for me to get another opinion. He advised me to go directly to an Oral And Maxillofacial Surgeon who has much more expertise when it comes to wisdom tooth extraction as the risk of side effects and complications was minimal.

In-between my work shifts and other commitments, I finally managed to free up some time to meet Dr. NV Jayathilake (Cons. Oral & Maxillofacial Surgeon) – the reason I’m including his name in this article is because I had such a great experience with him and also because I got so many DM’s asking for his name. He was very patient and after examining my mouth, he explained that my mouth is overcrowded and there is no room for my wisdom teeth to breakthrough which is why they have got impacted. I could either take all 4 out (both sides) under general anaesthesia, or take out 2 at a time under local anaesthesia. He said I would have minimal post-operative swelling and pain, and only 24 hours of rest needed post-operatively if I took it out under local anaesthesia. I decided to go ahead with local anaesthesia, but he warned me that incase the tooth wouldn’t come out, I’d have to go under general anaesthesia.

I finally decided on a date when I didn’t have work the next day so that I would have enough time to recover post-operatively. The doctor told me to take a painkiller and small dose of a steroid an hour prior to the procedure to reduce post-operative pain and swelling. I was also told to eat breakfast because post-operatively I wouldn’t be able to have a solid meal till that night. Going in there, I was more scared of the local anaesthetic needle than anything else.

The doctor was extremely nice and explained the entire procedure. I decided to take out both my left upper and lower wisdom teeth. He first sprayed my mouth with xylocaine spray which is an anaesthetic spray. It’s the same spray used before endoscopy procedures to numb the oral cavity. Xylocaine spray especially helps with the local anaesthetic injections (you don’t feel it!), but if you swallow it, it does numb your throat as well. This may make you feel as if you can’t breath or swallow (even though you totally can), but don’t worry, this will wane off.

A couple of minutes after the xylocaine spray, he proceeded to inject the local anaesthesia (as mentioned before this was the part I was most petrified about!). I shockingly did not feel any pain at all! You can however feel the anaesthetic affect your nerves, and there’s a tingling feeling of the nerve becoming anaesthetised. Within seconds, the left side of my face was completely numb, my smile was lopsided and it was difficult to not drool! After a further 5 minutes, we started the extraction part. The bottom tooth put a good fight, but was extracted within minutes! I only felt a bit of pressure, but no pain at all. I didn’t even realise that the tooth had been pulled out. The top tooth came out without any trouble at all. I didn’t believe the entire procedure could be over so fast and had to even ask the nurse twice!

My two molars!

Post operative

Post operatively, I didn’t have much pain, but did take regular panadiene and a low dose steroid for 3 days. I initially was told to take off the gauze swab that was inserted into the mouth to cease bleeding. After that I had an ice drink first and then a couple of hours later I ate yoghurt as I was so hungry. For dinner I had a light diet and mainly chewed on my right side. Throughout the day they was a bit of sporadic bleeding mixed with saliva, but nothing too profuse. I regained feeling on the side of my face after about 2-3 hours. Till then, if I lied down, I kept a towel so that any drool was kept off my bed sheets.

The next couple of days I tried to increase the interval between the painkillers to wean off them and within a couple of days I was off them completely. I had very minimal post-operative swelling, and even this decreased after a week. After that, I experienced absolutely no problems except for the occasional piece of food getting stuck in the free space left behind post extraction.

So I got loads of questions asking if you should remove your wisdom teeth and who I went to, which is why I decided to write up my experience. If you do have wisdom teeth and they’re causing you absolutely no harm, then you really don’t need to do anything about it. But, if like me, it does cause you significant discomfort, then definitely get an opinion from a dental surgeon. Highly recommend seeing an Oral & Maxillofacial surgeon (definitely recommend Dr. Jayathilake). It didn’t cost me very much at all and I had a really (shockingly) pleasant experience! Hope this helps you 🙂

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Hi there!

Hi there! Dr. Rashmira Balasuriya is a medical doctor in Sri Lanka, currently training in Family Medicine. Navigating the healthcare system in Sri Lanka is no easy task and this website was created to help guide other foreign medical graduates and junior doctors. This website also helps demystify life as a doctor in Sri Lanka and also combats medical misinformation circulating amongst the general public!

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