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Wisdom Tooth Extraction vs Surgery: Understanding the Differences

Dentist and patient doing a check up

Wisdom teeth, known as third molars, grow between 17 and 25. Some individuals are fortunate not to experience any pain or issues, but others are not that lucky and have their wisdom teeth removed.

Tooth extraction or surgery are the two options for dental procedures when issues arise with wisdom teeth and affect their dental condition. Most patients choose a simple dental extraction because their case is not severe. However, not everyone has a milder case, leading to their dentist recommending dental surgery.

Furthermore, following recovery tips provided by your dentist or oral surgeon is essential during the healing process after wisdom tooth removal. These may include maintaining good oral hygiene, avoiding certain foods, and taking prescribed pain medication or antibiotics to prevent infection. You should also be aware of potential complications such as swelling, bleeding, or nerve damage and seek prompt medical attention if they occur.

Know the differences between wisdom teeth extractions and surgery in this guide.

What is wisdom tooth extraction?

Patient undergoing a procedure

Wisdom tooth extraction, a common dental procedure removes wisdom tooth. It is typically performed when the tooth has fully erupted or is easily accessible within the mouth. This procedure is often used to address issues such as tooth decay, gum disease, overcrowding, or discomfort caused by the presence of wisdom teeth.

The patient is usually administered local anaesthesia during a wisdom tooth extraction to numb the surrounding area and minimise discomfort. Sometimes, sedation may also help patients relax during the procedure. The dentist then carefully loosens the wisdom tooth from its socket in the jawbone and removes it using dental instruments.

Wisdom tooth extraction is a straightforward procedure for fully erupted or easily accessible teeth. It typically involves minimal post-operative discomfort and a relatively short recovery period. However, patients must follow proper aftercare instructions from their dentist or oral surgeon to promote healing and lessen the risk of complications such as infection or excessive bleeding.

When is extraction recommended?

Simple wisdom tooth extractions are recommended for fully erupted wisdom teeth, which cause no major issues. In such cases, the tooth can be easily accessed by the dentist, facilitating a straightforward removal process. Additionally, extraction may be an option for some partially erupted wisdom teeth that are accessible and do not cause significant complications.

When a wisdom tooth has completely erupted and is not causing any problems, extraction may be recommended to avoid potential issues in the future. Removing these teeth can help prevent overcrowding, misalignment, and difficulty maintaining good oral hygiene.

Extraction may be advised for partially erupted wisdom teeth if they are prone to recurrent infections, causing discomfort, or posing a risk to adjacent teeth or gum tissue. Sometimes, even partially erupted wisdom teeth can be fully removed if accessible and not deeply impacted.

Steps involved in a typical extraction procedure

In a typical extraction procedure, the dentist starts by numbing the area around the tooth with local anaesthesia to ensure the patient’s comfort. Once the area is numb, the dentist may use specialised instruments to loosen the tooth from its socket in the jawbone and surrounding gum tissue. 

After sufficiently loosening the tooth, the dentist gently removes it from the socket using dental forceps. Sometimes, the tooth must be sectioned into smaller pieces for easier removal. 

It’s important to note that this overview provides a simplified explanation of the extraction process. The steps may vary on factors such as the position of the tooth, its condition, and the patient’s individual needs. Your dentist will provide detailed information about the procedure and address any concerns you may have before proceeding.

What is wisdom tooth surgery?

Dentist cleaning patients teeth

Wisdom tooth surgeries are more complex dental procedures for removing impacted wisdom teeth, meaning they are trapped within the jawbone and unable to erupt fully into the mouth. Unlike simple extractions, typically performed for fully erupted or easily accessible teeth, wisdom tooth surgery is necessary when the tooth is deeply embedded or requires additional bone or tissue removal for extraction.

During wisdom tooth surgery, the oral maxillofacial surgeon make incisions in the gum tissues and remove a portion of the jawbone to access the impacted tooth. Sometimes, the tooth must be made into smaller pieces for easier removal. 

Wisdom tooth surgery is often performed under local or general anaesthesia to ensure the patient’s comfort and minimise pain during the procedure. Due to the complexity of the procedure and the need for additional tissue manipulation, it may involve more post-operative discomfort and a longer recovery period than simple extractions.

When is surgery necessary?

Surgery for wisdom teeth becomes necessary in cases of impacted teeth, meaning they cannot fully emerge from the gum line and become trapped within the jawbone. This can lead to further complications such as swollen gums, pain, infection, or damage to nearby teeth and structures. 

When impacted wisdom teeth cause discomfort or pose a risk to oral health, surgery is often recommended. Additionally, there are situations where the extraction of wisdom teeth is deemed too difficult for a simple procedure, necessitating surgical intervention.

Several factors determine the need for wisdom tooth surgery, including the tooth’s position within the jawbone, the angle of eruption, and the surrounding bone structure. Teeth that are deeply impacted or positioned at awkward angles may require surgical removal to prevent future problems.

Furthermore, dentists consider surgery’s potential risks and benefits for each case. Factors such as the patient’s age, overall oral health, and underlying dental conditions also influence decision-making.

Types of wisdom tooth surgery

Patient treating a patient

Different surgical procedures for wisdom tooth removal exist, depending on the case’s complexity and the patient’s specific needs. The dentist or oral surgeon tailors these procedures to address each situation’s circumstances.

One type of surgical procedure involves removing bone or tissue surrounding the impacted wisdom tooth to access and extract it safely. This may involve making incisions in the gum tissue and removing a portion of the jawbone to expose the tooth for removal.

Another surgical procedure may involve stitching the area closed after removing the wisdom tooth to promote healing and lessen the risk of infection. This helps protect the surgical site and support blood clot formation, which is vital for recovery.

It’s important to note that the dentist or oral surgeon will determine the specific type of surgical procedure required for wisdom tooth removal based on factors such as the tooth’s position, the angle of eruption, and the patient’s overall oral health.

Surgical Extraction with Bone Removal

Surgical extraction with bone removal is one of the most common surgeries performed for impacted wisdom teeth. This procedure is typically utilised when wisdom teeth are deeply impacted within the jawbone and require additional bone removal to access and extract them safely.

During surgical extraction with bone removal, the oral surgeon begins by administering local or general anaesthesia to ensure the patient’s comfort. Once the area is numb, the surgeon incurs the gum tissues to expose the impacted tooth and surrounding bone.

Traditional instruments such as drills or chisels carefully remove a portion of the jawbone covering the impacted tooth. This process allows the surgeon to access the tooth and facilitate its extraction.

After the tooth has been extracted, the surgical site is thoroughly cleaned, and any remaining bone fragments are removed. The gum tissue is then stitched closed to minimise the risk of infection.

Surgical extraction with bone removal is an effective approach for managing impacted wisdom teeth that cannot be safely removed through simpler extraction methods. It allows the dental professional to access and extract the tooth while minimising trauma to surrounding tissues and structures.

Surgical extraction without bone removal

Surgical extraction without bone removal is less common for specific cases of impacted wisdom teeth where the bone does not cover the entire tooth crown. This procedure is typically employed when the affected tooth is partially covered by gum tissue, allowing extraction without removing bone from the jaw.

During the surgery without bone removal, the oral surgeon or oral maxillofacial surgeon begins by administering local or general anaesthesia to ensure patient comfort. Once the area is numb, the surgeon incurs the gum tissue to see the impacted tooth.

In cases where the tooth is partially covered by gum tissue but not fully encased in bone, the surgeon can often access and extract it without needing to remove the bone. Specialised instruments are used to carefully separate the tooth from the tissues and gently extract it from its position.

After the tooth has been successfully removed, the surgical site is thoroughly cleaned, and debris or remaining tissue is cleared away. The gum tissue may then be stitched closed to promote right healing and minimise the risk of infection.

Piezoelectric Surgery

Piezoelectric surgery is a modern dental technique that uses ultrasonic vibrations to facilitate bone removal during dental procedures. A piezoelectric device generates ultrasonic vibrations that are transmitted to a specialised surgical instrument, typically a thin, vibrating tip.

These ultrasonic vibrations allow for precise and controlled cutting of bone tissue while minimising trauma to soft tissues. The vibrations generated by the piezoelectric device are highly efficient at cutting through bone, making the procedure smoother and more predictable.

One key benefit of piezoelectric surgery is its ability to minimise trauma and swelling compared to traditional bone-cutting techniques, such as rotary instruments or manual chisels. The ultrasonic vibrations cause minimal damage to the surrounding tissues, reducing post-operative discomfort and faster patient healing times.

Laser-assisted Surgery

Laser-assisted surgery is a cutting-edge dental technique that uses laser energy to remove soft tissue and sometimes perform minor bone procedures. In this method, a specialised dental laser emits concentrated beams of light energy that can precisely target and vaporise tissue with remarkable accuracy.

When used for soft tissue procedures, such as gum contouring or periodontal therapy, the dental laser selectively removes or reshapes the gum tissue without damaging surrounding structures. This allows for precise and minimally invasive treatment of gum disease, gum recession, or aesthetic gum reshaping.

Dental lasers can also perform minor bone procedures in certain situations, such as removing small amounts of bone during dental implant placement or treating bone irregularities. While lasers are not typically used for major bone surgeries, they can provide precise and controlled bone ablation when needed.

One of the key advantages of laser-assisted surgery is its ability for faster recovery and reduce post-operative complications. The laser’s precise energy minimises trauma to surrounding tissues, resulting in less bleeding, swelling, and discomfort than traditional surgical techniques. Additionally, the heat generated by the laser can help sterilise the surgical site, reducing the risk of infection and promoting faster healing.

Comparing Wisdom Tooth Extraction vs Surgery

Wisdom tooth extraction is typically performed for fully erupted or easily accessible teeth, involving the straightforward removal of the tooth. General dentists often do it under local anaesthesia, requiring minimal post-operative care.

Wisdom tooth surgery, on the other hand, is necessary for impacted or complicated cases. It involves more complex procedures, such as bone removal or soft tissue manipulation, and may require the expertise of an oral surgeon. Surgery is associated with a longer recovery time and may involve more post-operative discomfort compared to simple extraction.

Complexity of Procedure

Extraction is typically less complex. It involves the straightforward removal of an impacted wisdom tooth, often without extensive surgical procedures. It usually doesn’t require stitches unless there are specific circumstances. 

Surgery, however, is more complex and may involve additional steps such as bone removal or tissue manipulation. Stitches are commonly used to close the surgical site after the procedure to promote proper healing.

Anesthesia used

Local anaesthesia is commonly used for wisdom tooth extraction. It numbs the area of the mouth where the tooth is being removed, providing pain relief during the procedure and allowing the patient to remain conscious.

In contrast, general anaesthesia is typically used for wisdom tooth surgery. It results in a state of unconsciousness, allowing the patient to sleep through the procedure without feeling any pain or discomfort. General anaesthesia is often preferred for more complex or invasive surgical procedures, ensuring the patient’s comfort and safety throughout the operation.

Recovery Time

Recovery time after wisdom tooth extraction is usually shorter than surgery because extraction involves less tissue trauma and simpler procedures. Patients might experience mild discomfort and swelling for a few days following extraction, most returning to normal activities within a few days to a week.

In contrast, recovery from wisdom tooth surgery may take longer due to the complexity of the procedure and the potential for more tissue trauma. Patients may experience more significant discomfort, swelling, and bruising, with recovery times ranging from several days to a few weeks, depending on the individual case.

During recovery from extraction and surgery, it’s essential to eat soft or liquid foods that are easy to chew and won’t irritate the surgical site. Examples include soups, smoothies, yoghurt, mashed potatoes, and scrambled eggs. Avoiding hard, spicy or crunchy foods can help prevent irritation or injury to the healing tissues.

Potential risks and complications

Both wisdom tooth extraction and surgery carry potential risks and complications, including infection, swelling, and bleeding. However, surgery may have slightly higher risks due to its more invasive nature than simple extraction.

Wisdom tooth removal surgery procedures involving bone removal or tissue manipulation may also carry a slightly higher risk of nerve damage or damage to adjacent teeth. Patients need to follow post-operative guides provided by their dentist or oral surgeon and seek prompt medical attention if any complications arise during recovery.

Cost Comparison

Feature Wisdom Tooth Extraction Wisdom Tooth Surgery
Complexity Less complex More complex
Procedure Loosening and removing the tooth May involve removing bone or tissue around the tooth, stitches
Anesthesia Typically local anesthesia (numbs the area) Local or general anesthesia (may put you to sleep)
Recovery Time Shorter (usually 3-5 days) Longer (usually 7-10 days)
Potential Risks Infection, swelling, discomfort Infection, swelling, discomfort, bleeding, nerve damage (slightly higher risk and extraction)
Suitability Fully erupted wisdom teeth, easily accessible teeth Impacted wisdom teeth, deeply buried teeth, angled teeth, complex ceses

FAQs about Wisdom Tooth Extraction and Surgery

To help address your concerns, we’ve compiled a list of frequently asked questions (FAQs) about wisdom tooth extraction and surgery.

How much Medisave can be used for wisdom tooth surgery?

The amount of Medisave claim that can be used for wisdom tooth surgery in Singapore depends on various factors, including the complexity of the procedure and whether it is performed in a public or private healthcare institution. Generally, Medisave can cover a portion of the surgical costs up to a specified limit set by the Ministry of Health (MOH).

Which procedure is more painful, extraction or surgery?

Both wisdom tooth extraction and surgery involve some level of discomfort. Still, surgery may be more painful due to its more invasive nature and potential for tissue manipulation or bone removal. However, the pain varies among individuals, and both procedures are typically performed under anaesthesia to minimise discomfort during the process.

How long does it take to recover from wisdom tooth extraction vs. surgery?

The recovery for wisdom tooth extraction is usually shorter, typically 3 to 5 days. In contrast, recovery from wisdom tooth surgery may take longer, averaging around 7 to 10 days. However, recovery times can vary based on factors such as the complexity of the case procedure, the patient’s overall health, and adherence to post-operative care instructions.

What are the risks associated with wisdom tooth extraction vs. surgery?

Both wisdom tooth extraction and surgery carry risks, including infection, swelling, and discomfort. However, surgery may have slightly higher risks due to its more invasive nature. Additional risks associated with surgery include bleeding and nerve damage. It’s essential for patients to discuss potential risks with their dentist or oral surgeon before the procedure and to follow post-operative care instructions carefully to minimise complications.

Why do wisdom teeth need to be removed?

Wisdom teeth may need removal due to impaction, overcrowding, decay, infection, damage to adjacent teeth, and other dental complications. Impacted wisdom teeth, which fail to emerge from the gums fully, can cause pain and illness. Their position at the back of the mouth makes them difficult to clean, increasing the risk of decay and gum disease. Furthermore, wisdom teeth can pressure adjacent teeth, leading to misalignment or damage. Dentists may recommend removal based on the individual’s oral health and symptoms or complications.

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