Europe's number 1 provider of laser eye surgery and a leader in spectacles, contact lenses and sunglasses.
Wisdom Tooth Extraction
National Institute for Clinical Excellence
Guidance on wisdom tooth extraction - patient notes.
What is NICE Guidance?
The National Institute for Clinical Excellence (NICE) is a part of the NHS. This institute uses a team of experts who produce guidance for both the NHS and patients regarding medicines, medical equipment and clinical procedures. When NICE evaluates these, the procedure is called an appraisal and takes place over a period of around 12 months. Appraisals involve the manufacturers of the technology, patient groups and professional organisations in order that a complete, thorough evaluation is made.
Some of the work conducted by NICE has included the appraisal of wisdom tooth extraction, providing guidance to the NHS which will help dentists and surgeons decide whether they need to make an extraction of a wisdom tooth, or if alternative treatment is more suitable.
What are wisdom teeth and why are they operated on?
Adult teeth appear from around the age of six upwards. Wisdom teeth are the last to arrive, usually between the ages of 18 and 24. Sometimes, however, wisdom teeth cause problems in the mouth as they grow. When a wisdom tooth does not break through to the surface of the gum, this is called an impacted wisdom tooth. Two reasons for a wisdom tooth failing to come through are due to a lack of space for the wisdom tooth to grow, or other teeth being in the way.
For most people, an impacted wisdom tooth does not cause any problems, but some people can suffer inflammation of the surrounding gum, a higher risk of tooth decay, gum disease in other teeth and possibly problems with teeth in later life.
The removal of wisdom teeth is one of the most common operations carried out in the UK. On occasion, impacted wisdom teeth have been removed even if they are not causing problems. As every operation entails risk, it is questionable as to whether the extraction of an unproblematic wisdom tooth has any benefit for the patient.
What does NICE recommend for wisdom tooth extraction?
Based on evidence following the appraisal, NICE gave the NHS the following recommendations regarding the extraction of a wisdom tooth:
- Impacted wisdom teeth that are free from disease (healthy) should not be operated on. There are two reasons for this:
- There is no reliable research to suggest that this practice benefits patients
- Patients who do have healthy wisdom teeth removed are being exposed to the risks of surgery. These can include nerve damage, damage to other teeth, infection, bleeding and, rarely, death. Also, following wisdom tooth extraction surgery, patients may experience swelling or pain and be unable to open their mouth fully
- Patients who have impacted wisdom teeth that are not causing problems should visit their dentist for their usual check-ups
- Only patients with diseased wisdom teeth, or other problems with their mouth, should have their wisdom teeth removed
Your dentist or oral surgeon will be aware of the sort of disease or condition which would require you to have wisdom tooth surgery. Examples include untreatable tooth decay, abscesses, cysts or tumours, disease of the tissues around the tooth or where the tooth is in the way of other surgery.
What should I do?
If you, a member of your family or a person in your care are having problems with one or more wisdom teeth, it is highly recommended that you consult your dentist or dental surgeon for professional advice on what action should be taken.
