What are the risks of the operation?
As with all operations, there are some risks to be considered when removing wisdom teeth. In addition to inflammation caused by the penetration of bacteria into the wound, there can be pain and redness. Post-operative bleeding from the wound sometimes occurs within the first few days.
Swelling and the formation of bruises can also occur. In the area of the upper jaw, the maxillary sinuses may open up, since they are located in the immediate vicinity of the roots of the upper teeth. This creates a direct connection between the upper jaw and the maxillary sinuses, which allows bacteria to migrate into these two parts of the oral cavity.
In order to prevent this, the access to the maxillary sinus is sutured with a mucous membrane flap. In the area of the roots of the teeth in the lower jaw, two important nerves run through the oral cavity, which can be damaged or injured during the operation. They supply the lower lip, part of the gums, the lower teeth, the back third of the tongue and the taste sensations via the tongue.
During the procedure, care must be taken to protect and preserve these structures. Jaw fractures are also among the risks, although these occur only rarely. The operation itself as well as an incorrect position of the wisdom teeth in the jaw (misalignment) lead to a weakening of the jawbone.
This increases the risk of fractures, especially in the initial period. After about 8 – 12 weeks the bone stabilizes again. Alveolitis sicca (dry dental alveolus) can occur as a further risk factor. This means that within a few days the blood cake can disintegrate, exposing the bone. Severe pain, unpleasant smelling bad breath and inflammatory reactions in the wound area are the result.
General or local anesthesia?
The choice of the anaesthetic procedure depends on several factors. The number of treatment sessions and the patient’s general state of health play an important role. The removal of two wisdom teeth can be done under local anesthesia (local anesthesia) using analgesic injections.
This eliminates pain, but the patient experiences all working noises such as drilling, cracking, vibrations etc. during the treatment in full consciousness. This can be experienced as very unpleasant by some patients.
If several wisdom teeth are to be extracted within one treatment session, general anesthesia may be necessary. This method of anaesthesia is also useful for anxious patients. An anesthesiologist (specialist in anesthesia medicine) must be present to monitor the progress of the anesthesia.
The anaesthetic is introduced by placing a venous access in the area of the elbow or hand. To ventilate the patient during the procedure, a breathing tube (tube) is placed through the mouth or nose up to the trachea and connected to a ventilator. Under general anesthesia, complete freedom from pain is guaranteed and the patient is not aware of the treatment sounds.
The costs for this procedure are usually not covered by the statutory health insurance companies. Also, no food or drink is allowed six hours before the operation. In addition to the two procedures mentioned above, nitrous oxide anesthesia or sedation may be possible alternatives.
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