Jaw Surgery and Dental Implants in Singapore Blog

Recently, an article in The Straits Times featured a case of a chef suing a dentist for causing him to lose sensation of his tongue after a wisdom tooth surgery. Certainly, for a chef, such a complication can be a career-ending event. So, how does a wisdom tooth surgery lead to numbness of the tongue and what can be done about it.

Continuing the story of debate on “Better Competency Development for Safe and Quality Dental Care”, this blog discusses the other oft-cited “higher risk” procedure, wisdom tooth surgery. So how complicated is wisdom tooth surgery? What kind of training do dentists need to perform this surgery properly.

Today, I removed the four wisdom teeth of the son of my first ever wisdom tooth patient. His father was my first ever wisdom tooth surgery patient thirty years ago. I was in final year dental school then and removal of that one tooth took two hours. It was a most traumatic experience, not just for the patient, but for me as well. He was bleeding and I was sweating. It was an arduous climb up Mount Everest. Post-operatively, the swelling was tremendous and the corner of the mouth was thoroughly bruised and abraded with all the tugging and pulling. Thirty years later, he sent his son to me for wisdom teeth removal.

I came across this article about vestigial body parts today and it struck a chord with me. I just reviewed an old patient who has been working deep in the Kalimantan forest for the past year. Before he left, we checked his oral condition thoroughly and did everything that needed to be done before he embarked on his new job in the jungle. Once inside, access to medical care is an 8-hour road trip. While his oral condition was fine the past year, he told me that he had a perforated appendix which needed emergency care. He endured the road trip and made it to hospital in time but it was a most harrowing experience. The wisdom tooth, like the appendix, is also a vestigial organ and is fully capable of causing an emergency that needed evacuation.

Wisdom tooth extraction in Singapore has become a rite of passage amongst teenagers and young adults. To a certain extent, this is related to a higher rate of orthodontic treatment in this segment of the population. However, should wisdom teeth, aka third molars, be routinely extracted even when they are not giving any trouble? There are currently two main opposing camps; one advocating routine prophylactic removal, another that says that a it should not be removed until it has caused recurrent problems. So which camp is right and which is wrong?

The wisdom tooth removal is probably the most commonly removed anatomical part of the body. No doubt it is a rudimentary structure that does not serve much function. In fact, more often than not, it fails to erupt properly and ends up causing trouble to the adjacent teeth. As such, not only do problematic wisdom teeth gets removed, even the non problematic ones are often extracted to prevent possible future problems. Herein lies the one of the major controversies around wisdom tooth surgery. Should non-problematic wisdom teeth be remove? I’ll illustrate the complexities with a case.

Wisdom tooth surgery is probably the most common surgery done by Oral and Maxillofacial Surgeons. Almost every teenager experiences some degree of discomfort from their wisdom teeth. Some will promptly seek treatment and the most expedient option is to remove the offending tooth. After all, most wisdom teeth, even the fully erupted ones, are not critical to our masticatory function. However, like with any surgery, wisdom tooth surgery has its risks and complications and patients need to be cognizant of these before deciding to remove their wisdom teeth. 

I came across this article in a Luxembourg newspaper which really seems odd. Is it possible to "grow" a wisdom tooth at 92? The article did not elaborate further, only talking about getting into the Guinness World Records. Checking up the Guinness website yielded the following:

"The oldest person to grow a wisdom tooth is Ingeborg Wolf-Wimmer (Austria, b. 10 June 1922) who was aged 92 years 258 days when a wisdom tooth was confirmed to have erupted, in Saarburg, Germany, on 23 February 2015. Ingeborg, who is originally from Austria, now lives in Luxembourg."

As it turned out, it is not so much "growing" a wisdom tooth but rather, a case of late eruption of the tooth. Wisdom teeth typically erupts into the mouth between late teens and early twenties, hence the term "wisdom" because this is the supposed age when one becomes a young adult and presumably, "wise", which is debatable but that's another story. So, for this lady, why did the wisdom tooth take so long to surface?

Wisdom teeth are the last teeth to erupt in the mouth. They typically erupt through the gum at about age 18, behind the second molars, which is why they are also called third molars. Why are they called wisdom teeth? Because at the age of 18, a child grows into a mature and wise adult and the appearance of the third molars coincide with the attainable of wisdom, at least in theory.

Wisdom tooth surgery is a common surgical procedure that many young patients have to undergo. Older patients may also need to have their wisdom teeth removed if they did not do it when they were younger. Cost of wisdom tooth surgery in Singapore can varying quite a fair bit, depending on the complexity of the case. As it is an essential surgery, Medisave can be used. There are several Medisave codes for wisdom tooth surgery, commensurate with the level of difficulty of the surgery. Let's take a look at how Medisave can be use for wisdom tooth surgery in Singapore.