If the flap of gum overlying the wisdom tooth (the
operculum) is infected / inflamed (pericoronitis), then this
can be removed by a number of means (‘cold steel’, glacial
acetic acid, radio-surgical means, laser or cautery).
It possible that the operculum may grow back and the
operculectomy may need to be repeated.
Lingual Nerve that supplies sensation to the tongue
(and if this is effected by the operculectomy, a numb
tongue may result as well as loss of taste on that side
of the tongue; the numbness can last up several
months) and sometimes aberrant blood vessels (that
can be surprisingly vigorous in bleeding).
Coupled with this, it can be quite sore afterwards and
there may be limitation of mouth opening.
If the wisdom teeth flare-ups have been quite episodic,
then it may be hard to know if the operculectomy has
in itself, been successful.
An operculectomy is sometimes considered if the upper,
opposing wisdom tooth is traumatising the operculum. The
SIGN Guidelines suggest pain associated with the lower
wisdom tooth is commonly exacerbated by the upper
wisdom tooth biting on the gum flap (operculum), causing
pain and discomfort.
Alternatively, if the upper wisdom tooth is easy to remove
and is non-functional, then immediate removal of that tooth
will often dramatically relieve the pain from the area. This
is particularly useful where there is likely to be delay in the
removal of the lower wisdom tooth and can be regarded as
an interim measure (after referral but prior to surgery).
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