Operculectomy

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).

Problems with the procedure:

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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).