Oh, wisdom teeth, where do we begin. As the furthest back and final molar to develop in the mouth wisdom teeth are often left to cram themselves into whatever space remains, resulting in a number of dental problems. Many dentists now recommend the removal of wisdom teeth regardless of whether they are giving you pain or not, but do you need them out? Let’s explore the subject in a little more detail.
What are wisdom teeth and why do they cause problems?
Wisdom teeth are also known as third molars and are the last teeth to erupt into the mouth usually between the ages of 18 and 23. By this time, most adults already have their other 28 teeth in place meaning that there’s not always enough room for wisdom teeth to come through properly without causing problems.
What kinds of problems can wisdom teeth cause?
Wisdom teeth that fail to come in properly are referred to as being ‘impacted’ which means that they have been blocked in some way by either the jaw bone or neighboring teeth. Impacted wisdom teeth often sit at an unusual angle, leaning up against the second molar or protruding out of the gum line and into the cheek. Because of the poor angle of impacted wisdom teeth, they can cause a number of problems including:
Pericoronitis occurs when the wisdom tooth only partially erupts from the gum and the remaining gum sitting atop the wisdom tooth becomes inflamed or swollen. Pericoronitis can be very painful making it difficult to chew and can result in a nasty infection.
- Bad breath
When wisdom teeth fail to come through properly they can leave a gap between the tooth and the gum line into which food debris can build up and rot. This can lead to bad breath, infection and a bad taste in the mouth.
- An aching jaw
When wisdom teeth are causing problems in the mouth they can cause the surrounding tissue to become inflamed making it difficult to open the mouth. When the mouth is opened the inflamed tissue stretches causing pain.
- Ulcers on the inner cheek
Wisdom teeth that are impacted can come in at an odd angle and sometimes point out towards the inner cheek. When wisdom teeth come in at this angle their cusps (point edges) can rub and dig into the soft tissue of the cheek leading to ulcers.
The pain from impacted wisdom teeth is often not localized to the mouth and can also be felt as earache and pain in the neck and jaw.
- Tooth decay
The debris that often forms around impacted wisdom teeth can increase the chances of the tooth experienced decay. Impacted wisdom teeth can also rub up against or put pressure on neighboring teeth resulting in tooth decay or damage.
The symptoms of an impacted and problematic wisdom teeth can flare up and resolve themselves multiple times per year and sometimes a person can go months between occurrences. This can leave people wondering if they should get their teeth out or not. So should you?
Should you have your wisdom teeth removed?
A wisdom tooth that is not impacted, or is impacted but not causing any problems can usually be left alone as even a minor procedure such as extraction can cause complications.
For those with impacted wisdom teeth that are causing the above problems then usually a dentist will recommend an alternative form of treatment first such as antibiotics or antiseptic mouthwash to try and heal up any ulcers and prevent tooth decay. If alternative treatments have been unsuccessful and the wisdom teeth are still causing issues then they will likely recommend that the wisdom teeth be removed.
At the end of the day the answer to the question ‘should I have my wisdom teeth removed’ should be assessed on a case by case basis and discussed with your dentist at an affordable dental office, but if you are experiencing any of the above problems and feel any sort of pain from your teeth then the likelihood is that this will only continue and it is better to have your offending teeth removed to prevent any further pain and complications.
What should you expect during wisdom tooth surgery?
Wisdom tooth surgery is very common and should take less than 45 minutes from start to finish. To make the procedure more comfortable patients are given a degree of sedation which can range from:
- Local anesthetic – where the mouth is numbed but you are alert during surgery
- IV sedation – sometimes referred to as conscious sedation where drugs are administered through the arm to make you feel relaxed and drowsy and local anesthetic is used in the mouth.
- General – usually reserved for very anxious or more severe surgeries general anesthetic will put you to sleep.
The offending teeth are then cut out of and removed from the mouth and in some cases, a few small stitches are used to close the wound and help it heal.
What should you expect after wisdom tooth surgery?
After wisdom tooth surgery your mouth will likely be very sore and you will probably experience some swelling and bruising. In the first few hours after surgery, it is very important that a blood clot forms to fill the hole and heal the gums, if this clot does not form or is washed away by drinking, eating or rinsing then it can cause a complication called ‘dry socket’ which can be very painful and require further treatment.
In the first 24 hours avoid brushing, spitting and rinsing and stick to wet, smooth, soft foods that can easily be swallowed.
After 24 hours you will be able to gently brush your teeth avoiding the removal area and should begin regularly rinsing your mouth out with salt water though still being careful not to dislodge any clots. By now you should be able to eat soft foods such as mashed potato, apple sauce, and yogurt and will soon be able to move onto semi-soft foods such as pasta. In general, healing takes between 3-7 days but take it easy and don’t reach straight for spicy, crunchy or hard foods. Also, try to give up bad habits such as smoking and excessive alcohol during this time as it can slow your healing.