Of all the permanent teeth, wisdom teeth are the last to appear. Also known as third molars, the wisdom teeth usually make an appearance when a person is between the ages of 19 and 21.
Because by this age the jaw is already matured, these teeth can be impacted by either not erupting fully or coming out sideways.
Sometimes, you’ll only know your wisdom teeth are in trouble when you experience pain.
Nowadays, removing wisdom teeth is quite a common practice. But do you know everything there is to know about why wisdom teeth need to be extracted or if they need to be extracted at all?
Dr. Priyanji De Silva, who has over 10 years of experience in dentistry, gives a comprehensive overview on wisdom teeth.
She practices all aspects of routine dentistry with a special interest in cosmetic dentistry (smile makeovers), implant dentistry (replacing missing teeth to improve functionality) and family dentistry (treating children).
Her practice is currently based at Atria-Pan Dental Group in Orchard.
If you have pain in your wisdom teeth, it is best to get your dentist to have a look.
When should you see the dentist about a wisdom tooth?
Most often, people are unaware that they have problems associated with a wisdom tooth.
It is diagnosed by chance when patients are seen for their routine check-ups. Those who don’t go for regular dental check-ups only know about it when pain arises.
Wisdom teeth often cause either of two dental infections:
- Tooth decay, which causes an acute toothache
- Gum infection or inflammation of the surrounding soft tissues causing swelling
Depending on the severity, the swelling might be visible only inside the mouth. If it’s an advanced infection, it may be visible outside on the face as well.
In very severe cases, the swelling spreads to the neck causing airway obstruction and difficulty in breathing.
There are several ways wisdom teeth can cause problems. Some of them are seen here.
What should you expect when you visit your dentist about your wisdom tooth?
A typical consultation for a wisdom tooth would involve:
- Clinical history: Any current symptoms of pain or infection. Any past incidence of infections and if so, the frequency.
- Examination of the teeth and gums: To assess presence of infection and tooth decay of the wisdom teeth and adjacent teeth.
The wisdom teeth are seen in red in this X-ray.
- X-rays: To determine the position of the wisdom tooth and to check if the wisdom tooth has erupted vertically or at an angle. The angle of the tooth and how deeply it is buried in the jaw bone will determine the kind of surgery needed.
Nerve positioning near to the wisdom tooth is checked. If some of the nerves are too close to the wisdom tooth, there might be a chance of nerve damage during surgery.
Other issues like cysts that sometimes form around the wisdom tooth are also identified and treated.
In what instances would a dentist suggest to remove wisdom teeth?
If the tooth has erupted vertically, functions well and is placed well in the jaw, the wisdom tooth does not require to be removed.
In some occasions, the decay is not visible from outside.
Extraction is needed if:
- The wisdom tooth has partially erupted causing a food trap that is not accessible to the patient to clean.
- If there is decay either on the wisdom tooth itself or the tooth just in front of it. (see the diagrams attached)
- If there is gum inflammation causing swelling
- If there are other wisdom tooth-related issues such as cysts
What’s the general process of wisdom tooth removal?
Depending on the position of the tooth, it could either involve a ” simple extraction” or a “surgical removal”.
A simple extraction is done by giving local anaesthesia and removing the tooth with forceps.
A surgical removal is required when the tooth has either erupted at an angle or is partially buried within the jawbone. This requires local anaesthesia.
Your dentist will assess your wisdom teeth and determine which method of removal will work.
With the current medical facilities that are available now, patient comfort is now greatly improved by offering Intra Venous (IV) sedation. Sedation during surgical removal is especially beneficial to anxious patients. Occasionally, the procedure is done under general anaesthesia.
Will there be any pain during the removal?
There is no pain during the procedure. However, if you are not sedated and awake during surgical removal you may feel some pressure and vibration of the handpiece.
What’s the recovery time like?
If it’s a simple extraction, downtime is minimal – that evening or a day at most!
If it’s surgical removal, it could vary from three to seven days. Swelling and pain will be managed by prescribing anti-inflammatory medicine.
Recovery from wisdom tooth extraction could take up to a week.
Also, antibiotics and antiseptic mouth rinses are given to prevent infection during the recovery period.
There will also be stiffening of the jaw muscles following surgery. This might limit mouth movements. This, together with the swelling, often makes it difficult for patients to eat a regular diet immediately following the surgical removal.
Also, the swelling limits social interaction, hence, three to seven days of medical leave is often given.
Should older kids get their wisdom teeth removed, and if yes, at how old?
The wisdom teeth are fully formed by 19-21 years of age.
This is a good time to have the wisdom teeth assessed for future risk of decay and infection. If the risk is high, preventive extractions will be advised as the elasticity of the bone is much higher in younger patients making surgical removal much easier and recovery much faster.
The sooner a patient is seen, the better – especially if there is a potential problem with the wisdom teeth.
Have you had any issues with your wisdom teeth? Did you have them removed? Let us know by leaving a comment below.