The third molars, or the wisdom teeth, are the last ones to erupt among the permanent teeth. Since they erupt, if they do erupt, at a mature age, normally between 17 and 25, they are often called “wisdom” teeth. Of course, there is no real connection between the eruption of wisdom teeth and intelligence. If you haven’t got your wisdom teeth, or have less than four of them, you do not have to go to a neurophysician. But you may need to see your dentist if you still haven’t got some or all of your wisdom teeth by your 25th birthday.
Impacted Wisdom Teeth
Wisdom teeth behave rather like elderly people. They are the last teeth to erupt in each jaw. And they may erupt partially or may not erupt at all. Teeth which do not erupt properly or remain below the gum are called “impacted” teeth. Most of the problems associated with wisdom teeth are associated with their impaction. Some of them include.
- Pain– This is the first and the least bothersome effect.
- Pericoronitis – Neglect can lead to gum injury under pressure of chewing and may result in infection in the gum tissue. This condition is called pericoronitis.
- Damage to adjacent teeth– Impacted wisdom teeth can damage the growth and alignment of adjacent teeth. Also, the infection may be transferred to neighboring gums and teeth.
- Cysts and Other Swelling –Cysts and swellings, if they form around an impacted tooth, require removal of the affected wisdom tooth fluid/pus-filled sacs.
- Damage to the bone
- Malocclusion – Not only can impacted wisdom teeth interfere with the correct alignment of neighboring teeth, but they can also make their realignment difficult. Therefore, if your dentist feels that there is a lack of space in your jaws for proper orthodontic treatment of all the teeth, he or she may decide to remove your wisdom teeth.
Extraction of Wisdom Teeth; Is it the Only Option?
In view of the reasons listed above dentists normally advise the extraction of an impacted wisdom tooth which is found to be a source of one more of these above problems. Some dentists even advise an unconditional removal all wisdom teeth whether they get impacted or not. The removal of a tooth is much easier when it has not yet grown large roots. For this reason, the American Dental Association (ADA) recommends that individuals between ages 16 and 19 should have their wisdom teeth assessed to determine if extraction would be useful as a preventive step.
Very often this is done by your dentist or oral surgeon.
The logic supporting this approach is:
- The impacted tooth is a likely source problem in the future even if not now. this means there is lower risk of complications.
- Even symptom-free wisdom teeth can harbor infection which can appear or spread later.
- Wisdom teeth promote the chances of acquiring gum disease and tooth cavities (caries).
- Extraction of a wisdom tooth at later ages will definitely be more difficult when it has become more firmly rooted.
Is the Extraction of Wisdom Teeth Risky – What Are the Complications?
Extraction of wisdom teeth normally does not result in any long-term complications. However, in some rare cases, one or more of the following issues may come up:
- Dry socket– If the blood clot formed after surgery is removed a condition known as dry socket may result, this is effectively an empty tooth socket where the clot fails to form, it is usually very painful. However, this condition arises rarely.
- Infection of extraction sites– Normally your dentist will advise antibiotics to prevent any follow-up infection. But in case of non-compliance infection may result.
- Sinus damage– There is a possibility sinus damage in case of extraction upper wisdom teeth. However, your dentist is well aware of this and will take the necessary precautions during the procedure. You have nothing to worry about if the procedure is performed by a qualified and experienced dentist.
- Weakening of the jawbone– This is a remote possibility.
- Damage to nerves– Damage to nerves in the vicinity of the wisdom teeth can result in the reduction, or even loss of sensation in the lower lip, tongue or the chin region.
The procedure of Wisdom Tooth Removal
- Anesthesia– It is a normal practice to give anesthesia to avoid pain during the procedure. It can be one of three types depending on the pain threshold level.
- Local anesthesia. Anesthetic injections are given in the region around the tooth with a very fine and sharp needle. To avoid the pain of injection you may even be applied with a numbing liquid. You will remain fully awake during the surgery but will not feel any pain. It is possible that you do feel some pressure.
- Sedation– An intravenous injection may be given in your arm to sedate you. Sedation will make you unconscious. Additionally, a local anesthesia may be used to numb your gums.
- General anesthesia. This will be needed only in very special cases. General anesthesia (GA) makes you totally unconscious. Under GA, your body functions like blood pressure, breathing rate, temperature, and fluids are closely monitored by the team.
- Incision– A cut is made in the top of the gum to expose the tooth and the underlying bone.
- Bone Removal – Any bone which is impeding access to the tooth is removed.
- Tooth Sectioning – The tooth may be divided into sections if the dentist finds it easier to remove the tooth in parts.
Wisdom teeth removal recovery time
Full recovery after having a wisdom tooth removed is usually a few weeks. You should, however, begin to notice that the bruising and swelling and immediate pain reduces after 24 hours. If you continue to feel pain then use an ice pack on your cheek.
After 48 hours you could consider a salt water mouthwash to gently swirl around your mouth, please avoid excessive and violent washing of your mouth as this could dislodge the clot.
Time off work after having a wisdom tooth removed
Depending on the job you have it is normally advised to have 48 hours off, this just gives the initial healing phase time to begin. When you go back to work avoid rushing around and increasing your blood pressure too much, also avoid stimulants such as caffeine as this again may increase your heart rate and blood pressure which could dislodge the clot.
Dr Lage has a special interest in Implant Dentistry, Mercury free Dentistry, Root Canal Treatments (Endodontics), and Cosmetic Dentistry (crowns, bridges, veneers, teeth whitening).
He is very calm and very good with children and nervous patients.
Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French.