What are wisdom teeth? The terminology comes from the fact that they grow much later than the other teeth, when you supposedly are “wiser” than when the earlier teeth came out.
Normally, wisdom teeth appear when a person is between the ages of seventeen and twenty-five. You normally end up with four of them, on each side at the back of the top and bottom rows. However there are people who have grown more than four.
What is so special about wisdom teeth? What you may hear about them is that they have to be removed and it is painful. However, this is not the average; most people don’t need to have them removed.
There are several ways wisdom teeth can cause problems. Some of the main ones are outlined below:
Impaction
In dental terminology, an impacted wisdom tooth is jammed sideways under the gums, i.e. it has not grown out of the gums. It is wedged sideways against a barrier, usually the root of another tooth; thus, it is not able to break through the gums. Three patterns are possible (with the most common listed first):
- The tooth is angled in the direction of the front of the mouth.
- The tooth is angled in the direction of the back of the mouth.
- The tooth is at a 90-degree angle, bumping sideways into the molar next door.
Partial Eruption
Partial eruption means that a tooth only partially emerges. The main problem with this is that the gums are firmly attached only at the lower part of the tooth. The rest is covered by loose gum tissue, which turns into something like a flap, also known as an “operculum.” Food can easily get lodged in there, but it’s hard to get to the area via toothbrush, so infection or tooth decay (or both) may be the result.
Infection
Infected tissue, which may or may not be abscessed, is usually indicated by swollen gums and redness around the molar, difficulty in opening the mouth, a bad odor or taste in the mouth, or a pain in the jaw, which can also extend down the neck.
Even if a difficulty like one of the above happens with any of your wisdom teeth, it does not necessarily constitute a reason to remove them. Your dentist or dental surgeon will make that determination, depending on whether he believes it is going to cause more harm than good to keep those molars.
The loose gum (operculum) could be sliced off, but this operation is usually not recommended, due to possible nerve damage in the cheek or tongue.
Removing Wisdom Teeth
Some reasons to remove wisdom teeth are:
- They can cause pain due to rubbing against cheeks or tongue.
- They can be liable to infection, resulting in extreme discomfort or worse.
- They can push your teeth out of place, causing crowding.
- They can cause serious pain and medical problems.
The dental surgery itself is very complicated. Since a wisdom tooth is a large molar, usually embedded deeply in the gums and sometimes still stuck to the jaw bone, a high degree of care is taken to ensure the entire tooth is removed. Also, close to the wisdom teeth, there are some nerves that go to the tongue and cheeks. It is important not to disturb these at all, because permanent damage could be done.
Post-Operative Care
Following surgery, after-care instructions are given and must be followed so there won’t be future problems. A post-surgical visit with your surgeon is necessary and usually recommended about seven to ten days after the extraction. The surgeon will want to ensure that the healing of the wound is going well with no complications.
Usually the bleeding doesn’t end completely for two to three days, but the amount of blood is less after the first day. Most dentists suggest not to rinse the mouth, as this might hinder healing and clotting.
Gauze pads are usually supplied, but if you run out, you can substitute wet tea bags; tea contains tannins, which help reduce bleeding. If the bleeding continues heavily after the first day, the doctor should be notified as soon as possible.
You may also notice something that smells bad coming from the surgical area for a week or two. This is normal and should disappear.
An empty tooth socket can get clogged with dirt or food. The surgeon can clear it out so it doesn’t get infected.
A “dry socket” is an inflammation of the bone next to the socket. It is not completely known why this occurs, but some suggest that the condition might be brought on by pressure (such as suction or blowing) on the healing wound. Ibuprofen, or another anti-inflammatory, reduces the inflammation and pain, usually fairly quickly – within weeks, not months.
You can expect some swelling. But it should be all gone in about a week. If the surgical area swells up again later, your surgeon should be informed as soon as it happens.
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