What are wisdom teeth?

Adults generally have twenty-eight teeth up to their mid-twenties, and then the wisdom teeth start to grow in right at the back of the gums, behind the second molars. Wisdom teeth are also called third molars because of their positioning, there are four altogether – two on the upper jaw and two on the lower jaw. They are generally referred to as wisdom teeth because they are thought to appear slightly later in life than other adult teeth, implying that the person is older and wiser.

Why do they often cause problems?

Wisdom teeth start to emerge at a time when the twenty-eight adult teeth are in place and settled, this means that a lot of the time there isn’t enough room for them to properly grow. Problems with wisdom teeth range from partial eruption to being severely impacted; here are some of the complications associated with them – not all of which require invasive surgery.

Impacted wisdom teeth – This means that the tooth has not grown through at the right angle, or broken the gums correctly, how it is impacted depends on the way it sits underneath the tissue.

Vertical impaction – The tooth has attempted to break through the gums at the correct angle originally, but because of lack of space it has caught on the tooth in front of it and cannot properly erupt.

Horizontal impaction – This is where the tooth has completely failed to approach at the right angle, it sits horizontally next to the second molar and can’t reach the surface at all.

Mesial impaction – In this instance, the tooth has erupted before it has reached the correct position, it breaches the gum line but points towards the front of the mouth.

Distal impaction – The opposite to a mesial impaction, the tooth becomes lodged in a position facing away from the tooth next to it.

Do they have to be removed?

If an impacted wisdom tooth is ignored, there is a chance it could cause further dental problems down the line and the best course of action is to remove it. However, lots of dentists are currently arguing that it’s unnecessary to extract the teeth if they are not painful or at risk of infection – even if they are impacted, due to the trauma of the operation.

How will I know if I should have them taken out?

Mild discomfort or tenderness as the wisdom teeth begin to grow is quite normal, but if they become very painful you should see a dentist as they might need to come out. As with most dental problems, you should consult with a professional sooner rather than later, make an appointment at the Pearl Dental Clinic if you have any concerns about your wisdom teeth.

If your teeth are impacted, it’s up to your dentist to assess whether they need to be removed, if no disease is apparent you may just be prescribed some painkillers and allowed to go home without any surgery.

How are they extracted?

Should your dentist decide your impacted teeth pose a risk of infection, they may refer you to an oral surgeon – a dentist who deals specifically in oral procedures as opposed to orthodontics or cosmetic dentistry – or they may chose to perform the treatment themselves.

After anaesthetic is administered to the area in question, the surgeon will make an incision into the gum line in order to access the tooth underneath, they will then use specially designed tools to loosen the root to allow for extraction. When the wisdom tooth is sufficiently weakened, forceps are used to pry it out of the mouth and the incision is sewn up to heal.

What are the complications?

Pain and soreness is a fairly common side effect of wisdom tooth removal, this will be at its worst for no more than two or three days, any longer than that could be cause for concern and you may want to return to the clinic to make sure nothing untoward is going on.

Oral surgeons and dentists the world over are experienced in removing wisdom teeth and thousands of procedures are carried out everyday, unfortunately this doesn’t mean it is risk free. Before your surgery begins, your dentist should talk you through the possible problems that could arise, the good news is that very few wisdom teeth extractions suffer major complications, and the ones that do are not likely to be life threatening. That said, it’s always best to know what can go wrong, in case you’re one of the unlucky few.

Infection – Bacteria can cause big problems when it gets in the wrong places, and with millions of them in your mouth, it’s hard to avoid. Antibiotics should clear up any infection, but make sure you go straight to the dentist if you notice any severe swelling or other signs of diseased tissue.

Heavy bleeding – A certain amount of bleeding is normal, wisdom teeth are very large and if they’re impacted particularly deeply they can cause heavy bleeding, if you have unsuccessfully tried to stem the flow and there are no signs of clotting, you should get to a clinic as soon as possible – call an emergency dentist if you have trouble out of working hours.

Dry socket – This is a common complaint associated with wisdom teeth removal, it’s called dry socket because there is no clot developing in the space vacated by the tooth, or it has become dislodged. You will know if this occurs because there will be a throbbing pain in your jaw and there may be a bad smell or taste coming from the socket. You can avoid this problem by following your dentist instructions post-surgery, not smoking, and using anti-bacterial mouthwash.

Partial numbness – Nerve damage during the operation can lead to partial numbness in the gums, in most cases this is a temporary condition that may also cause you to lose feeling in your lips, cheeks and parts of your tongue. If this does occur, you need to be careful when chewing or eating hot food because you won’t be aware of any injuries you may be causing.