April 28, 2018

Wisdom Teeth and Their Extraction

Wisdom teeth or the third molars can begin erupting from the age of 17 onward, and are given this name as they are supposed to erupt at a time when people are becoming a little older and wiser. These teeth are something of a throwback to an earlier age when our diets consisted of much rougher food that required a lot more chewing. Today’s diet doesn’t really need the extra chewing power provided by wisdom teeth.

Some people never get their wisdom teeth, while others will have problems when they try to come through. The reason for this is that the human jaw has evolved to become smaller, and there is often insufficient room for the wisdom teeth to come through.

What Problems Can Be Caused By Wisdom Teeth?

Wisdom teeth can become impacted underneath other teeth, or sometimes they can partially erupt, allowing food and bacteria to get trapped in the surrounding gum tissue, potentially causing infection and gum disease. Gum disease in this area can often go unnoticed as it is so far back in the mouth, but can improve if the wisdom teeth are extracted. If they are impacted then occasionally they can cause a cyst to form in the soft tissue surrounding the wisdom tooth, and this can be quite serious as it can cause damage to the surrounding teeth and bone.

Why has my dentist suggested my wisdom teeth removed?

It might seem as if your wisdom teeth are okay, especially if they don’t cause you any problems or pain. However a lack of pain doesn’t mean everything is fine, as they will need careful monitoring and regular evaluations. The American Association of Oral and Maxillofacial Surgeons have estimated around 85% of wisdom teeth will eventually need to be extracted. Even wisdom teeth that have erupted normally can cause problems. Wisdom teeth can cause crowding, and it can be very difficult to clean properly this far back in the mouth. This area is much more prone towards developing decay and disease.

Is The Surgery to Remove Wisdom Teeth Complicated?

If your dentist has recommended you have your wisdom teeth removed, and if the case is straightforward they may do this surgery for you in their dental office. If it’s a little more complicated, or if you need more than one removing, they may refer you to an oral surgeon.

This might sound dramatic but it’s nothing to be worried about, and an oral surgeon will almost certainly be able to complete the extraction very quickly as they carry out this type of treatment all the time. You’ll either receive a local anaesthetic, or can be sedated, or can have a general anaesthetic depending on the complexity of the case. If you’re worried or anxious about having this type of surgery then it’s likely your dentist may recommend sedation or general anesthesia to ensure you are comfortable.

How Will I feel After Surgery?

You could experience some discomfort for a few days, and your dentist or oral surgeon might give you a prescription for painkillers. There may be some bleeding for a while afterwards, but this should subside within a few hours at the most, and should have completely ceased after 24 hours. You can reduce any swelling by using an icepack, or some people find it more comfortable to use moist heat to relieve pain or discomfort. It’s best to stick to soft foods for a day or two, to give the extraction site a chance to heal.

It is also best not to use a drinking straw, as even though this might seem like a good idea the sucking action can loosen the blood clot that forms in the socket left by the extraction. If the clot loosened it can create a condition called dry socket, and this can slow down the healing. This is an inflammatory condition that can be quite painful and which may need extra treatment.

The chance of having any sort of complications is less than 2%, although it’s slightly higher if you have wisdom teeth removed from your lower jaw2 rather than the upper jaw. You should try to avoid touching the area with your tongue or fingers, but will still need to carefully brush your teeth.

Occasionally there is the risk of suffering from numbness after the local anaesthetic wears off, as this can be due to inflammation or injury of the nerves in the jaw. It is very rare for this numbness to be permanent3. Your surgeon will be able to discuss any possible risks with you beforehand, but it’s important to remember this type of surgery is incredibly common and low risk.


References

  1. Stewart PS, Costerton JW: Antibiotic resistance of bacteria in biofilms. Lancet 2001;358:135
  2. Bui CH, et al. (2003). Types, frequencies, and risk factors for complications after third molar extraction. Journal of Oral and Maxillofacial Surgery, 61(12): 1379-1389.
  3. Esposito M (2008). Impacted wisdom teeth. Online version of Clinical Evidence. Also available online: http://www.clinicalevidence.com.