Our third molars, commonly known as wisdom teeth, usually come in between the age of 17 and 25. They come in last, erupting just behind the second molars. Some people, we may as well call them lucky ones, never get them. But why do we get wisdom teeth and what is their purpose?
Many anthropology theories claim that wisdom teeth are so called vestigial organs which functionality we do not need today. In the past, wisdom teeth had their purpose as people were feeding on rough food. More chewing was required than today. Due to the nature of our diet today, wisdom teeth have lost their purpose. And given the numerous problems they can cause, wisdom teeth can be a burden.
Over the centuries, our mouth has gone smaller and food has become softer. This led to some patients often not having enough space for their third molars to erupt properly. Besides, wisdom teeth can be tricky to reach, making it hard to remove plaque. This will often result in decay and cavity. A series of other problems can occur when wisdom teeth do not grow out and they remain tucked away. Patients who experience inverted third molars, would ideally have them removed in adolescence and prevent the further consequences. Still, a large majority of patients develop wisdom teeth normally and they do not need to go through the extraction procedure.
In most cases, dentists will remove wisdom teeth when there is insufficient space in the jaw for them to erupt and function properly. The main reason for extraction is the eruption can cause overcrowding, painful nerves, and gum inflammation. Wisdom teeth can also run into other teeth or grow in the wrong direction becoming impacted. In both cases, most dentists will recommend an extraction.
The most frequent consequences are teeth crowding, painful and sensitive gums. Infection of the gums can range from mild and occasional (dull pain, discomfort and sensitivity) to serious and recurring. If the tooth partially comes through, it can let plaque bacteria into the gums causing an infection. The intensity of the infection (known as pericoronitis) will depend on the strength of your immune system and severity of the tooth impaction. In the worst case scenario, the patient will have difficulty chewing and swallowing. If this happens, dentists will prescribe antibiotics and analgesics before the necessary tooth extraction. The impaction can also cause chronic tooth decay due to the difficulty in maintaining proper oral hygiene.
Other non-infectious conditions can also occur. Cysts and tumors can grow in the tissue associated with the impacted tooth. If not removed at the earliest stage, they can cause a severe damage to the jaw bone. Furthermore, if your teeth have become crowded, your dentist will recommend wearing braces.
All the above mentioned infectious and noninfectious conditions will put you in pain and you will have a hard time maintaining oral health. This is why it is crucial to recognise the early symptoms of impacted wisdom teeth and deal with it as soon as possible.
Get in touch with MGA Dental if you experience:
● Red, swollen and bleeding gums, especially around the molar area
● Jaw pain and swelling, in any area of the jaw
● Bad breath that doesn’t go away after brushing, flossing and rinsing with mouthwash
● Difficulty opening your mouth
When your dentist notices crowding of teeth, they will recommend an X-ray. Most likely an OPG - a panoramic view of the lower face. When the X-ray is performed, the whole jaw and lower and upper teeth are visible in a single image. The entire scan process is painless and is the fastest way to assess the condition of all teeth and jaw bones. Of course, if your dentist suspects other dental issues, they might opt for a different type of scan.
Wisdom teeth can cause significant damage before pain or other obvious symptoms appear. If the wisdom tooth has begun to impact while deep in the bone, it could severely crowd the teeth. In some cases, this is the only visible symptom of inverted wisdom teeth and can last for quite some time before more serious symptoms develop. To ensure the early assessment, do not skip 6 monthly dental checkups.
The early stages of impaction are a good time to extract the wisdom tooth before it causes inflammation, pain and dental cysts. If left until the symptoms occur, the treatment will be more difficult to perform, more painful, and recovery time will be longer. The extraction procedure is also easier to perform when there is no gum swelling. Bacteria that cause the inflammation will prolong the recovery and increase the risk of the procedure. In cases of swelling and pain, dentists will prescribe antibiotics, generally for a minimum of 7 days immediately before the treatment.
To sum up the benefits of early wisdom tooth removal:
● The teeth are smaller due to a minimal root development
● Periodontal problems are minimal, reducing the likelihood of gum swelling
● The risks are significantly decreased as there are fewer complications
● Recovery time is shorter and the healing process is easier for the patient
Before World War II, third molars were only removed when they caused extreme discomfort. Today, most dentists will recommend removal as a preventative measure. This is the case even if the patient does not experience pain and there are no other signs of inverted molars. Having wisdom teeth removed has almost become a “rite of passage” in adolescence. While wisdom teeth removal does prevent dental problems in adulthood, the decision to remove them should not be taken lightly.
At MGA Dental, we believe that a careful assessment of your oral health is crucial. An assessment of the third molar's position, growth and impact on surrounding teeth will determine the required action. If the arch length and position is satisfactory, we opt to monitor the wisdom teeth's progress. If the space in the patient’s jaw is inadequate, we will recommend the extraction procedure.
Necessary or not, wisdom teeth removal, as any other medical procedure, carries certain risks. In most cases, the complications are not long-term, but can be fairly unpleasant. The surgical removal of bone and incision in the gum tissue can cause severe pain or a dry socket. Other complications can include damage to surrounding tissues - nerves, sinuses and nearby teeth.
A part of costs may be covered by the health insurance, but the removal will still cost you a significant sum, depending on the type of procedure.
To summarise, wisdom teeth removal may not be necessary if:
● The wisdom teeth are healthy and/or fully erupted
● You have a cavity on the wisdom tooth, which can be easily treated
● Gum swelling is minimal and there is a good chance that the tooth will erupt
● X-rays show the teeth are correctly positioned and are not crowded
Depending on the case, the extraction can last from 20 minutes to a couple of hours. There are 4 main types of wisdom teeth: those with no impaction, soft tissue impaction, partial bony and complete bony impaction. The latter is the hardest to deal with, as the tooth is completely encased in the jaw bone. This procedure could last a couple of hours as the jaw bone needs to be shaved away in order to expose the tooth.
A local anaesthetic is applied before the procedure with an injection to gums surrounding the tooth. The extraction is painless as the whole mouth area is completely numb. Depending on the size of the gum tissue cut, the wound might or might not need sutures. The stitches are removed when the wound heals completely - up to 10 days after the extraction. If the gum tissue is infected and there is pus, the tissue will be most likely left open to heal.
Post-operative swelling is quite common, so applying ice packs to the affected area is advised. While the pain is still strong and the wound is bleeding, you should avoid eating hard and hot foods. Be sure to take sick leave and rest for a few days. Do not participate in any strenuous activities (such as sports or travel) and try to talk as little as possible. Do not drink from straws or smoke, and stick to the instructions your dentist gives you. You will likely be prescribed a painkiller to deal with the pain after the procedure.
If you have been wondering whether you need an extraction or not, do not hesitate and schedule an appointment at MGA Dental. Rest assured that you will receive a dedicated consultation and complete, cutting-edge treatment.