Wisdom teeth or third molars are the last teeth to erupt, they come in between the ages of 17 and 25 years; they can cause discomfort and even severe pain, if this happens to you, the only way to relieve symptoms is by extracting them.
Below we will explain the possible complications caused by wisdom teeth, when you can keep them, when should be removed, and the benefits and drawbacks of removing them.
Where are wisdom teeth located?
They are located at the end of the dental arch, behind the second molar. In many cases, they are not visible since they don’t erupt properly, in other cases, a part of the tooth can be seen while the rest is covered by gum.
The best way to correctly visualize their position, shape, and size is through X-rays.
Is it necessary to remove them?
No, in many cases they erupt correctly and cause nothing more than gum irritation for a few days.
In these cases where they don’t cause any symptoms or affect the other molars, there is no reason to extract them.
You can live a completely normal life with them, you just have to make sure to clean them well, since being located at the end of the dental arch they can be a bit difficult to reach with the toothbrush so it’s very easy to get wisdom tooth decay.
When is a wisdom tooth extraction necessary?
The need to extract them is due to human evolution and lifestyle changes that have caused us to have smaller jaws without enough space for them to erupt properly.
It will also be necessary to extract the impacted wisdom teeth when despite having enough space, they develop in the wrong position preventing them from coming out, they usually end up impacted against the second molars (horizontal wisdom teeth), affecting the health of surrounding teeth.
In cases where neighboring teeth are affected, getting an emergency wisdom tooth extraction will be advisable to prevent further damage to healthy teeth.
What symptoms do wisdom teeth cause?
Like any other tooth, they cause inflammation of the gums and discomfort in the adjacent area.
However, when they can’t erupt correctly, the symptoms can go from moderate to severe, the first signs of wisdom teeth coming in are:
- Pain and inflammation in the gum.
- Gum bleeding.
- Bad breath.
- Pericoronitis.
- Cheek swelling.
- Jaw pain and difficulty opening the mouth.
- infections.
- Dental crowding due to pressure exerted on surrounding teeth.
- Ear pain.
- In some cases, episodes of moderate fever may occur.
How to relieve wisdom teeth pain?
Over-the-counter pain relievers, as well as applying cold to the inflamed area and rinsing your mouth with salt and water, are very effective options for relieving the pain caused by erupting wisdom teeth.
However, in cases where the third molars fail to erupt properly, pain relief is temporary, as only tooth extraction can fix the discomfort permanently.
Wisdom tooth surgery
In many cases, the only way to relieve symptoms is getting wisdom teeth out through a surgical extraction that an oral surgeon should perform.
Below we will explain the wisdom teeth removal protocol step by step, but keep in mind that it may vary according to each particular case:
- Application of anesthesia: Local anesthesia is usually enough to perform the surgery in the dental clinic, but if considered necessary, the surgeon can do a conscious sedation to help the patient remain calm during surgery; In some special cases, general anesthesia might be necessary, if so, the surgery must be carried out in an operating room.
- The incision in the gum: The surgeon will cut the gum to expose the jaw area where the third molar is located.
- Osteotomy: The osteotomy consists of removing a part of the alveolar bone that covers the tooth to gain access to it. This step is optional and depends on the position of the tooth, it is necessary if the tooth is in a horizontal position.
- Odontosection: It consists of cutting the tooth into several parts in order to extract it more easily, the odontosection is not always necessary, this will depend on the position of the tooth.
- Cleaning and disinfection: Once the tooth is extracted, the surgeon must clean the area thoroughly to remove any remaining tooth or bone before suturing the gum.
- Suturing the gum: The surgeon puts the gum back in its original position and does stitches to facilitate healing, the suture can be resorbable (it disappears on its own) or surgical (it must be removed by the surgeon after a few days); In some cases when the incisions are very small, it will not be necessary to suture the wound.
Wisdom teeth removal after care
- Maintain absolute bed rest for at least 24 hours after surgery.
- Avoid intense physical activity for about a week.
- Do not brush your teeth during the first 24 hours, after this period, be especially careful when brushing the surgery area.
- Maintain a soft diet for the first week and gradually incorporate semi-hard foods as you start to tolerate them better.
- Avoid lying down without pillows as this position can increase swelling from wisdom teeth removal and postoperative pain, keep a semi-sitting position.
- Do not drink coffee, alcohol, hot or acidic beverages, or use a straw as the suction may affect the healing of the incision.
- You can use over-the-counter pain relievers to ease the pain, although your surgeon will most likely prescribe a specific pain reliever or medicated mouthwash.
- If you are a smoker, avoid doing so for at least the first 3 days after the intervention.
- Gently rinsing your mouth with salt and water after each meal will help reduce inflammation.
- During the first 24 hours it is recommended to apply cold intermittently, that is, apply a cold compress on your cheek for a few minutes and then remove it for a few minutes.
- After the first 24 hours, intermittent applications of heat are recommended, this can be done with cloths moistened with warm water.
- Depending on each case and the complexity of the surgery, each surgeon can add some special care after surgery as he deems appropriate, make sure you follow the specialist’s instructions to the letter.
Possible complications after removal
There are 3 possible complications that can occur, fortunately, all of them can be easily solved with the appropriate treatment:
- Dry socket: The dry socket occurs when the blood clot that should form in the space where the molar used to be, detaches or does not form properly, leaving the socket unprotected, and causing an inflammatory process that is quite painful.
- Injury to nerve structures: In cases where the roots of the wisdom teeth are too close to the lingual and dental nerves, it is possible that these are injured, however, the injury to these nerves does not produce any type of facial paralysis and the problem can be solved with the proper treatment.
- Bucosinusal communication: When it comes to wisdom teeth in the upper dental arch, it is possible that the roots of the tooth are inside the maxillary sinus cavity and when it is extracted, it will connect the oral cavity and the maxillary sinuses, in this case, treatment should be administered to prevent the onset of sinusitis and a treatment plan should be established to close the communication as soon as possible.
Wisdom teeth removal surgery cost
The cost to get wisdom teeth removed goes around $300 and $1.500, this huge range is possible since some extractions might be very simple while others might require a surgical procedure that involves sedation and a more complex technique.
Frequent Q&A
At what age do wisdom teeth come in?
They appear on average between the ages of 17 and 25, although they can appear much later, depending on the characteristics of each person.
Why do we have wisdom teeth?
Wisdom teeth originally served as a set of spare teeth that erupted to replace teeth lost throughout the first few decades of life, this made sense in ancient times.
However, in the modern world, the loss of molars is no longer as common, in addition, the diet that humans currently maintain has caused us to have smaller jaws, leaving little room for the eruption of wisdom teeth.
Therefore, third molars no longer play any functional role in our development and can even affect the health of adjacent healthy teeth.
How many wisdom teeth do we have?
There are 4 wisdom teeth in total, one on each side of the upper arch and one on each side of the lower arch.
Wisdom teeth can cause bad breath?
Yes, any erupting teeth can cause temporary bad breath since it is common to experience gum bleeding and decomposition of blood produces a strong smell in the mouth.
Wisdom teeth can cause ear pain?
Yes, since they are located so close to the ear structures, an inflammation process in the area can cause referred pain to the ears.
After wisdom teeth removal when can I use a straw?
It is advisable to avoid straws at least for two weeks after the extracción since the pressure produced inside the mouth when sucking can cause the blood clot to dislodge and this can cause a dry socket.
Are wisdom teeth removal painful?
No, the procedure is carried out under anesthesia, however, you will experience swelling and discomfort after the extraction.
Are wisdom teeth extractions covered by insurance?
Yes, insurance companies will cover the extraction if it is a medical need, e.g. you have impacted wisdom teeth, they are causing pain, or affecting neighboring teeth.
What is the name of wisdom teeth?
Wisdom teeth’ real name is third molars.
Does everyone have wisdom teeth?
No, in fact, the absence of wisdom teeth is becoming more common day by day, this is due to a developmental defect called dental agenesis, fortunately, in the case of wisdom teeth this does not represent a problem, it can even be beneficial for the patient.
Can 2 wisdom teeth be removed at the same time?
Yes, even 4 teeth can be removed at the same time, this will depend on the planning of each case and what is most convenient for each patient; if the use of general anesthesia is required then it is advisable to perform multiple extractions at once.
Is it necessary to remove wisdom teeth to put on braces?
Not in all cases, however, if you have crowded teeth and need extra space to align them, removing them is a good option, although there are other more conservative techniques such as dental stripping, your orthodontist will help you choose the most suitable option for you.
References
- Ouassime, K., Rachid, A., Amine, K., Ousmane, B., & Faiçal, S. (2021). The wisdom behind the third molars removal: A prospective study of 106 cases. Annals of Medicine and Surgery, 68. https://doi.org/10.1016/j.amsu.2021.102639
- Hallab, L., Azzouzi, A., & Chami, B. (2022). Quality of life after extraction of mandibular wisdom teeth: A systematic review. Annals of Medicine and Surgery, 81. https://doi.org/10.1016/j.amsu.2022.104387