Wisdom Teeth

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Wisdom Teeth
  1. What is so special about wisdom teeth?
    Wisdom teeth (the third molars) are supposed to erupt by 18 years of age. Due to the process of evolution and change in diet from raw uncooked food to soft and cooked food habits the jaws are progressively becoming short in length. So, third molars (the last ones to erupt) may not have enough space in the jaw. They may not erupt and get locked against the neighbouring teeth. These are called impacted teeth.
  2. Why are they called wisdom teeth?
    The wisdom teeth usually erupt by 18 years of age – thought to be an age at which a person is getting “wiser”. It has no connection with the intelligence or wisdom.
  3. What problems can wisdom teeth cause?
    Of all the teeth, wisdom teeth are the ones that can cause maximum problems while erupting, removal and during healing after removal. Because of the inadequate space for their eruption, they may be placed at an angle with the tooth ahead resulting in an improper contact.

    • Their position may permit them to erupt only partially resulting in food lodgment and infection of the gum around the crown.
    • Infection causing swelling and pain.
    • The unnatural contact and food lodgment can also lead to decay of the wisdom tooth as well as the second molar which is the adjacent tooth an cause pain.
    • Such pain may get referred and be felt as earache or headache. Wisdom teeth are also known to develop cysts around them.
    • Cause ulceration to cheeks around them more often teeth and on rare occasions this may lead to cancer.

    Ask your dentist of such potential problems during your routine visit for a dental check-up.

  4. What are the treatment options for the wisdom teeth causing trouble?
    Wisdom teeth that have fully erupted in their proper positions can function like other teeth. Trouble with those that can erupt in the proper position can be treated by medication or by removal of the gum covering the wisdom tooth by surgery if required. However, when the wisdom tooth has no chance of eruption in a proper position and be able to function normally, but has the potential of causing harm as described earlier, it must be removed even if surgery is required to remove it. That may prove to be the wisest thing you did about the wisdom tooth. A dental surgeon may himself remove your wisdom tooth or refer you to a specialist – the oral and maxillo facial surgeon.
  5. How does one prepare for the treatment? Any precautions?
    Once a problem is detected with your wisdom tooth it must be assessed. The first step is to take X-rays. Two type of X-rays are often taken – one on a small dental X-ray film called the intra oral X-ray and the other showing the entire jaw called panoramic X-ray or the “OPG”. Assessment must also be made of the other surrounding structures and your general health as far as fitness for surgery. Please feel free to ask your doctor about the operation. He will be glad to answer to your queries.
  6. What does one expect during removal of a wisdom tooth?
    Most often, the surgery for removal of a wisdom tooth is carried out under local anesthesia which is similar to that given for removal of any other tooth. If you are nervous, you may ask for sedation in addition to local anesthesia. You may be more comfortable with these particularly if you have chosen to get all your wisdom teeth removed at one time which is possible and could be more convenient. Under local anesthesia you will have no pain, but under general anesthesia you will not know anything. For general anesthesia you may be taken to a hospital and an anesthetist woul be needed. Surgery under local anesthesia can be done in the dental clinic or in the oral surgeon clinic as well.

    During surgery the wisdom tooth is properly exposed by cutting through the overlying gum, some bone around the tooth removed by drillings if necessary, the tooth removed and the gum stitched back into the earlier position to close the wound. The operator may choose to remove the wisdom tooth by dividing it into pieces so that less of bone need be removed. So, don’t be surprised or worried that the tooth is being removal in pieces. The time taken will depend upon how difficult the tooth is to remove because of its position, the degree of your moth opening, your cooperation and of course the skill of the operator.

  7. How is the recovery after surgery?
    Wisdom tooth removal will cause you some discomfort in the few days immediately following removal.

    • Food:
      You can have ice-cream, cold drinks and soft food on the day of operation and are allowed eating normal food from next day.
    • Pain:
      Usually moderate on the 1st day and then reduces gradually. Occasionally pain increases on the 3rd or 4th day and is relieved better by the dentists attention and intervention.
    • Bleeding:
      Some was oozing on the day of operation seen as blood stained saliva.
    • Swelling:
      mild to moderate swelling appears on the day following surgery and then decrease gradually. Some difficulty in opening the mouth and swallowing is experienced by most patients for 4-5 days. Your dentist will tell you how all this discomfort can be reduced and will prescribe medicines, the entire course of which must be taken as prescribed. Most patients do not have to keep away from work for more than a day or two and feel normal in a week’s time.
  8. When does the wound heal?
    Whereas most of the discomfort is felt in the first week after surgery, the complete healing of the wound and smoothing of the gum in the area takes about three months. But most often the wound hardly needs any attention, except routine gargling of the mouth, after the first week. Incidentally, the lost wisdom tooth does not need to be replaced.
  9. What are the risk and complications of the surgery for removal of wisdom teeth?
    If you are operated under general anesthesia, the anesthesia & its risk & complications are the same as with general anesthesia for any other operation. Risk and complications of the surgery are not frequent occurrences but one must be aware of them. These includes wound infection , inability to open the mouth, prolonged numbness of the side particularly the lip 7 fracture of the jaw. Your dentist/oral surgeon will explain and attend to these.