Wisdom teeth, which dental professionals refer to as third molars, are the very last teeth to erupt in your mouth. There are many myths and misnomers surrounding wisdom teeth, so it’s important to discern the facts from the fiction. The wisdom teeth normally erupt in the late teenage years or even in the early twenties for most people. Although the third molar can be healthy and used when it aligns with the other teeth, oftentimes, they are misaligned and a dentist or dental surgeon will need to remove them to prevent complications, such as damage to the adjacent teeth, the jaw bone or even the nerves. Also, they can be extremely uncomfortable.
Wisdom teeth also can become impacted, which means they become embedded in the soft tissue and/or the jawbone, only breaking through the gum tissue partially. This impaction or partial eruption can allow bacteria to build up around the tooth, causing an infection known at pericoronitis. Pericoronitis can become severe and spread beyond your jaw to your neck and even your cheeks, causing symptoms, such as pain, swelling, stiffness in and around the jawbone – and a general feeling of malaise. Impacted wisdom teeth are difficult to floss and brush, which leads to decay, and eventually, gum disease.
What You Need to Know
X-rays can show the dentist if your wisdom teeth will continue to erupt in a crooked pattern, and that is a valid reason for extraction. Another problem dentists often see is the development of a fluid-filled sac around the partially erupted wisdom tooth, which can damage the surrounding tissue and bone. If you experience any of these symptoms, which may indicate the presence of pericoronitis, visit your dentist right away:
- Persistent bad breath
- Difficulty opening the mouth
- Pain or tenderness of your gums or jaw bone
- Prolonged headaches or jaw aches
- Redness and swelling of the gums around the impacted tooth
- Swollen lymph nodes of the neck
- Unpleasant taste when biting down on or near the area
- Visible gap where a tooth did not emerge
Do You Have Wisdom Teeth?
If you aren’t sure if you have them, ask your dentist. They can find out by taking x-rays, and then they can check the position and alignment of them for you. If you need them removed, your dentist may refer you an oral surgeon for a consultation and removal. Most dentists will recommend extraction in order to avoid problems later. Wisdom teeth extraction is less painful and results in fewer complications when done at a younger age when the teeth roots are not fully developed and the jawbone is a bit less dense. Recovery time is longer and the chance of complications increases with age so dentists recommend that teens and young adults have their wisdom teeth checked and evaluated before they get older.
Is Extraction Necessary?
Many people question the need for removing wisdom teeth. Dentists must evaluate each patient’s specific condition to make the best decision. Your dentist may decide that extraction is not necessary if your teeth are:
- Fully erupted
- Grown in completely
- Positioned correctly
- Biting properly in alignment with opposite teeth
- Easy to clean as part of your daily dental hygiene
Your wisdom teeth must meet all of the above criteria. If they don’t, your dentist may decide to take preventative measures and recommend extraction.
Why is Impaction a Common Problem?
Because they are located at the very back of your mouth, wisdom teeth don’t always have enough room to grow correctly, and this is what causes most problems. Without proper space, wisdom teeth may grow at various angles in the jawbone, even in a horizontal direction. If they are crowded enough, they can only emerge partly through the gums, or they may not erupt at all, trapping them in the jaw. Dentists recommend extracting them when a person is younger rather than older, because the jawbone becomes more rigid with age, making removal and healing take longer.
The Removal Procedure
The position of the tooth and its stage of development dictate the exact procedure the oral surgeon will use to extract it. If the tooth has erupted fully, the dentist can extract it as they would any other tooth. However, if it is impacted, the dental surgeon will need to make an incision in the gum tissue to remove any bone that formed over the tooth. They may take small sections out, rather that the entire tooth. Although it sounds like a complicated procedure, oral surgeons are trained and highly skilled in this common procedure.
Most people do well with local anesthesia, numbing the surrounding tissue the same was as for a cavity filling; however, the exact procedure depends on whether or not the tooth is impacted. Talk to your dentist about sedating medications, such as nitrous oxide or an oral sedative, especially if you suffer from dental anxiety. If this is the case, you’ll need to arrange for someone to drive you to and from your appointment. Recovery time depends on the type of extraction, and your dentist will inform you of what to expect, as well as how to speed up the process.
Although they are rare, complications can occur, and your dentist will want to inform you of them, so you can avoid them. They are as follows:
- Dry Socket – This is a common complication that happens when the blood clot doesn’t form in the extracted tooth socket, or when the blood clot has been dislodged. The absence of clot formation delays healing. Dry socket can occur three to four days following the extraction. It can be quite painful and may include a foul mouth odor, indicating infection. The dentist or oral surgeon can treat it by placing medication in the dry socket.
- Paresthesia – A much more rare complication of wisdom teeth extraction, this happens when the wisdom teeth grow in the jawbone very close to the nerves. Sometimes, the extraction process may bruise or damage the nerves, and this can result in numbness of the tongue, lip, or chin, which can last a few days, weeks, months, or may even be permanent. As bad as it sounds, simply leaving the wisdom tooth there can cause much more damage, so the dentist must make the decision to remove it. This is why making regular dental checkup appointments is so critical, from childhood onward.
Simple extraction of a properly-aligned wisdom tooth costs less than an impacted wisdom tooth; however, costs vary in different areas of the country, so contact your dentist or oral surgeon to discuss the fees. You should also check with both your dental insurance carrier and medical insurance provider. One or the other type of insurance usually covers a portion of the cost of wisdom teeth removal, because it is necessary, preventative surgery. Wisdom teeth don’t always cause problems; however, regular dental checkups can detect problems before they arise, saving patients much pain, expense and inconvenience later on in life.
Any surgical or invasive procedure carries risks. Before proceeding with a surgical or invasive procedure, you should seek a second opinion from an appropriately qualified health practitioner.