Wisdom Teeth

Overview of wisdom teeth

Oral health is an essential component of a healthy lifestyle. Negligence of oral health and limited dental care practices can cause several complications like dental decay and even loss of teeth. One common problem pertaining to oral health is the emergence of “wisdom teeth”. It should be made clear in the first place that the eruption of wisdom teeth is not some dental disorder. But the associated complications should be taken into account. In most cases, painful and impacted wisdom teeth are found to appear which makes it compulsory to uproot those teeth. Wisdom teeth are one of the leading causes of dental surgery. They impact the cost of hospitalization in every nation.

What are wisdom teeth?

Wisdom teeth, also known as “third molar” are the last set of permanent teeth that appear in an individual. They usually erupt in the late teens or early twenties (17-25 years).

A normal adult typically has 32 teeth. Four additional teeth (wisdom teeth) appear after a certain age in the upper and lower jaws (at the back of the mouth). In few rare cases, more than four wisdom teeth can appear.

Wisdom teeth cause a lot of pain and complications while erupting. The pain is severe in those cases where the jaw is very small to make room for new teeth. In such cases, the wisdom teeth break through the gums in a slant position. Doctors call them “impacted wisdom teeth”. At times, due to the acute shortage of space, wisdom teeth do not erupt at all. They remain buried (trapped) beneath the gums. These are called “trapped wisdom teeth”.

Symptoms of wisdom teeth

Severe symptoms and complications arise at the time of eruption of impacted teeth. These are as follows-

• Gum disease: Gum infections and periodontal diseases occur when food particles and bacteria linger between the emerging teeth and the gum. Acute gum inflammation and infections occur in such cases. It is prevalent in 50-60% of patients.
• Dental caries: The wisdom teeth often emerge in an angular fashion. It makes the proper cleaning of the teeth (removal of dental plaque) becomes impossible. This often leads to dental decay and caries in the teeth. 25-30% of patients suffer from this condition.
• Teeth crowding: Due to the abnormal slanted position of the teeth, the neighboring teeth are often displaced. After that, those teeth attain an angular position. This may worsen during the full growth phase of the wisdom teeth.
• Root recession: Due to multiple factors like pressure created by the new teeth, infection and inflammation of surrounding tissue (occurs in dental plaque), the root of the adjoining teeth start to recede and gradually disappear.
• Cyst: Fluid-filled blisters or cysts may appear in the vicinity of the new teeth. With time, it affects the jaw bone. It occurs in less than 1% of patients.

Apart from these, the following additional symptoms might appear-

• Severe pain due to the swelling of the jaw and cheek region
• Pain in the gums
• Tenderness and touch sensitivity in the areas adjacent to the new teeth
• A toothache
• Reddish and swollen gums
• Bad taste in the mouth on biting with the wisdom teeth or neighboring teeth
• A headache that originates from persistent pain in the jaw
• Difficulty chewing, swallowing or opening the mouth
• Bad breath
• Occasional fever
• Recurrent infection of the gum that passes over a portion of a teeth (pericoronitis)
• Formation of abscess in the gums

What are the different types of wisdom teeth?

This section will discuss the different categories of wisdom teeth-

• Unerupted teeth: It is the initial phase where the wisdom tooth remains within the jaw. It is covered by tissues and bones (partially). Pain at this stage is an indicator of the emergence of wisdom teeth.
• Partially erupted teeth: In this phase, the wisdom tooth does not develop fully. They are still in the stage of growth.
• Impacted teeth: An impacted wisdom tooth occurs when the jaw area is relatively small. It is not capable of accommodating more teeth. Obstruction and pressure from the adjoining teeth aggravate the situation. In this case, the wisdom tooth erupts in an angular position.

What anesthetics do the dentists use?

In most cases, wisdom teeth give rise to severe complications and impede the normal healthy lifestyle. In such cases, the doctors advise surgery and complete removal of teeth. The following anesthetics are normally used before surgery or to alleviate the pain in general-

• Local anesthetic: After injection into the gums, a local anesthetic is used to create numbness of the jaw in order to facilitate a painless surgical treatment.
• Intravenous sedative: The intravenous sedative is usually injected into the arm even before injecting local anesthetic. This makes the patient drowsy and does not make him feel any pain during the operation.
• General anesthetic: It is injected only during a very complicated and critical wisdom teeth surgery which causes the person to sleep.

What are the complications after surgery?

The following symptoms may be observed after surgery of wisdom teeth-

• Persistent pain for 3 to 7 days
• Swelling of jaw and cheeks within 2-3 days of surgery
• Bruising is observed on the cheek, face or upper part of the neck (ecchymosis)
• Production of blood tinged saliva
• Hemorrhage
• The stiffness of jaw lasting for a couple of days
• Difficulty swallowing (soft food recommended in the post-surgery period)
• The extreme sensitivity of teeth
• Bad breath that stays for a week
• Cellulitis, hemorrhage or abscess formation due to soft tissue infections
• Displacement of adjacent tooth
• Fracture of the mandible (lower jawbone) or maxilla (upper jaw bone)

Diagnosis and Treatment

Dental probe and dental radiograph are recommended for the proper diagnosis of wisdom teeth. Treatment for impacted wisdom teeth is as follows.

• Impacted wisdom teeth will need to be extracted. Here, the dentist will make a slit in the gums and move any obstruction at the base of the impacted tooth. Post which the gums are stitched and gauze is put in place of the empty socket.
• Post the wisdom teeth extraction; doctors will give the patients instructions on how to go about caring for the wound.

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