What are “wisdom teeth”?
Wisdom teeth, or third molars, are the last permanent teeth to develop, often erupting in the late teens or early twenties. Dental problems are often encountered which are generally treated through removal.
Many people have jaws that are too small to allow their wisdom teeth to grow in properly, often resulting in the teeth becoming impacted. Some problems that are encountered are pain, infection, gum disease, decay (wisdom teeth or nearby teeth), crowding which can cause misalignment and interference with other dental or orthodontic work.
What makes them different?
Wisdom teeth are very similar to your other permanent teeth, but are the last to develop and grow in. Most people have four (one in each corner) but some naturally lack one or more.
Wisdom teeth are molars which, like other molars, are designed for chewing. As they are “third” molars, there are eight others to do the chewing and most people get along fine without their wisdom teeth.
How do I know if my wisdom teeth need to be removed?
Before your surgeon recommends removal, you will receive a thorough evaluation, including x-rays and dental examination. X-rays allow the surgeon to assess the positions of teeth that haven’t fully erupted and can also show decay and other problems such as bone loss. Your dental exam will include a review of your dental history, an assessment of overall oral health, an examination of the visible parts (if any) of your wisdom teeth and any signs of infection.
Wisdom teeth can grow in any direction and often become impacted in the jawbone, even if they grow in straight. They can cause acute (sudden) problems or chronic (ongoing) problems or no problems at all. The use of dental x-rays to determine how the wisdom teeth are forming before problems occur may prevent you from experiencing the pain associated with future problems.
What treatment options do I have?
Early removal is often the recommended course of action. Removal becomes more difficult as the patient grows older because the roots mature and become more firmly anchored to the jawbone over time. Your surgeon may recommend the removal of all four wisdom teeth in a single procedure, even if they are not all causing problems. Alternatively, the teeth from each side of the mouth may be removed in separate procedures.
Other options include close, regular follow-up to check for complications, medication to control some symptoms and to treat infections, and minor surgery such as opercularectomy (removal of gum tissue overlapping the tooth).
What are the risks and potential complications?
- Sore joints and muscles
- Dry socket
- Infection
- Side effects of anesthesia
- Sinus problems
- Nerve injury
- Weakining of the jaw
How should I prepare for surgery?
Wisdom teeth are often removed in the oral surgeon’s office, or in an outpatient surgical centre such as a hospital. Including recovery from anesthesia, you will likely require around 2 hours for the procedure.
You should:
- Arrange for time off from work or school
- Tell your surgeon about any medications you might be taking
- Follow the instructions you’ve been given for eating and drinking before surgery
- Wear loose, comfortable clothing
- Arrange for a ride home
Recovery
Your mouth will need time to heal. Some bleeding is normal on the first day after surgery. You may also see some facial bruising and swelling for the first week. Healing will be quickest if you get lots of rest, eat and drink nutritious foods and take care of the extraction site(s).
Make sure you:
- Control bleeding by biting down on the gauze and applying constant pressure. Bleeding should stop within 2 hours, although some oozing for a few days is normal
- Take medications as directed
- Reduce swelling by applying ice pack periodically and avoiding drinking hot liquids
- Get lots of rest
- Drink nutritious liquids such as vegetable juice, 100% fruit juice or milk
- Protect the extraction site by not brushing your teeth or rinsing your mouth during the first day and avoid smoking or drinking through a straw as suction can dislodge the blood clot.
You should call your doctor right away if:
- The pain becomes more severe on the day after surgery and can’t be controlled with pain medication
- Bleeding becomes hard to control or comes in spurts
- You have fever or chills
- Swelling around the extraction site worsens
- You have itching, a rash or other allergic reactions
- You have persistent nausea or vomiting