Wisdom teeth are the
third and final set of molars that most people get in their late teens
or early twenties. Sometimes these teeth can be a valuable asset to the
mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
Wisdom teeth present potential problems when they are misaligned - they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed "impacted." Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
How Do I Know if I Have Wisdom Teeth?
Ask your dentist about the positioning of your wisdom teeth. He or
she may take an X-ray periodically to evaluate for the presence and
alignment of your wisdom teeth. Your dentist may also decide to send you
to an oral surgeon for further evaluation.
Your dentist or oral surgeon may recommend that your wisdom teeth be
extracted even before problems develop. This is done to avoid a more
painful or more complicated extraction that might have to be done a few
years later. Removal is easier in young people, when the wisdom teeth
roots are not yet fully developed and the bone is less dense. In older
people, recovery and healing time tend to be longer.
How Are Wisdom Teeth Removed?
The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
What Happens During Wisdom Teeth Removal?
Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic
-- the same injection with the same medication you would receive to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative is desired to control any anxiety. Sedating medications that could be selected include: nitrous oxide (otherwise known as "laughing gas"), an oral sedative (for example,
Valium), or an intravenous sedative (administered via an injection into your veins). If nitrous oxide is given, you will be able to drive yourself home. If any of the other medications is selected, you will need someone to drive you both to and from the appointment.
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Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Gum disease is caused by plaque and may result in tooth loss without proper treatment. Symptoms and signs of gum disease (gingivitis or periodontal disease) include receding gums, bad breath and pocket formation between the teeth and gums. Treatment depends upon the stage of the gum disease, how you responded to earlier treatments, and your overall health.
Dry socket is a painful condition that sometimes occurs after a tooth has been pulled. Dry socket can occur if the blood clot protecting the bone and nerves in the hole in the bone where the tooth was pulled becomes dislodged after extraction. In addition to pain, symptoms include bad breath and a bad taste in your mouth. People who smoke, have poor oral hygiene, and those who use birth control pills have a greater likelihood of developing dry socket. This condition may be treated with aspirin, ibuprofen, a nerve block, or medication prescribed by your dentist.
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Wisdom teeth, otherwise known as third molars, are the last set of teeth to
develop. Sometimes these teeth emerge from the gum line and the jaw is large
enough to allow room for them, but most of the time, this is not the case. More
often, one or more of these third molars fails to emerge in proper alignment or
fails to fully emerge through the gum line and becomes entrapped or
"impacted" between the jawbone and the gum tissue. Impacted wisdom
teeth can result in swelling, pain, and infection of the gum tissue surrounding
the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage
to nearby teeth, gums, and bone and can sometimes lead to the formation of
cysts or tumors that can destroy sections of the jaw. Therefore, dentists
recommend people with impacted wisdom teeth have them surgically removed.
It's not just wisdom teeth that sometimes become impacted and need to be
removed. Other teeth, such as the cuspid...
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