If I had a dollar for every patient that came through the door worried that their wisdom teeth are going to infect the rest of their mouth, or cause infection thus needing removal…I’d be happily retired by now. There are many misconceptions and old wives tales about wisdom teeth. The best way to clarify these issues, is to identify some basic Q&As regarding these teeth.
What are Wisdom Teeth?
The wisdom teeth are the 3rd molars in each quadrant of the mouth. Some say that they are called “wisdom teeth” as they generally appear so late – much later than the other teeth, at an age where people are presumably “wiser” than as a child, when the other teeth erupt.
Is it normal to not have wisdom teeth?
Wisdom teeth are the most variable tooth in the mouth. Many people do not have a complete set of wisdom teeth. Some people may have only two or three and others have no Wisdom Teeth. Having all, none, or some Wisdom Teeth is considered normal. Wisdom Teeth erupt (come up, into the mouth) behind the second (12 year old) molar and do not replace any baby (primary) teeth. Wisdom Teeth usually erupt when a person is between 15 to 20 years of age, however this is extremely variable. Occasionally Wisdom Teeth may erupt much later in life. This is particularly likely if other molars are removed as this may allow a previously trapped (impacted) Wisdom Tooth to erupt.
Do wisdom teeth always hurt?
Just as young kids experience teething pain when teeth erupt, so too can adults. This discomfort is usually a low grade, “niggling” pain which can also be felt as pressure against the other teeth. This discomfort does not generally last very long and is usually controlled with analgesic such as panadol and nurofen.
However…
Often when wisdom teeth erupt (particularly in impacted cases), a small infection can occur in the gum surrounding the erupting tooth. This is particularly noticed when the tooth is only partially erupted, leaving a small flap of gum to lie across the tooth to act as a food pack. This is called “periocoronitis” and is the result of plaque bacteria becoming trapped between the gum and the erupting tooth. It certainly doesn’t help that the wisdom tooth is also difficult to reach with a toothbrush, being the tooth at the very most rear!
Pericoronitis can be mild to very painful, and may cause swelling which results in limited opening of the jaw. The bacteria need to be removed and a dentist can assist with this, however, can often reoccur in more than one occasion. Sometimes, antibiotics are prescribed as well as antiseptic mouthwashes to be used to help flush out the area to allow healing. Smoking may increase the risk of periocoronitis.
Do all wisdom teeth need to come out?
As mentioned earlier, wisdom teeth are simply a term used to describe the 3rd molar in the mouth. If this 3rd molar erupts without any complications (like any other tooth), then simple answer is, “no”. However, wisdom teeth are often removed if:
– they are impacted. This means that the tooth may not be growing in a favourable direction, which can lead to infection, cyst development, and decay.
-they have had multiple bouts of pericoronitis.
-they are unfavorably positioned causing difficulties in speech, function and cleaning. This is often seen in the upper jaw when the wisdom tooth can often erupt in the direction toward the cheek on widen opening causing ulceration to the cheek.
-they have no function. Often, if one wisdom tooth is removed, the other wisdom tooth above or below it, which would normally have bitten against the removed tooth, will have no function. It may be advisable to have these teeth removed due to the difficulty which is sometimes experienced with cleaning.
If I have problems with my teeth, when should wisdom teeth come out?
If Wisdom Teeth do need to be removed it is usually best done at a younger age. Obviously the teeth must be old enough to have formed properly before being removed. Younger patients have a faster healing capacity, and softer bone, allowing for easier removal. Younger patients are also usually medically fit and healthy, and able to cope easily with minor operations. This is not to say that Wisdom Teeth cannot be removed much later in life, but there is an increased risk of complications.
Do I have to go to hospital to get them removed?
That depends on the particular tooth. Some teeth can be simply removed under local anesthesia like any other extraction. However, impacted (trapped) teeth will often require minor oral surgery to cut the tooth out of the surrounding gum and bone. This can be done under local or general anesthesia. Some patients prefer to have this procedure done in a hospital setting with an oral surgeon, as it is more comfortable. It is best to discuss with your dentist which treatment option best suits you.
I hope this has provided you with an insight of understanding a bit of background about wisdom teeth. If there are any further questions, please feel free to comment and I’ll get back to you ASAP! 