Impactions, Infections and Eruptions - wisdom teeth can sound like a natural disaster. Also known as third molars, wisdom teeth are the last pair of molars to erupt (poke through the gum), and usually emerge in your late teens to early twenties - well after your mouth is already a full-house.
Over the millennia, the human approach to food has adapted, with access to cutlery, food processing and cooking, our mouths no longer need to take a chunk out of a carcass we’ve dragged to our cave, and over time our mouths have reduced in size, whilst the extra teeth still remain.
The growth path of wisdom teeth can be unpredictable, sometimes they'll move for a short time then stop for years. They may look like they're growing fine with no risks to other teeth, before changing direction and pushing against other teeth in a couple of months, known as an impacted wisdom tooth.
Guidance on wisdom teeth can vary based on the dentist and their own professional experience. You might receive guidance that the wisdom teeth should be removed at the earliest opportunity to avoid problems in the future. In contrast, some dentists may prefer to monitor the situation and only act with pain or infection management if the need arises, recommending a removal as a last resort after multiple problems. This is because wisdom tooth removal can be a problematic and invasive procedure with risks and complications as with any surgery. More on this later.
Whether you’ve received one type of guidance or another, if you’re feeling harassed by your third molars, the option to remove or not remove is something you can be more confident about if you’re armed with more information.
Please make sure you get a detailed analysis and tailored recommendation from your own dentist to ensure you’re making the right decision for your health and wellbeing. Whilst these articles are built from insights and regular conversations with our Smart Dental Care practitioners, please be aware this is generalised information and not directly related to your personal situation, history or health complications.
Wisdom Tooth Risks
Jeopardises Straightening Treatments
While there are the lucky few who still have the room - generally speaking, our oral cavity has shrunk to no longer allow space for wisdom teeth to erupt without affecting nearby teeth. This can lead to overcrowding, and trigger the other teeth to migrate. If you’ve already had orthodontic treatments like braces and clear aligners, this can undo months or even years of straightening progress.
Pocket Infection and Debris Build-up
Growth of wisdom teeth is often described as erratic and unpredictable, sometimes they’ll erupt all the way, partially or not at all. They may look like they’re growing through straight and with no risk to nearby teeth, before changing course and clashing with your molars. When wisdom teeth erupt partially, the opening they create can trap food and become hard to access with normal brushing, making it prone to bacteria and infection. Your dentist might recommend a hot salt water rinse to cleanse the area and settle irritated gums, as well as interdental toothbrushes like Tepes to try to get access to this pocket for a more thorough cleaning.
Impaction and Tooth Integrity
If the wisdom teeth are growing at a more severe angle, the top of them can end up pointing directly at your other teeth, eventually crushing them as it continues along its path. This is referred to as an impacted wisdom tooth, and your dentist may recommend a removal due to the risk it poses to your other teeth.
TMD and Misalignment
Wisdom teeth not only grow into other teeth, but they can grow towards the jawbone too, which can get in the way of your bite function, creating misalignment and pressure. Additionally, if the wisdom tooth only erupts on one side and extends higher than the nearest molar, even by a millimetre, you’ll notice the difference.
That’s a millimetre of your jaw being off-kilter, of your jaw muscles moving differently, and the hinges compensating too. Pressure and pain and can reach all the way to the ear where the jaw meets the skull, and could lead to a condition called Temporomandibular Disorder (TMD). TMD can result in sharp twinges and pain in the jawbone and muscle when eating, chewing or speaking. These symptoms can persist for an extended period of time and worsen if the cause isn't addressed.
Wisdom tooth Benefits
There are no scientifically proven benefits to wisdom teeth.
They are too far back, too difficult to clean, which makes them prone to bacteria and decay.
There are occasions when all four erupt and grow through nice and straight without posing problems but this is exceedingly rare.
Surgery Risks
After an exam to determine the progression of the wisdom teeth, the dentist will decide between a simple or surgical extraction. Simple extractions are performed when there is enough exposed tooth that the dentist can simply pull it out with forceps. If teeth are too difficult to access, a surgical extraction may be necessary. Below are some complications of extraction.
Broken Jaw
The pressure and exertion required to dislodge a wisdom tooth may be so strong that the removal actually causes a fracture or break in the jawbone.
Nerve Damage (Paresthesia)
The roots of wisdom teeth can sit next to the anterior nerve, which runs around your jaw and assists with normal jaw function. During a removal, there's a possibility of this nerve being damaged with tearing or bruising which may affect your ability to open and close your mouth and cause numbness of the tongue, lip, or chin. This could end up being short term or long term depending on the severity of the nerve damage.
Fractured tooth
A risk mostly associated with an advanced stage of wisdom tooth decay, the tooth may be too damaged to be gripped tightly and breaks during the removal, leaving behind fragments of the tooth or root which can end up being pushed too far down or becoming too small to grip with forceps, requiring more invasive surgery.
Post-operative Dry Socket
As mentioned in in the Q&A series, a dry socket occurs when a blood clot fails to form or is dislodged from the empty tooth socket. While not a risk posed during surgery, this can occur during your recovery, slowing down the healing process leading to additional pain, infection and other complications.
You can however lessen the chances of developing a dry socket. Avoid using a drinking straw or smoking cigarettes, as the suction required can easily dislodge the blood clot.
Avoid smoking after an oral surgery for at least for 48hours, as the harmful chemicals can inhibit healing.
Try to stick to eating softer foods which don't require too much chewing. As for hygiene, your dentist may advise you to skip brushing for the first 24hours, and brush carefully the next day. Do not swill with mouthwash or water as this will most likely dislodge the blood clot.
Surgery Benefits
Whilst it is an unpleasant experience to go through, if your wisdom teeth have been plaguing you for years with repeated rawness, infections and nagging worries whenever it moves, it may be a relief that you'll never have to worry about it causing you hassle in future. Other benefits of having the removal;
- Preserves orthodontic treatments and alignment
- Lowers your costs of repeated visits for infection management over the long term
- Saves teeth which are at risk of being impacted
- Long term peace of mind
It’s a scary and triggering topic for most, but hopefully the process feels less scary with some background understanding. Remember, this advice is generalised, and professional opinion can vary, especially when individual patient circumstances or underlying conditions are considered.
Maintain your oral health or get expert medical advice from your local Smart Dental Care practitioner. If you feel the need to discuss your options or proceed with an extraction, please get in touch with us via phone on 0161 820 3477 or book online today.
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