What are wisdom teeth?
A wisdom tooth is a common name for the last molars or the 3rd molars. These teeth are referred to as wisdom teeth as they erupt around the age of 17-21 yrs the age when we apparently become “wise” therefore the term wisdom teeth. There are 2 sets of 3rd molars that are 4 wisdom teeth 2 in each jaw on the right and left side.
Why are these teeth impacted?
It is believed that as humans are evolving the sizes of our jaws are becoming smaller this decrease in the size of our jaws is not accompanied by a similar decrease in the size or number of teeth. Since the 3rd molars are the last teeth to erupt they are most often left with no or very little space to erupt. If a tooth does not appear in the mouth and is left in the jaw bone beyond the age when it should appear the condition is known as impaction.
Why do we need to get wisdom teeth removed?
The 3rd molars or wisdom teeth are often impacted, that is they do not appear completely into the mouth and may be stuck in the jaws. These teeth may cause a wide array of complications from pain to cancer. It is therefore important that we get these teeth removed.
- Pain: The impacted teeth may cause pressure on associated nerves and adjacent teeth, in some case it may erupt in an abnormal direction or due to an infection. The pain of an impacted tooth may be very severe making eating or even opening you mouth difficult.
- Pericoronitis: It is a term given to the infection around the gums of a partially erupted tooth. The condition is characterised by severe pain, swelling and a reduced moth opening. If left unattended it may progress to severe infection of the peri-oral tissues called Ludwig’s angina that can obstruct the airways causing an emergency.
- Crowding of Anterior Teeth: The erupting 3rd molar may push against the teeth in from causing crowding of the anterior teeth creating an aesthetic problem.
- Cysts: The 3rd molars may sometimes be associated with a cyst this cyst may grow in size causing fractures of the jaw and even pain and swelling.
- Cancer: The lining of the cyst may sometimes undergo cancerous changes a condition known as ameloblastoma.
When to decide to get a tooth removed:
There is no need to get all the impacted wisdom teeth removed however in case the tooth is causing complications and pain it is a good idea to get them removed. Some physicians suggested a wait and watch approach for those patients where they believe the tooth might erupt or if they believe that the problems may subside with time.
Complications of getting your wisdom teeth removed:
The removal of a wisdom tooth is a surgical process and as is the case with any surgery is associated with certain inherent complications. Some of the complications that can be expected with getting a wisdom tooth removed are:
- Infection: If the surgery is not performed aseptically, proper antibiotics cover is not taken or the patient has certain diseases such as diabetes it could increase your chances of getting an infection.
- Bleeding: During the surgical procedure the surgeon may inadvertently damage a major artery or blood vessel resulting in excessive bleeding.
- Damage to nerves: This is most often the case with the removal of lower molars; the nerve damage may or may not heal with time. It could result in loss of sensation to the lower lip.
- Fracture: In some cases if lot of bone needs to be removed for the removal of a tooth the bone may fracture this again is the common case with the lower molars.
- Trismus: Is the medical term for the difficulty in opening the mouth, in some case the surgical procedure may be too prolonged or surrounding structures may be damaged this may result in difficulty in opening the mouth.
- Exposure of the maxillary sinus: When the maxillary or upper tooth is place to deep in the bone it may cause the maxillary sinus which is in close proximity to the upper teeth to get exposed in the mouth.
How to prepare for a wisdom tooth extraction?
Before you go to your dentist for an extraction there are some things that you should keep in mind:
- Start taking your antibiotics and also pain killers that have been prescribed to you by your dentist.
- Do not go on an empty stomach as the surgery may take some time (2-3 hrs) and it may also be difficult to eat after the surgery.
- Things to remember after wisdom tooth removal.
- Take the full course of your antibiotics and medications prescribed to you.
- Keep your mouth clean and use a mouth wash regularly.
- Visit your dentist if you feel any pain bleeding or the other complications listed above.