Wisdom Teeth and Dental Health

wisdom teethWisdom teeth are the third four molars and they get their name by being the last teeth to appear in young adulthood. They appear between the ages 17 – 25. In some cases, these teeth prove a valuable asset to the mouth when properly aligned and remain healthy. However, in most people they are misaligned and affect other teeth when developing which requires removal.

Misaligned wisdom teeth

When wisdom teeth develop misaligned, they are positioned horizontally, angled towards or away from the premolars (second molars), or angled inwards or outward. This poor alignment can damage adjacent teeth, the jaw bone and nerve endings.

Impacted wisdom teeth

When wisdom teeth are impacted, they are closed within the jaw bone or the soft tissue or they just appear partially through the gum. These partial wisdom teeth make a way for the bacteria to enter the tooth and cause gum or teeth infection, resulting in swelling, pain, jaw stiffness and general discomfort. These incompletely erupted wisdom teeth are also prone to gum disease and tooth decay as their awkward location creates difficulty in brushing and flossing.

How to Know the Presence of Wisdom Teeth?

You need to go for a physical examination to check the position of wisdom teeth with your dentist. An X-ray is taken to check the alignment of the wisdom teeth. Your dentist will then refer you to an oral surgeon according to the requirement for further evaluation.

You dentist may then suggest your wisdom teeth to be extracted before any problems arise. This will help to avoid more complicated and painful extraction which is to be done a few years later. Wisdom teeth removal is easier when young itself because the roots and jaw bones are less developed.  In elderly people, healing takes more time.

Wisdom Teeth Removal

The relative ease on extracting the wisdom teeth depends on the location and stage of teeth development. A fully erupted wisdom tooth is very easy to extract than any other tooth. A wisdom tooth that is embedded in the jaw bone or underneath the gums will require a slit in the gums and removal of bone that lies over the tooth. The tooth is removed in small sections than at a time to reduce the amount of bone to be removed to extract the tooth.

Consequences during Wisdom Teeth Removal

Before extracting the wisdom teeth, the surrounding gum tissue is numbed by injecting a local anesthetic. In addition to anesthetic, the dentist also gives a sedative to help control anxiety. Either oral or intravenous sedatives are given. Sedatives include nitrous oxide (laughing gas) or valium. If nitrous oxide is administered, you can feel neither pain nor discomfort and can easily drive yourself home. If any other medication is administered, you need someone else to drive you home.

What to Expect During Recovery Stage of Wisdom Teeth Removal?

After extracting wisdom teeth, the time of recovery depends on the extent of teeth removal. It may vary from a simple removal of completely erupted tooth to a partially erupted tooth).

The first 24 hours

Bleeding – Bleeding may take place for long time after tooth removal. Place a piece of clean moist tissue over the tooth socket and bite down deeply. Apply pressure firmly for nearly 45 minutes. A moist tea bag is a best alternative. The tannic acid content in tea heals blood clots. This works when there is small amount of bleeding. However, if bleeding is heavy, contact your dentist. Avoid cold drinks, hot liquids, rinsing or spitting as these activities can disperse the clot leading to dry socket.

Facial swelling – This occurs in the area where the tooth is removed. To minimize facial swelling, take a piece of ice, wrap in a cloth and place on that swollen area for about 10 minutes. Repeat this procedure every now and then during the 24 period.

Medications – Pain medications like ibuprofen and acetaminophen work for mild to moderate pain. If the pain is severe, it is better to consult your dentist.

Antibiotics – Your dentist will prescribe certain antibiotics prior to tooth removal. These are to be continued until you finish the prescription.

Foods – You need to restrict yourselves to a liquid diet until the anesthesia wears off. Restrict yourselves to soft foods and also avoid alcohol if you are on narcotic medicines.

Continue brushing – Brush your teeth and make sure you will not touch teeth neighboring the removed teeth. You can resume gentle brushing on day two. Avoid using mouth rinses for a few days as they can irritate the removal site.

After 24 hours

Facial swelling – This can be treated by applying heat compress after the first 24 hours of ice compress. Apply a moistened warm towel on the area for 20 minutes and remove. Repeat if the swelling is still present.

Rinse your mouth – Take ½ teaspoon of salt and mix in a cup of warm water. Rinse your mouth using this solution after food and before bedtime.

Stitches – Stitches is used and are of self dissolving type, require no post treatment. However, if they are not of self dissolving type, you need to visit your dentist within one week of time.

Watch out for dry socket – Dry socket symptoms may develop when proper care is not taken during the first 24 hours. This requires your dentist’s help.

Complete healing – Healing may take time from a few weeks to a few months. Within one to two weeks, enough healing can take place for you to use your mouth reasonably.

Complications involved in Wisdom Teeth Removal

Any of the two complications will at any cost arise after wisdom teeth removal. They are:

Dry socket – This is a common complication that occurs after extracting teeth. It occurs when a blood clot fails to form in the removed tooth socket or when the blood clot that has already formed is dispelled. The healing is delayed without formation of blood clots. Dry socket can occur within 3 – 4 days following the tooth removal, accompanied with mild to severe pain and bad mouth odor.

Paresthesia – This is a rare complication of wisdom teeth removal. Wisdom teeth situated in the jaw bone will be close to nerve endings. These nerves can be damaged or bruised while removing the wisdom tooth.  This will result in numbness of the chin, lip and tongue which lasts for a few days to months or can also be permanent.