Wisdom Tooth

Wisdom teeth are third molars that usually appear between the ages of 17 and 24 (although they may appear when older, younger, or may not appear at all). They are commonly extracted when they affect other teeth; this impaction is colloquially known as “coming in sideways. Most people have four wisdom teeth, but it is possible to have more or fewer. The absence of one or more wisdom teeth is an example of hypodontia. Any extra teeth are referred to as supernumerary teeth.

Between the ages of 17 and 25, most people have their final set of molars, called wisdom teeth. The name stems from the fact that having these teeth come in later in life gives the person time to learn and gain experiences. The wisdom teeth are the furthest back in a person’s mouth, also called the third molars. Usually, a person has four of them; however, there can be fewer or none at all.

There is usually not enough room for the wisdom teeth in a person’s mouth. They can be misaligned or not come in at all, so removal of these teeth is typically required.

If these molars are positioned incorrectly or angled improperly, they can squeeze other teeth out of place or cause damage to the other teeth, jawbone, or nerves. By crowding adjacent teeth, there can be a higher risk of trapping plaque and greater susceptibility to decay.

If the wisdom teeth do not fully erupt, but are present and caught in the soft tissue under the gums or jawbone, they are considered “impacted”. If they are not removed, infection and abbesses can occur, as well as pain, stiffness in the jaw, swelling, and general malaise and illness.

Due to the location of the wisdom teeth in a person’s mouth, they can be difficult to clean. If there is an issue with eruption and the teeth are partially covered, they can be at risk of debris accumulating and at risk of possible infection occurring.

If the gum bed extends over the top of the wisdom tooth and forms a partial cover, it is called an operculum. Due to the challenge of cleaning these teeth, which is exacerbated by this situation, a needless syringe may be required to pressure wash the area in an attempt to remove any trapped particles and plaque.

When the operculum does not disappear or if the wisdom teeth do not come in straight, and are caught in an angle under the gum line, extraction is the solution. If a horizontal impaction is left intact, growing ninety degrees forward, the tooth can grow into the roots of the second molars.

The most common situation is when the wisdom teeth are angled forwards, towards the front of the mouth, called a mesioangular impaction.

If this is the case, the teeth located on the lower row of the mandible, are easier to remove.

The maxilla holds the top teeth, which are the easiest to remove if the wisdom teeth are angled backward. This is called a distoangular impaction and is a much rarer occurrence.

Symptoms such as redness, pain, swelling, difficulty opening the jaw, bad odor, or general illness attributed to your wisdom teeth can progress into a severe infection if left untreated. If you are suffering any of these warning signs, contact your dentist or health care provider to find the root cause.

When wisdom teeth are causing detrimental issues due to improper positioning or full or partial impaction, they need to be addressed by your dentist to determine the best course of action to keep you healthy.

Instructions for Home Care Following the Extraction (Removal) of a Tooth

The anesthetic typically leaves your lips, teeth, and tongue feeling numb after the appointment.

For this reason, you should avoid chewing for two hours following surgery, or until the numbness has completely worn off.

Some discomfort after the extraction is normal. An over-the-counter pain reliever, such as ibuprofen or paracetamol (not aspirin), is usually sufficient.

We can also give you a prescription for a stronger pain reliever if needed.

To avoid nausea, do not take pain medication on an empty stomach.

You can also decrease pain and swelling by applying an ice pack—20 minutes on, 20 minutes off—for the first six hours following the extraction.

A blood clot will form on the extraction site, and this clot is vital to the healing process. To keep the clot intact, avoid touching the extraction site with your tongue or fingers, do not drink liquids through a straw, and do not spit vigorously.

Blowing your nose or sneezing violently can also dislodge the blood clot and impair healing, so if you have an upper respiratory infection or suffer from allergies, be sure to have the appropriate sinus medication on hand.

Do not rinse your mouth for 48 hours.

Smoking, or allowing food particles to pack into the tooth’s socket, should be avoided, as both will significantly affect the healing process. 24 hours following the procedure, you should rinse gently with a warm salt water solution (dissolve one teaspoon of salt with one cup of warm water); gently swish the solution around the affected area, and spit carefully. You should do this 2-3 times each day for the week following the extraction.

If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. Relax as much as possible and avoid all strenuous activities for the first 24 hours following surgery.

You should eat once the numbness has worn off, as nourishment is important to the healing process. Limit your diet to soft foods like yogurt, soft soups, ice cream, or soft-cooked eggs for the first 48 hours.

Drink at least eight large glasses of water or fruit juice each day.

Keep your head elevated with pillows to control bleeding. We will give you “bite packs” in case you get bleeding later. Please bite gently but firmly for 20 minutes until the bleeding stops. You can also bite gently but firmly on a moist tea bag for 20 minutes. Be sure to call our practice if bleeding persists or increases.

Be sure to brush and floss the other areas of your mouth as you would normally.

The space left by the tooth will feel a bit strange to you at first. Eventually, new bone and gum tissue will grow into the gap left by the extraction.

It is important to consider replacing missing teeth to avoid adjacent teeth (if present) moving and impairing chewing function.

We will advise you about suitable treatment options. Teeth can be replaced by dental implants, dental bridges, or cosmetic dentures.