What are Wisdom Teeth and Why are They So Awkward?

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A toothache or dental pain is the most frequent reason for dental visits, and often the discomfort is caused by wisdom teeth. Your wisdom teeth are the final teeth to erupt and are the third molars, a set of large chewing teeth located right at the back of the mouth. It is difficult to prevent wisdom tooth problems, even in people who have good oral hygiene and no other signs of dental disease. Wisdom tooth problems can cause infection, swelling and of course, pain.

What are Wisdom Teeth?

Everybody has two sets of teeth. The first is the primary teeth, also called baby or milk teeth and these develop in infancy, remaining in place for the first few years until they are gradually replaced by the permanent or adult teeth. It is a process of replacement that begins from age six and continues until the early teens. The wisdom teeth are the very last to erupt, usually making an appearance during the late teens or even well into the twenties. By the time these teeth come through, an adult will have a complete set of 32 teeth, that is if all four wisdom teeth come through. However, some people will only have just one, two or three wisdom tooth or maybe none.

It’s believed that as our diets have become softer and easier to chew, it’s reduced the wear and tear on teeth, so there is less reason to have wisdom teeth. Up until quite recently, wisdom teeth were routinely removed by dentists because of lack of space in the jaw. Nowadays, many dentists prefer to wait and see if wisdom teeth can erupt normally before deciding to remove them. 

What Happens When Wisdom Teeth Do Cause Problems?

In cases where there is insufficient room for wisdom teeth, they can become impacted, and this is where the wisdom tooth tries to emerge at an abnormal angle. Not surprisingly, an impacted wisdom tooth can be painful because it presses on the adjacent tooth, or it may remain partly erupted and where it is still partially covered with gum. 

When a wisdom tooth is only partially erupted, the pocket of gum tissue can collect food and other debris, potentially causing tooth decay and infection in the gum tissue. Very rarely, an impacted wisdom tooth may develop a cyst. Because wisdom teeth that are impacted are never fully functional, the best way to deal with the problems they can create is to remove the tooth.

When to Have Wisdom Teeth Removed

If your wisdom teeth have yet to erupt, your dentist is probably keeping a close eye on their development through regular dental x-rays. These x-rays allow your dentist to see the position of the tooth and to predict if it can erupt normally and without problems. For many people, their wisdom teeth will come through normally, and there isn’t any need to remove them. With others, it may be clear that wisdom teeth cannot come through without becoming impacted, or that they have abnormalities and need to be removed. 

If your dentist suggests removing your wisdom teeth, they will want to time the procedure quite carefully. Removing wisdom teeth too soon can be more challenging because the teeth will be more deeply located in the jawbone. Removing wisdom teeth too late can allow problems to develop that could otherwise have been avoided. 

Usually, it’s better to have your wisdom teeth out when you are younger because at this stage the teeth won’t yet have become fused in the jawbone. Even if you don’t have the chance to have them removed when you are young, then don’t panic because it is possible to have wisdom teeth extracted at any age. 

More complicated wisdom teeth removals are likely to be referred to an oral surgeon who routinely carries out this type of treatment and who is highly experienced in ensuring the process is as smooth and as comfortable as possible. Often a wisdom tooth is cut into sections while still in the jawbone because the smaller pieces are easier to remove and require a smaller incision.

Are There Any Risks Associated with Wisdom Teeth Removal?

Every type of surgery carries some level of risk, and it’s reasonable to expect some swelling, bruising and some minor discomfort after having teeth removed. These symptoms should reduce within the first few days and shouldn’t last any more than a week. Most people will find their wisdom tooth removal is complication-free, but there is a tiny chance that problems may arise. These problems include dry socket, post-operative infections or nerve injury.

Dry Socket

Dry socket only affects a tiny percentage of wisdom teeth removals and can develop if the blood clot that forms in the empty socket is dislodged soon after tooth extraction procedure. The blood clot is essential for helping to protect the empty socket, allowing healing to occur. It’s more likely to become dislodged if you smoke or if you drink through a straw because of the sucking action. Dry socket generally occurs a few days after the extraction, and the empty socket becomes more painful instead of healing as expected. It is a straightforward condition to correct, as your dentist will need to clean out the empty socket so it can heal properly, only delaying the healing process by a few days.

Post-Operative Infections

The risk of post-operative infection is a complication that can occur after any type of surgery. If your dentist believes this risk is higher for you, they may recommend antibiotics and especially if there are already signs of infection at the surgery site.

Nerve Injury

The nerve that affects the feeling in the chin and lip is quite close to the tooth roots of lower wisdom teeth. Occasionally the nerve may become damaged during removal, leading to some temporary numbness. Another nerve that lets you feel your tongue can also be bruised during wisdom tooth removal. It is very rare for any nerve injury to be permanent.