Wisdom teeth are the last posterior teeth to erupt. Also called as third molars. There are 4 wisdom teeth in oral cavity. 2 each in upper and lower jaws. They placed at the end of the oral cavity, erupt upto the age of 29 yrs. They can erupt fully like other teeth or can erupt partially or can be impacted in the bone .
Partially impacted wisdom teeth:
Usually seen in lack of space in the upper and lower jaw ,small jaw size. So there is not enough space for the wisdom teeth to erupt fully through the gums. It tries to erupt by applying pressure on front teeth so at times patient feels radiating pain in other teeth as well. While it tries to erupt it can cause a flap of tissue to remain over the tooth. This flap causes pain and swelling in the gingival tissue. This flap can trap food and bacteria resulting in gum pain. This is termed as pericoronitis.
Impacted wisdom teeth:
If the jaw size small and if there no space at all for the wisdom tooth to erupt then they get stuck or impacted in the jaw bone. It doesn’t necessarily cause pain.
So not in all situations wisdom teeth hurt . The dentist will suggest appropriate treatment if needed before any major symptoms develop.
Wisdom tooth removal is a common procedure. An x-ray, taken for diagnosis and treatment planning.
The x-ray reveals the cause of the pain which could be:
- Due to insufficient space for eruption
- Pressure on the adjacent tooth
- Cervical and root caries of the adjacent tooth
- Pericoronitis in case of partially erupted third molar
- Decay of partially erupted wisdom teeth
- Limited mouth opening
- Odontogenic cyst
- Cellulitis due to bacterial infection.
The above conditions treated with antibiotics, antiseptic mouthwashes, saltwater warm gargles, and maintaining good oral hygiene. When the line of action does not suffice surgical removal of wisdom tooth is considered.
Also if there is no antagonist tooth against the wisdom tooth and if there is recurrent pericoronitis one should consider removing the wisdom tooth.
Procedure to remove wisdom teeth:
It is a small surgical procedure. If your dentist concludes on extracting your third molar, one should know that the whole procedure would be under local anesthesia and the extraction would get completed in a maximum of 2-3 hours. This procedure is completely painless. The gingiva surrounding the tooth retracted exposing the corresponding bone and tooth.
Impacted or partially impacted molar’s extraction involves cutting of a jaw bone to expose the tooth structure. If your teeth completely erupted bone fragments need incising. Once the tooth structure adequately exposed so as to elevate it or section it, your dentist will extract the tooth. Impacted and partially impacted teeth placed at different angulations and according to the angulation, the technique of extracting the teeth may vary. This procedure is technique and skill-sensitive. Most oral surgeons summoned to the clinic or suitable for such kinds of extractions.
Once the extraction performed the extraction site thoroughly washed with betadine for no residue of any infection. The retracted gingiva then sutured to its place and a gauze pack given to the patient to reduce bleeding and clot formation. Which in turn helps in healing.
There are the 5 most common complications after wisdom teeth removable:
1. Dry Socket (Alveolar Osteitis):
After wisdom tooth extraction formation of blood clot helps in wound healing , but if this the blood is displaced then alveolar osteitis or dry socket can be formed, where the nerve underneath the gums is exposed. In such situation there would sharp throbbing pain at the extraction site. This pain is usually experienced after 2-3 days of wisdom tooth extraction. If moderate or severe pain continues after taking medications as well one should consult your dentist or the oral surgeon. They will clean the extracted site and cover the never with a zinc-oxide eugenol pack which will sooth the nerve and promote healing.
2. Pain and Swelling:
Mild pain and swelling are the most common and typical complications after extraction. They both last hardly 2-3 days after the extraction and this effect minimalized if one takes the prescribed medicines by your dentist.
3. Limited mouth opening:
One may experience trismus or temporary reduced mouth opening after a lengthy procedure of tooth extraction. and it resolves on its own within a week’s time. If the stiffness in the jaw continues and is prolonged heat therapy, pain medication,muscle relaxants or jaw opening devices can be used.
4. Excessive Bleeding:
It takes 8-12 hours normally for bleeding to stop after extraction. if bleeding persist with excessive flow consult your dentist. Avoid smoking and rinsing your mouth vigorously.
5. Lip Numbness:
This complication is very rare it can be temporary. if the numbness seems to be more than 2 days it could be due to nerve damage. The wisdom tooth is close to the inferior alveolar nerve, during extraction procedure if the nerve get damaged an individual can experience numbness in the lips or jaw.
Post Extraction indications and medications are given to the patient. And if all the instructions followed and medications consumed properly will help in speedy and painless recovery.
We at Royals inform our patients prior to the treatment procedure about the complications and the care to be taken after the procedure as well so as to help our patients with a healthy post treatment experience.