You may have heard from your peers the horror stories about their wisdom teeth and the excruciating pain that ensured due to it. Every adult who has had their wisdom teeth removed has something to say about their experience- mostly poor and unpleasant. Wisdom tooth removal is fundamentally very common. Americans have upwards of about ten million wisdom teeth extractions done each year. Despite the high figures, most of us do not know what they are and why you need to get them removed. Here’s Wisdom Tooth 101 where you can understand the why’s and how’s of wisdom tooth removals. Do you need them? Stay tuned!

What is a wisdom tooth?

A wisdom tooth, clinically known as the third molar is one of the three molars that make up a single quadrant (one section- left or right) of your mouth. It is located at the posterior-most end of your oral cavity after the first and second molars. The age at which they usually erupt can vary from person to person, however, they generally occur between late teens and early twenties, commonly between the ages of 16 to 21. The eruption may even begin as early as 13 and typically erupts before the age of 25. If they have not come out of hiding till then, chances are they may not visibly erupt spontaneously by themselves.

Contrary to popular belief, they do not actually impact your wisdom! Shocker! It is also possible for you to have none, fewer or more (supernumerary teeth) than four wisdom teeth in your mouth. Most adults grapple with the fact that their wisdom teeth do not erupt. When inadequate space is present to accommodate four fully-fledged wisdom teeth in your mouth, they can cause pain and discomfort, even so far as causing tooth decay as proper oral hygiene becomes more difficult.

Why do we have wisdom teeth?

Wisdom teeth do not actually have a function. Most anthropologists believe that wisdom teeth were necessary back in the day for our human ancestors to be able to chew a major diet of raw roots, leaves, meat, and hard nuts. This is pertinent to the history of human evolution because in modern days we have adapted to cook our food and use cutlery to cut, crush, or smash edibles into bite-sized pieces. In other words, modern humans do not need wisdom teeth anymore. Furthermore, our ancestors possibly had larger jaws that helped them chew foliage. Today our jaws do not have enough room for the wisdom teeth which are massively just rudimentary now.

What is wisdom tooth impaction?

When a wisdom tooth fully develops in the mouth but fails to break through the layer of gums, it is referred to as “impacted”. One that emerges only halfway is known as a partially impacted wisdom tooth. In both cases, the impacted tooth begins to grow at an angle:

• At an angle toward the second molar (mesial impaction)
• At an angle toward the back of the mouth (distal impaction)
• At a right angle to other teeth within the jawbone or in a “lying down” position (horizontal impaction)
• Straight up at a right angle but stays trapped within the jawbone due to lack of space (vertical impaction)
• Reverse or upside-down in the back of the mouth (inverted impaction)

The recommends that people between the ages of 16 and 19 have their wisdom teeth evaluated by their dentist to assess the teeth for potential impaction and to see if the removal is necessary.

How do I know that I need a wisdom tooth extraction?

An impacted tooth can cause a lot of problems for your oral cavity because of the sheer lack of space and the pressure it inserts on the surrounding tissues and the other teeth. You are more likely to get your wisdom tooth extracted if you exhibit certain symptoms that make your everyday oral functions difficult to perform. Look out for these tell-tale signs of an impacted tooth waiting for extraction.

• Inflammation and infection of the surrounding gum tissues (pericoronitis) in a partially erupted wisdom tooth
• Intense tooth pain at the site
• Bacterial growth and deepened pockets at the gum margin
• Swollen, red, bleeding, and tender gums (gingivitis or periodontitis)
• Tooth decay in a partially erupted wisdom tooth
• Damage to the nearby tooth or surrounding bone.
• Development of a fluid-filled sac (cyst) around the wisdom tooth
• Collection of pus (abscess) in your wisdom teeth
• Bacterial infection in the cheek, tongue, or throat (cellulitis)
• Shifting of the other teeth
• Crowding of the adjacent teeth, causing misalignment
• Sinus issues and congestion due to impacted wisdom teeth

Pre-Op Instructions for wisdom teeth removal

Most dentists recommend impacted wisdom teeth removal when the roots are between ⅓ and ⅔ developed. Waiting until later could threaten the health of the surrounding oral tissues and increase the risk of complications like injuries to your nerves and sinuses. Your oral surgeon will talk to you about the process of wisdom tooth extraction. This medical and dental history-taking is crucial and should be disclosed as honestly as possible. It would most likely include questions about any health problems you may have (including genetic and congenital), drugs you may take on a regular basis, and the type of anesthesia you will have during the procedure.

Prior to the surgical procedure, you will be instructed to abide by these pre-surgery recommendations:

you do not eat or drink anything for 8 hours before surgery.

• Do not eat or drink anything for at least 8 hours before surgery, if you are scheduled to have general anesthesia
• No smoking for at least 12 hours before the surgery.
• A responsible adult to accompany you to the dental office.
• Loose-fitting clothing to be worn.
• Contact lenses, jewelry, and dental appliances to be removed.
• Illnesses like a cold, sore throat, upset bowels to be reported to the dentist.
• Any routine medications to be taken as usual

How is a wisdom tooth extraction surgery done?

Your surgery should take 45 minutes or less. An x-ray may be taken before starting the surgery to help determine the status of the impacted wisdom tooth. A local anesthetic will be given to numb the tooth and the surrounding area. If you are particularly anxious about the surgery, your dentist may give you a sedative to help you relax but keep you alert enough to respond to prompts. A general anesthetic is rarely used for a wisdom tooth removal.

• A small incision will be made in the gum to access the wisdom tooth
• A small piece of the bone covering the tooth is removed.
• The tooth may be dissected into smaller parts to make it easier for removal.
• You may feel some pressure before the tooth is removed.
• The dentist rocks the tooth back and forth to loosen it.
• Upon removal, the surgical site is disinfected.

Post-surgical care for extracted wisdom teeth

Gauze is placed over the site of extraction and you will be asked to put pressure on it by biting your jaws for up to an hour following the procedure. This allows a blood clot to form in the empty tooth socket. Blood clots are important for healing so try not to dislodge them as your wound site will be exposed to food, drinks, and bacterial infection, potentially leading to dry socket formation. Sometimes you may also be prescribed antibiotics to arrest any ongoing infection.

For 2rr4 hours after removing your wisdom tooth, you should avoid:

• Rinsing your mouth out with liquid
• Drinking alcohol and smoking
• Drinking hot liquids such as tea or soup
• Strenuous physical activity

After your wisdom teeth have been removed, you may have swelling and discomfort. This should last up to 2 weeks, after which it begins to subside. While you are recovering, avoid eating excessively spicy or hot food and drinking from a straw.

You should get your wisdom teeth removed if they show signs of impaction. But what if they pose no problems, should you still remove them as a precautionary measure? There is an ongoing debate whether it is in fact safe and smart to extract teeth without the onset of difficult symptoms. One profound 2014 review that looked at seven papers examining the health and wellbeing of the adults who left their wisdom teeth in, showed some interesting results. They found that leaving wisdom teeth in did lead to an increased risk of complications later on. Contact 4Smile to connect to the best oral surgeons for your wisdom tooth removal!