Introduction
Wisdom teeth are the third set of molars at the very back of your mouth. Most people have four of them, two on the top and two on the bottom, although some people might have fewer, or even none at all. They are typically the last teeth to emerge, usually appearing between the ages of 17 and 25, a period often referred to as the “age of wisdom.” This is why they are called wisdom teeth, as this stage is associated with the maturity and “wisdom” of adulthood.
For many people, wisdom teeth can cause problems because our jaws are often not large enough to accommodate them comfortably. When there isn’t enough space, wisdom teeth can become impacted, which means they get stuck under the gums or grow at odd angles. This can lead to pain, infection, or pressure on nearby teeth, which is why dentists sometimes recommend having them removed.
Common Issues
Wisdom teeth can lead to several common issues, especially when there isn’t enough space in the jaw for them to grow in properly. Here are some of the most frequent problems:
- Impaction: Wisdom teeth often don’t have enough room to fully emerge, which can cause them to become impacted, meaning they are trapped under the gum line or in the jaw. Impacted wisdom teeth can grow sideways, press against other teeth, or remain partially trapped.
- Infection or Gum Disease: Partially erupted wisdom teeth create pockets around the gums where food and bacteria can get trapped, leading to infections, swelling, and gum disease (pericoronitis). This can cause pain, swelling, and difficulty in opening the mouth.
- Crowding: The eruption of wisdom teeth can push against neighbouring molars, leading to crowding or misalignment of other teeth. This is especially a concern for people who have already undergone orthodontic treatment, as it can undo the results.
- Cavities: Wisdom teeth are located far back in the mouth, making them difficult to clean properly. This can lead to a build up of plaque and bacteria, increasing the risk of cavities and tooth decay on the wisdom teeth and neighbouring molars.
- Cysts or Tumors: Impacted wisdom teeth can develop cysts, which are fluid-filled sacs that can damage the jawbone, nerves, and nearby teeth. In rare cases, tumors can form around impacted teeth, leading to more serious complications.
- Pain and Discomfort: Even if they don’t cause other problems, wisdom teeth often cause general pain, pressure, or discomfort in the jaw and gums as they try to erupt.
Symptoms
When wisdom teeth start to come in, especially if they are impacted or there isn’t enough room for them, various symptoms can arise. Here are some common signs that wisdom teeth might be causing problems:
- Pain or Discomfort: This is one of the most common symptoms. The pain can be felt in the back of the mouth near the molars, and sometimes it radiates to the jaw or other areas of the mouth.
- Swelling of Gums: Wisdom teeth can cause the gums around the area to become swollen, tender, and sometimes red. This swelling can extend to the jaw area and may be noticeable when opening the mouth.
- Jaw Stiffness or Swelling: Jaw stiffness, pain, or a sensation of tightness near the back of the mouth can occur as wisdom teeth push against other teeth or press against the jaw.
- Headaches or Ear Pain: Pain can radiate from the jaw area to other areas of the face, leading to headaches or even ear pain, as the jaw and ear nerves are connected.
- Bad Breath or Unpleasant Taste: Partially erupted wisdom teeth can create pockets around the gums where bacteria and food particles can accumulate, leading to bad breath or an unpleasant taste in the mouth.
- Difficulty Opening the Mouth: This can happen if the area around the wisdom teeth becomes swollen or infected, making it difficult or painful to open the mouth fully.
- Red, Inflamed, or Bleeding Gums: When wisdom teeth are impacted or partially erupted, they can irritate surrounding gum tissue, leading to redness, inflammation, or even bleeding when brushing or flossing.
- Sinus Issues: Wisdom teeth in the upper jaw are located near the sinuses, so their growth can sometimes cause sinus pressure, pain, or congestion.
If these symptoms appear, especially if they are persistent or worsening, it’s a good idea to consult a dentist. They can assess the position of the wisdom teeth and recommend treatment, which may include extraction if needed.
Diagnosis and Treatment
The diagnosis and treatment of wisdom teeth typically involve a series of steps aimed at identifying any potential issues and addressing them to prevent complications.
Diagnosis
- Dental Examination: The dentist or oral surgeon will examine your mouth, paying special attention to the areas where wisdom teeth are located. They will check for visible signs of eruption, swelling, redness, or signs of infection in the gums.
- X-rays: Dental X-rays are commonly used to assess the position of wisdom teeth, especially if they are impacted or have not yet erupted. X-rays can show if the wisdom teeth are pressing against other teeth, if there is enough space in the jaw, or if there are cysts or other issues.
- 3D Imaging: In some cases, a 3D scan (such as a cone beam CT) may be used to get a more detailed look at the position of the wisdom teeth and their relation to nerves and other structures in the jaw.
Treatment Options
Treatment for wisdom teeth depends on their position, the symptoms they cause, and the potential for future issues.
- Observation: If the wisdom teeth are healthy, correctly positioned, and not causing any symptoms, the dentist may simply monitor them through regular check-ups to ensure they don’t cause issues later.
- Medications for Pain and Infection:
- Pain relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage mild pain.
- Antibiotics: If there is an infection (pericoronitis), antibiotics may be prescribed to manage or prevent it before a more permanent treatment is performed.
- Surgical Extraction:
- Simple Extraction: If a wisdom tooth is fully erupted and accessible, it can sometimes be removed with a simple extraction procedure.
- Surgical Extraction: For impacted or partially erupted wisdom teeth, a surgical procedure may be necessary. This involves making an incision in the gum, sometimes removing bone around the tooth, and then extracting the tooth in sections if needed.
- Care After Extraction: Following removal, there are specific aftercare steps to help with healing and prevent complications like dry socket:
- Avoid vigorous rinsing, spitting, or using straws for a few days.
- Stick to soft foods initially and avoid chewing near the extraction site.
- Rinse with warm salt water after the first 24 hours to keep the area clean.
- Orthodontic Consultation: If there is concern that the wisdom teeth might push on other teeth and cause crowding, a consultation with an orthodontist may be advised.
When to Consider Wisdom Teeth Removal
Wisdom teeth extraction is commonly recommended if they:
- Cause persistent pain or infection.
- Are impacted or poorly aligned.
- Pose a risk of damaging nearby teeth.
- Have cavities or signs of gum disease.
In general, timely diagnosis and treatment can prevent many of the issues associated with wisdom teeth. A dentist or oral surgeon can provide personalized recommendations based on the specific condition of the wisdom teeth and surrounding structures. If wisdom teeth cause issues or show signs of potential problems, dentists may recommend their removal to prevent complications.
