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WISDOM TEETH
What are wisdom teeth?
Adults have a maximum of 32 permanent teeth.
The wisdom teeth or 3rd
molars are the last teeth that come into the mouth right at the back. They
usually appear between the ages of 17-25 years however, they may appear
several years later as well. There are usually 4 wisdom teeth though there
can be more and in this instance they are called supernumerary teeth.
As a state of evolution, nowadays people
often have smaller jaw size which is often too small to accommodate all
32 teeth. Sometimes due to the lack of space wisdom teeth do not develop
at all. If present however, there is not enough room for them to erupt
and they may get stuck against the tooth in front. The wisdom tooth is
often at an angle and will then be described by your dentist as
impacted. If
this impacted tooth tries to come through there are likely to be
associated problems. Lower wisdom teeth are more likely to be impacted
than the upper ones.
What are the associated problems?
If part of the wisdom tooth has appeared
through the gums and part of it is still covered then the gum covering the
partially erupted tooth may become sore and swollen. This causes food
particles and bacteria to accumulate under the margin of the gum. This area
is not easily cleansable and thus perpetuates a vicious cycle. The condition
is known as
‘pericoronitis’
and can cause a substantial amount of pain and discomfort.
Your dentist can treat this condition by cleaning and irrigating the area
with an antiseptic solution and he/she may prescribe antibiotics based on
severity of clinical conditions. Your dentist will probably advise use of
warm saline rinses, chlorohexidine mouth wash and pain relieving tablets
such as aspirin or paracetamol. The problem should subside with the above
treatment however, should the pain continue it is advisable to contact your
dentist immediately.
As per the current NICE guidelines, 3 or more
such episodes of pericoronitis warrant the removal of the wisdom tooth.
Do wisdom teeth always cause problems?
They do not necessarily cause problems in every situation. If the jaw size
allows enough space for them, they erupt without any problem into their
normal, useful position without causing any problem to adjacent tissues or
teeth. There may be slight discomfort which is associated with the normal
eruption sequence.
How can the dentist tell if a wisdom tooth will be problematic?
Your dentist will need to take x-rays to see the position and angulation of
the tooth and from this x-ray will also be able to judge whether there is
enough room for the tooth to come through into a useful position.
When is removal of the wisdom toot indicated?
Wisdom teeth that are not causing any problems will not need to be removed.
Your dentist will only suggest removing a wisdom tooth if
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It is very painful
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There have been 3 or more episodes of pericoronitis as discussed previously
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If the tooth has only partially erupted and is decayed
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When it is clear on an x-ray that there is not sufficient room for the tooth
to erupt into a useful position
Is the removal of a wisdom tooth different from that of any other tooth?
Removal of the wisdom tooth is often more challenging and requires more
skill than the removal of other teeth present in the mouth. Depending on the
position and angle of the tooth within the bone, its relation to the tooth
in front of it and the shape of the roots, your dentist will advise you as
to how easy or difficult the removal of the tooth will be. Upper wisdom
teeth are often more straightforward to remove than lower ones. Sometimes it
may be necessary to refer you to a specialist (oral surgeon) for removal of
the tooth.
The tooth can be removed painlessly by
administering a local anesthetic (numbing agent) or by use of sedation
techniques. Sometimes a general anesthetic maybe recommended, however this
is only administered in a hospital under advice of a specialist. You may
receive stitches.
Our dentist will probably want to see
you again after 1 week to remove the stitches and to review the healing.
What happens after removal of a wisdom tooth?
·
There may be some pain and swelling for a few days afterwards. Your dentist
will prescribe pain relieving medication to help with this. He/she may also
prescribe a course of antibiotics. It is important to follow advice
concerning maintenance of oral hygiene and the use of mouthwashes to help
aid the healing process.
·
It is best to avoid excessive activity and also to avoid smoking and
drinking for at least the next 24 hours after the removal of the tooth. This
helps prevent bleeding problems and development of a painful conditions
called dry socket. You should refrain from smoking for as long as possible
after the initial 24 hour period is over.
·
There is a possibility of numbness of the lower lip after removal of the
tooth. The dentist will discuss the probability of this with you.
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