Which teeth are the wisdom teeth?
"Wisdom teeth" are a type of molar. Molars are the chewing teeth found furthest in the back of the mouth.
Most humans have 1st, 2nd and 3rd molars. A person's third molars are their wisdom teeth.
A person's third molars will erupt (come into place) right behind their second molars (if there is room for them and they are aligned properly). With most people, this eruption process takes place during their late teens or early twenties (ages 18 to 24 years, although eruption outside of this range is not uncommon).
Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal. Wisdom teeth present potential problems when they are misaligned – they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed "impacted." Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
How Do I Know if I Have Wisdom Teeth? Wisdom teeth present potential problems when they are misaligned – they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon for further evaluation. Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer. How Are Wisdom Teeth Removed? The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position. Your oral healthcare provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
What Happens During Wisdom Teeth Removal? Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic – the same injection with the samemedication you would receive to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative is desired to control any anxiety. Sedating medications that could be selected include: nitrous oxide (otherwise known as "laughing gas"), an oral sedative (for example, Valium), or an intravenous sedative (administered via an injection into your veins). If nitrous oxide is given, you will be able to drive yourself home. If any of the other medications is selected, you will need someone to drive you both to and from the appointment. What Does Recovery Involve After Wisdom Teeth Are Pulled? After having your wisdom teeth removed, the speed of your recovery depends on the degree of difficulty of the extraction (a simple extraction of a fully erupted tooth versus a tooth impacted into the jawbone). In general, here's what to expect. During the first 24 hours Bleeding may occur for several hours after tooth extraction. To control it, position a piece of clean moist gauze over the empty tooth socket and bite down firmly. Apply constant pressure for about 45 minutes. A moistened tea bag is an effective alternative. The tannic acid in tea helps healing blood clots to form (blood clots function similarly to scab over an open wound). Repeat this process if a small degree of bleeding continues; if heavy bleeding continues to occur, contact your dentist or oral surgeon. Avoid rinsing or spitting for 24 hours after tooth extraction, avoid "sucking" actions (for example, don't drink beverages through straws or smoke) and avoid hot liquids (such as coffee or soup). These activities can dislodge the clot, causing a dry socket (see below) to develop. Facial swelling in the area where the tooth was extracted typically occurs. To minimize swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a schedule of 10-minutes on, followed by 20-minutes off. Repeat as necessary during this first 24-hour period. Pain medications, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can be taken for minor pain. Your dentist or oral surgeon may prescribe more potent pain relievers, such as narcotics, if necessary. Antibiotics that may have been prescribed prior to tooth extraction (to treat any active infection around the wisdom tooth to be extracted) should continue to be taken until the full prescription is gone. Foods should be restricted to a liquid diet until all the numbness from anesthesia has worn off. Eat soft foods for a few days. Also avoid alcohol if you're also taking narcotic pain medication. Continue to brush your teeth, but avoid the teeth directly neighboring the extracted tooth during the first 24 hours. On day two, resume the gentle brushing of your teeth. Do not use commercial mouth rinses — these can irritate the extraction site.
After 24 hours Facial swelling in the area of the tooth extraction should be treated with heat after the first 24 hours of ice. Apply a moist warm towel to the area on a 20-minute on, 20-minute off schedule. Repeat as necessary. Rinse your mouth with warm salt water (1/2 teaspoon of salt in a cup of warm water) after meals and before bed. Do not use commercial mouth rinses. Stitches, if used and if not of the self-dissolving type, need to be removed by your oral health care provider in about 1 week. If you do require stitches, ask what type you have been given. Watch for signs of dry socket (described below). This condition requires treatment by your oral health care provider. Complete healing doesn't occur for a few weeks to a few months following the extraction. However, usually within the first week or two, enough healing has taken place for use of your mouth to be reasonably comfortable in the area of the extraction. Your dentist will explain what to expect in your specific case. What Are Potential Complications of Wisdom Tooth Removal? Two of the more important complications after having your wisdom teeth removed include: Dry socket. Dry socket is a common complication that occurs when either a blood clot has failed to form in the extracted tooth socket or else the blood clot that did form has been dislodged. Without clot formation, healing will be delayed. When it happens, dry socket typically occurs 3 or 4 days following the extraction and is accompanied by pain (ranging from "dull" to moderate to severe) and a foul mouth odor. Your dentist or oral surgeon will treat the dry socket by placing medication in the socket. Paresthesia. Paresthesia is a less frequently occurring complication. Wisdom teeth entrapped in the jawbone are often close to nerves. Sometimes these nerves can be bruised or damaged during the tooth removal process. The result is a numbness (called a paresthesia) of the tongue, lip, or chin that can last a few days, weeks, months, or may even be permanent. How Much Does Wisdom Teeth Extraction Cost? Simple extraction of a wisdom tooth can cost as little as $99 per tooth. The cost of wisdom teeth that are impacted can cost between $230 and $340 and even more. Because costs vary in different areas of the country, contact your dentist or oral surgeon for their charges. Also check with both your dental insurance carrier and medical insurance provider. One or the other type of insurance may cover a portion of the cost of wisdom teeth removal.
Sometimes, wisdom teeth come in normally and provide the mouth with another set of powerful, food-crushing molars. Unfortunately, that is the exception and not the rule.
It seems like pretty much everyone has their wisdom teeth (third molars) extracted before they come in around the age of 18. A lot of people wonder why our bodies even bother to make wisdom teeth if we just end up removing them. That's a good question.
One theory is that a long time ago people lost teeth a lot earlier due to poor oral hygiene and the third molars came in later in life to provide fresh, healthy teeth. Since some teeth had already fallen out, there was room for the wisdom teeth.
Currently, wisdom teeth are usually extracted as a preventive measure so that other problems do not occur later in life.
The reasons dental professionals remove wisdom are many, but they all boil down to one main reason – there is simply not enough room in the mouth for wisdom teeth.
There Isn't Enough Room for Wisdom Teeth
Here are a few reasons why dentists normally extract wisdom teeth:
- There isn't enough room in the jaw for them to come in.
- There won't be enough room in the mouth for them to come in.
- Due to lack of space, wisdom teeth often come in at an awkward angle and can damage adjacent teeth.
- If they never break through into the mouth, they can cause big problems later on.
- Since they are so far back, they are harder to clean. This increases the likelihood of developing cavities and gum disease.
There Isn't Enough Room in the Jaw for Wisdom Teeth
You can barely see the wisdom tooth poking out of the gums. There is not enough room for it to fully erupt.
Some people have smaller bones than others. Sometimes, the jaws are not big enough to contain all of the teeth that our bodies produce. After taking a diagnostic x-ray, your dentist can best advise you as to whether or not you will have enough room in your jaw to allow the wisdom teeth to erupt normally.
There Won't Be Enough Room in the Mouth for Wisdom Teeth
Sometimes wisdom teeth can't come up far enough into the mouth to serve as functional teeth. In some cases, the wisdom teeth only partially erupt into the mouth and can result in severe pain in the gingiva (gums) when biting.
You can see an example of this in the photo to the left.
Wisdom Teeth Come in at an Awkward Angle
Wisdom teeth usually have a tendency to be abnormal. They sometimes look very different and often they come into the mouth at different angles due to a lack of space.
This x-ray shows two wisdom teeth that are coming in at very awkward angles. The upper wisdom tooth is pointing toward the back of the mouth and the lower wisdom tooth is pointing directly at the molar in front of it, which can potentially damage that tooth.
As you can see in the x-ray to the right, the upper wisdom tooth is pointing backwards and the lower one looks like it is going to run into the tooth in front of it.
Many wisdom teeth try to erupt into the mouth by pushing on the molar right in front of it. This can make it easy for the adjacent molar to get a cavity. It can also cause the gums to recede around that tooth. This can sometimes severely damage the adjacent molar that both itand the wisdom tooth need to be extracted.
Wisdom Teeth Can Cause Big Problems Later On
One of my professors at dental school showed me an x-ray of a patient that never had his wisdom teeth extracted. Even though this patient was in his 50's, an infection had started around his impacted wisdom tooth. This resulted in a necessary surgery that cost thousands of dollars. This surgery could have been prevented by simply removing the wisdom teeth at an early age when the tooth and roots were small and still forming.
When a tooth is just sitting inside the jawbone for many years, it can form what is called adentigerous cyst. This cyst can eventually turn into cancer.
Wisdom Teeth Are Hard to Clean and Often Get Cavities
The brown spot on the far back tooth is a cavity
Some of the patients that I see at the dental school have their wisdom teeth. In many cases, they complain that they are very hard to clean. They say that it is almost impossible to brush and floss way back there.
Because of this, many wisdom teeth develop cavities. If someone can't clean their wisdom teeth, then it's a good idea to get them taken out before they cause pain and problems.
In the picture to the left, you can see a young man's teeth. The last tooth in back is the wisdom tooth. It looks like the very back of the wisdom tooth was very hard for this young man to clean. Because of this, he developed a cavity and it looks like the tooth probably was extracted.cause of this, he developed a cavity and it looks like the tooth probably was extracted.
- A guide to Wisdom Teeth (tourismdentalindia.com)
- Why Dentists Take Dental X-Rays (tourismdentalindia.com)
- Myths about Dentistry (tourismdentalindia.com)
- Orthodontic Retainers (tourismdentalindia.com)
- Common Dental Problems And How To Avoid Them (tourismdentalindia.com)
- Dental Implants (tourismdentalindia.com)