What are wisdom teeth?
As we grow into adolescence, our wisdom teeth erupt at the back of our mouth. They are the third and the last of the molars to erupt on each side of the upper and lower jaws. For most people, the wisdom teeth appear between the ages of 17 and 21, and this happens without experiencing any problems.
In other people however, the wisdom teeth erupt with pain and some degree of discomfort. Wisdom teeth begin growing in early childhood. By the time they grow through the gums in the late teens, the rest of the adult teeth are already in place, so the wisdom teeth are unable to grow properly due to lack of space.
They may occasionally emerge at an angle or only partially emerge and become stuck within the gum tissue or bone. Wisdom teeth that come through this way are referred to as 'impacted'.
The problems with wisdom teeth
Not all wisdom teeth cause problems. When they have not completely broken through to the surface of the gum, they sometimes create problems. Dental caries may develop if food gets trapped around the edges of the wisdom teeth and plaque begins to break down the surface of the teeth, creating cavities.
Gum disease may also develop if the plaques release toxins that irritate the gums, causing pain and swelling around the gums. Bacterial infection may spread to the soft tissues surrounding the gum and the mouth. A gum abscess may develop if pus collects as a result of the bacterial infection. Wisdom teeth can also emerge crooked, causing painful crowding and disease.
Deciding to extract
These problems can often be managed conservatively with antibiotics and antiseptic mouthwash. Extraction of the wisdom teeth becomes inevitable if conservative measures fail to resolve the problems of pain, discomfort, infection, gum disease, damage to adjacent teeth, or these problems become recurrent.
Best time to extract
Assessment of the wisdom teeth by the dentist will often help in resolving the decision to go ahead with extraction. It is best to carry out wisdom teeth extraction in the late teens or early twenties when the teeth's roots have not solidified in the jaw bones. Extraction later in life carries a slightly higher risk of damaging a major nerve in the jaw.
The duration of the procedure varies, depending on what needs to be done to get the offending tooth removed. It will usually be preceded by a local anaesthetic injection to numb the area around the tooth. If the tooth is impacted or embedded in the bone, the dentist will make an incision into the gums and cut the tooth into smaller pieces in order to reduce bone damage. If the tooth is not impacted, it may be sufficient to rock the tooth back and forth in order to widen the tooth socket.
It is usual to experience some swelling and discomfort for a few days after the extraction, but in some cases, these might persist for one or two weeks. It is essential to adhere strictly to the dentist's after-care instructions, as failure to do so may lead to delayed healing or infection.