What/where are your wisdom teeth?
Wisdom teeth are the third molar teeth and are the last teeth to erupt into the mouth. There are two on the top and two more on the bottom. They normally erupt into the mouth in the late teens or in the early twenties. However in some cases they can come through at a later age. Some come through with little or no pain however more can cause pain, tenderness and irritation.
Difficulty
It is important to say firstly that the majority of people presenting with “wisdom tooth pain” are having difficulty with the lower wisdom teeth. As these teeth come into the mouth the gum around the area can get inflamed and patients report a “flap of gum” over the tooth. If food and plaque get trapped around this loose gum the area it can get very inflamed and or infected. This is a condition known as pericoronitis and will often require anti-biotics or anti-inflammatories.
Symptoms include –
- Pain
- Swelling
- Bleeding
- Bad Breath
Often there is little room for these teeth to come through and they can get stuck on the tooth in front or in the bone around the area. This is known as impaction and cause issues such as tooth decay, gum disease, halitosis or a cyst.
Treatment
Our advice is to keep the area as clean as possible brushing two-three times daily and using interdental brushes or floss around the area. We also recommend using an anti-bacterial mouthwash to help keeping the area clean. If the area becomes infected anti-biotics are warranted.
To extract or not to extract you wisdom teeth
If the wisdom teeth are giving no difficulty or any associated pathology then there is no justification to extract them.
Reasons to extract –
- Unrestorable decay
- Causing gum disease
- Persistent pericoronitis requiring antibiotics
- Related cyst or abscess
It’s the authors opinion that if 3 courses of antibiotics are given within a two-year period extraction is required.
Complications in Wisdom Tooth extraction
The majority of upper wisdom teeth that require extraction are deemed routine but often lower wisdom teeth are only partially through. As a result they may very close to the nerve that supplies touch and sensation to the lower lip. In these cases, a surgical extraction may be required and this is undertaken by an oral surgeon or a maxillo-facial surgeon. We at Shandon Dental can arrange a referral for this to be completed.
This can be completed under local anaesthetic, sedation or general anaesthetic.
Unsure
If you are not sure about the nature or position of your wisdom teeth contact us for an appointment and we will will be happy to assess them for you.
References- youtube video on wisdom teeth