Most people will have a 3rd set of molars, which are also know as “wisdom teeth” begin to emerge anytime between the ages of 15-20 years. While in some cases they will emerge from the gum line easily, in many cases they will fail to emerge and become impacted. Impacted wisdom teeth are very painful and should be removed as soon as possible.
In many cases they fail to emerge or only partially emerge because of insufficient room in the patient’s mouth to accommodate the extra teeth. Many patients with impacted wisdom teeth will experience a dull ache in the back of their jaw, as well as pain around the ear. In some cases they will begin to notice other teeth shifting or getting out of alignment, as the wisdom teeth begin to emerge and the new teeth compete with other teeth over limited space.
Even if the teeth emerge completely without any issues, most dentists will recommend their removal, due to the difficultly of keeping the new teeth cleaned properly, which can result in additional dental issues over time.
A dentist or an oral surgeon will do the wisdom teeth extraction, with most straightforward wisdom teeth extractions being done by a dentist. Typically an oral surgeon will perform partial or full impactions, due to the specialized techniques required. In many cases, the dentist will recommend that the patient undergo the procedure under sedation. This allows the patient to sleep through the procedure, but not requiring any breathing assistance. The recovery time for the procedure varies from patient to patient, but most people are back to normal activities within a couple of days of he procedure.
Posted on behalf of Dr. Mac Worley, Mountain View Oral Surgery and Dental Implants
What causes the pain that is experienced with wisdom teeth? Wisdom teeth aren’t like any other teeth. Instead, they erupt years later into early adulthood, long after the previous permanent teeth have erupted. Some of this discomfort is due to the eruption process, but there are other conditions frequently seen in wisdom tooth eruption that are due to complications in the development process. In many cases, wisdom teeth extractions are necessary to prevent further complications.
One of the most common reasons wisdom teeth don’t come into the mouth and cause some discomfort is due to them being impacted. If the tooth is erupting at an angle, it may find itself wedged against adjacent teeth. Not only does this prevent the tooth from ever erupting, it can also damage the adjacent tooth to which it is impacted against.
Partially Erupted Teeth
If the tooth is partially impacted, that means it has only partially erupted into the mouth. Part of the tooth is wedged by something else, resulting in only a small portion of the crown coming through the gum tissue. This makes it possible for food and bacteria to enter into the gum pocket around the wisdom tooth. Because this area is almost impossible to clean using traditional oral hygiene methods, it can easily become infected.
Decay or Abscesses
Wisdom teeth are very difficult to keep clean due to their location. Even patients with exceptional oral hygiene find that their wisdom teeth may easily develop decay. Combined with a tooth that is partially erupted, it is highly likely for these teeth to develop decay, infection, and dental abscesses if not properly treated early on. As a result, these infections can affect the next tooth, creating a chain reaction.
Posted on behalf of Mountain View Oral Surgery and Dental Implants
Your final set of molars usually erupts between your late teens to mid-twenties, and are most commonly known as wisdom teeth. These teeth are the 3rd set of molars located just behind the set that erupted around the time you were 12 years old. While most of us don’t recall having pain or discomfort during the eruption of our other teeth, many people experience moderate discomfort associated with their wisdom teeth.
Because of their location and common jaw anatomy, wisdom teeth are at an increased risk to develop gum infections, bone loss and tooth decay. This is mostly due to the fact that their location makes them extremely difficult to keep clean, and they can be prone to allow food or bacteria to pack under the gums around them. Unfortunately it doesn’t just stop there. When dental diseases develop in one tooth, they also spread to the adjacent teeth. That means when you can’t keep a wisdom tooth clean, healthy and decay free, that decay jumps right over to the next molar sitting right beside it.
While extracting wisdom teeth isn’t always needed, the American Dental Association does recommend wisdom teeth extractions for the following reasons:
Some people have great oral anatomy that allows their wisdom teeth to erupt unobstructed, with wonderful access to keep them clean. Others on the other hand, may have shorter jaws that prevent the tooth from even breaking through, and cause it to become impacted against the roots of another tooth. In order for your dentist to determine the health of your wisdom teeth, a large panoramic x-ray will be taken. These films are taken once about every three to five years, which are often enough to properly evaluate the formation of wisdom teeth.
As with any outpatient surgical procedure, there are specific precautions that must be observed in order to manage pain, prevent infection, and optimize healing after a wisdom tooth extraction. Following these simple steps will ensure speedy and optimal healing of the tooth extraction site.
Avoid trauma to the extraction site
For a few days after extraction, the wound is still tender, painful and susceptible to infection and bleeding. Nothing must be done to disrupt the blood clot that forms in the extraction socket since this can lead to a very painful condition called a dry socket which significantly prolongs healing time. Thus, hard, sticky, and chewy foods should be avoided. A liquid or soft diet and chewing on the other side of the mouth are recommended to avoid putting pressure on the wound. Other activities which may disturb the extraction site include touching the wound, spitting, gargling, sucking through a straw, and physical exercise. These should be avoided for a few days.
Keep the extraction site clean
Maintaining a clean mouth is critical to decrease the chances of infection and promote healing after tooth extraction. The day after surgery, normal brushing and flossing should be resumed as tolerated, but special care should be taken when brushing the teeth near the extraction site. Some bleeding is expected but the accumulation of blood in the extraction socket can create a breeding ground for bacteria. Thus, gently rinsing with warm salt water three times a day after meals is recommended to wash away debris and blood, and to foster sterile conditions in the oral cavity. This can be started as early as four hours following surgery.
Smoking should be avoided in the first 48 hours following dental extraction since the heat and nicotine can hinder blood clot formation. It is also necessary to refrain from alcohol for at least 14 days. Alcohol not only interferes with the blood clotting process, it also reduces the effectiveness of the antibiotics that patients must take following tooth extraction. Resist the temptation to use antiseptic mouthwashes since they also contain alcohol. Because the mouth is initially numb, in order to avoid burns, it is best to refrain from eating hot or spicy foods.
Manage pain, bleeding and swelling
For the first 48 hours after surgery, pain, jaw stiffness and swelling are not uncommon. Usually an anti-inflammatory painkiller will be prescribed or one can be purchased over-the-counter. All post-op medications should be taken on time and as prescribed. Painkillers that thin the blood, such as aspirin, are not recommended since they can trigger bleeding. Another good way to manage pain and swelling is by using an icepack for 15 minutes on the outer cheek near the extraction site. Bleeding can be controlled by biting down on a gauze pad or a moistened tea bag for 30 minutes. Getting adequate rest is also a good way to ward off pain. Immediately after the operation, resting in a sitting position, or lying down with the head elevated, is recommended to reduce bleeding.
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