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Wisdom teeth

What are wisdom teeth?

Wisdom teeth are an extra pair of molars that grow behind the two adult molars, they usually appear during the late teens to mid-twenties – hence the name, suggesting that the person has gained wisdom as they get older. Most people will grow three molars on each side, but about a third of the adult population won’t grow any wisdom teeth at all, perhaps because they are not essential and are slowly being bred out of humans. Wisdom teeth can prove to be quite problematic if they don’t erupt properly, and often have to be removed due to their effect on the rest of the adult teeth.

What is an impacted wisdom tooth?

A large percentage of adults in the UK will have to have their wisdom teeth removed because of impaction, this means they don’t break through the gum tissue in the correct way, leaving the other teeth at risk of infection, toothache, and crowding – there isn’t always enough room for the molars to fit, so they shuffle the rest of the teeth forward to create space.

Mesioangular impaction – this is the most common form of impaction, almost half of all wisdom teeth impactions appear as mesioangular. A tooth affected in this way would be angled towards the front of the mouth, instead of standing upright.

Vertical impaction – this also occurs relatively frequently, characterised by partial areas of the tooth breaking through the gum line, whilst the rest remains covered.

There are two other types of wisdom teeth impaction impaction, but they are much less commonplace:

Distoangular impaction – only a small percentage of cases will appear like this, with the tooth pointing backwards towards the opening of the throat.

Horizontal impaction – an even smaller number of adults have wisdom teeth that impact horizontally, those that do will notice that there is a space where a tooth has grown, but it doesn’t seem to be attempting to break through. An x-ray will show that the tooth is lying on its side at a ninety degree angle to the rest of the teeth, growing into the roots of the molar next to it.

In most cases, these wisdom teeth will cause dental complications if they are not removed, and dentists will recommend an extraction to avoid infection or root damage.

What will happen if wisdom teeth are not removed?

Extracting wisdom teeth is not a simple procedure, and can be exacerbated by the position of the offending molar; however, if the impaction puts the rest of the mouth at risk, it can be the only course of action available. It’s a fairly common treatment, if you ask around your family and friends, you’re sure to find someone who has experienced it. Unfortunately, problematic wisdom teeth are all too common as well, the biggest risks being infection and bacteria.

Partially erupted molars or ones that lean on the surrounding teeth at an inappropriate angle can be very difficult to clean, particularly if some of the biting surface is covered by remaining gum tissue – called the operculum. It’s hard to clean under the operculum with just a toothbrush, and food particles can easily gather beneath it, as can harmful bacteria. Without treatment, the area can become infected and the hidden tooth will start to rot. Typical symptoms include; red and swollen gums, pain in the jaw, a bad smell or taste coming from the area, and problems opening or closing the mouth – this is due to the position of the wisdom teeth, behind the first and second molars. If this sounds familiar to you, make an appointment with your dentist immediately, the problem is not going to solve itself and will only start to deteriorate more rapidly if you ignore it. Untreated infections can become very serious if left to spread unabated.

Most partial eruptions will result in a tooth extraction; it’s the simplest way to deal with the problem. Adults can function perfectly well without the wisdom teeth, so it’s the best way to provide permanent relief.

A few unlucky patients may find that inflammation around a partially erupted molar leads to a dental cyst developing. Studies have shown that this tends to occur in older patients, and those who have left their impaction without treatment. They are not usually life threatening, but can be very troublesome and cause a lot of pain. The best thing you can do to avoid this situation is to alert your dentist as soon as you suspect that one or more of your wisdom teeth have become impacted to some degree. Staff at the Pearl Dental Clinic have a wealth of experience in this area, and will be able to put your mind at rest, give them a call if you are concerned about impacted wisdom teeth.

What happens during a wisdom tooth extraction?

Extracting wisdom teeth is something all dentists will be familiar with; they know that wisdom teeth that are waiting to erupt can cause as many problems as impacted ones. Most extractions will be pre-emptive, if you have your dentist take a look at your wisdom teeth as soon as they begin to show, they can potentially avoid any complications down the line.

Many wisdom teeth can be easily extracted in the same way as any other molars, but if they are deeply impacted it can cause difficulties. Fully erupted wisdom teeth should be loosened in the socket, and then pulled out in only a few minutes – much like a normal extraction. For extreme wisdom tooth impactions, the oral surgeon will have to cut into the gums and use specially designed tools to loosen the tooth, before extracting it with forceps. Once the molar is fully removed, the incision is stitched up. There are sometimes complications with this type of extraction – particularly if the tooth is impacted in the bone, so if you have undergone the removal of a severely impacted wisdom tooth, make sure you listen to your dentist and follow their advice, and keep a close eye on the area in question, looking out for signs of infection – swelling, redness, or oozing from the wound.

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