September 18, 2017 ABC Children's Dentistry
What are wisdom teeth?
They are actually your third set of molars and typically come in between the ages of 17 – 25, the “age of wisdom.” An interesting tidbit is that while some people have all four of their wisdom teeth, others have just a few – or none at all.
Some anthropologists believe wisdom teeth are the result of an evolutionary process to help with our ancestors’ diet of coarse food (roots, nuts, meats, etc.) that required more chewing power. In their view, the innovations of modern technologies – including the use of forks, spoons and knives – has made wisdom teeth virtually useless.
Speaking with The Atlantic magazine, anthropologist Peter Ungar said this about the way humans adapted in terms of their wisdom teeth. “It’s a uniquely modern problem because we don’t grow our jaws long enough to accommodate our teeth. It turns out that nature has selected our jaw length on the basis of what it expects us to be doing during the period of time the jaw is growing. The more frequently you put force on the jaw, the longer the jaw grows. Nature has to guesstimate how long your jaw should be for teeth of a given size.”
Why are wisdom teeth called “wisdom teeth”?
While they are officially known as our “third molars,” we actually need to go back in time for the answer to this question – all the way back to the days of Hippocrates, the renowned Greek physician. He referred to the teeth as “sophronisteres” – meaning “prudent.”
During the times of the Roman Empire, the third molars were given the name “dentes sapientiae” – which means “teeth of wisdom.”
Generally speaking, they are called “wisdom teeth” because they are the last set of teeth to come in, and when they do, it’s at a time when we’re supposedly wiser than our younger years.
Why do wisdom teeth need to be removed?
Not everyone finds it necessary to have their wisdom teeth removed. If the wisdom teeth are positioned correctly and are not causing pain or other dental problems, removal may not be necessary.
Even if wisdom teeth are not removed, it’s crucial that you continue to monitor them
In many cases, though, removal of wisdom teeth is done to prevent future problems from developing. For example, known problems that wisdom teeth can contribute to include:
- Damage to other teeth caused by the wisdom teeth actually pushing them around
- Jaw damage caused by cysts formed around wisdom teeth
- Sinus issues, including congestion, pain and pressure
- Inflamed gums that are difficult to clean
- Cavities caused by pockets created between teeth that enable bacteria to grow
One of the most common reasons for having wisdom teeth removed is because they are impacted. When this happens, the tooth cannot fully grow in because it has run into a type of barrier. The barrier could be another tooth, the orientation of the wisdom tooth as it sits in the jaw or the size of the jaw itself.
“It is important to monitor third molars early to evaluate how they enter the mouth,” said
the president of the American Association of Oral and Maxillofacial Surgeons (AAOMS). “If there is not adequate room for them to erupt and be maintained in the mouth, it is wise to have them removed before such problems as infection and/or possible damage to neighboring teeth, occur.
“The best available evidence to date shows that surgery is appropriate in those cases
where third molars show signs of disease, or where there is a high probability that disease will develop,” said the president. “In cases where the third molars are entering the mouth correctly and there is no evidence of cavities or disease, an oral and maxillofacial surgeon or other dental professional may recommend active and routine monitoring of these teeth to assure that they remain problem-free. The worst thing that you can do is ignore them.”
As soon as they begin to cause problems or when X-rays and dental examination show they may cause trouble down the line, it’s time for wisdom teeth to come out. The trick is that as we age, the bones in our mouths become harder, making our teeth more difficult to remove.
There are, however, a few advantages to keeping your wisdom teeth. For example, they can give support for a dental bridge or serve as a substitute for a missing molar.
When to have wisdom teeth removed.
Studies show that the risks of complication from wisdom tooth extraction is greater for patients 35-years-old and older than it is for younger patients.
“Wisdom teeth surgery is less complicated and recovery is faster when a patient is
younger, as the roots are not fully developed and the surrounding bone is softer. This minimizes the risk of damaging nearby nerves and other areas,” said the AAOMS president.
What causes a wisdom tooth to become impacted?
A tooth become impacted because it has run into a barrier. In the case of a wisdom tooth, this may result in it partially emerging or not emerging at all.
Whether the tooth is visible or not, it’s becoming impacted could result in the tooth:
- Growing at an angle in the direction of the next tooth
- Growing at an angle facing the back of the mouth
- Remaining trapped within the jawbone
What are the symptoms of impacted wisdom teeth?
Not all impacted wisdom teeth will produce symptoms, the most common ones include:
- Red or swollen gums
- Jaw pain
- Tender or bleeding gums
- Bad breath
- Unpleasant taste in the mouth
- Difficulty opening your mouth
How are wisdom teeth removed?
The removal process itself should take about 45 minutes or less. Typically, you’ll meet with your oral surgeon beforehand, and this is a good time to:
Review health issues you may be experiencing or are dealing with
Go over medications you’re currently taking
Discuss the types of anesthesia that you will be given during the surgery
Before your wisdom teeth are removed, you’ll be given a local anesthetic to numb the affected area. If you are having all of your wisdom teeth removed, you may be given a general anesthetic that will prevent pain and help you to sleep through the entire procedure.
Removing your wisdom teeth
In order to remove your wisdom tooth, your oral surgeon will open the gum tissue covering the tooth, and separate the tissue joining the tooth to the jaw bone.
If it’s necessary for your oral surgeon to cut through gums or bone to remove your wisdom teeth, the wound will be closed with just a few stitches that will dissolve in a matter of days.
Following the procedure
You will most likely experience swelling and mild discomfort for about three days.
During this time, you should:
- Combat the swelling with an ice pack to the affected side of your face
- Exercise your jaw by gently opening and closing your mouth
- Begin brushing your teeth again on the second day following the procedure – but be careful about brushing against blood clots
- Drink plenty of liquids
- Avoid drinking through a straw because the sucking motion can actually loosen blood clots that help your mouth to heal
- Rinse your mouth gently with salt water
While it will probably be tempting to brush your teeth after the procedure, you shouldn’t do so for at least a day. You should also avoid even rinsing and spitting.
What should I eat after having my wisdom teeth removed?
The key is to eat only soft foods for several days immediately following your procedure. Suggestions include:
- Mashed potatoes
- Scrambled eggs
- Protein shakes
How long does it take to recover from having wisdom teeth removed?
In the majority of cases, the recovery process from having wisdom teeth removed is only a few days. While the first two days will be the most uncomfortable, most patients being feeling more like themselves by the third day.
In fact, while you may still be experiencing some swelling, you should be able to resume a more substantial diet by the third or fourth day.
What can I do about pain from wisdom teeth?
There are a few things that have been known to reduce pain caused by wisdom teeth.
- Sore mouth rinse
Mix one cup of warm water with one teaspoon of salt; stir until it’s dissolved. Swish in your mouth for about one minute before spitting it into your sink.
Before applying this gel-based numbing agent, dry the affected area with a cloth.
- Clove or clove oil
While this may technically be an old wives’ remedy, it’s been known to work. Take a whole clove and place it directly on the affected area. Keep it there until you feel a numbing sensation. You can achieve the same effect by dampening a cotton ball with clove oil and brushing it against the affected area.
How do wisdom teeth affect sinuses?
While it doesn’t happen often, the eruption of wisdom teeth can have a direct effect on your sinuses, and it’s all about location.
The wisdom teeth of the upper jaw are what causes the harm. They sit far back in the mouth, right below your sinuses. As your wisdom teeth grow and develop their roots, they sometimes produce pressure on the sinuses by pushing against them.
Can wisdom teeth cause headaches?
Absolutely! A headache caused by a wisdom tooth is the direct result of irregular pressure in the jaw. As your wisdom teeth come in, they may force other teeth out of the way, which can result in you subconsciously adjusting your jaw position. This in turn can lead to a shift in your jaw joints to an unnatural – and uncomfortable – position.
Can wisdom teeth cause ear pain?
It’s really all about cause-and-effect. An impacted wisdom tooth can produce pain in your jaw which can then migrate to the ear.
Most of the time, though, the ear pain is cause by Temporomandibular Joint Dysfunction – more commonly known as TMJ. This painful condition occurs when jaw joints get out of alignment.
How many wisdom teeth does a person have?
It depends upon the person. Most of us have four wisdom teeth; one in each corner. Some have fewer, while others have extras.
As for why some have more or fewer wisdom teeth – or none at all – we need to look at evolution. Science tells that at one time, humans had four sets of third molars (six in both upper and lower jaws).
There was a period in our evolution when our brain size greatly expanded in size. And as our brain grew, we needed a larger brain case. This, in turn, led to our jaws becoming more narrow so that it could stay connected to lower part of the skull.
According to research, genetics and environment have both contributed to the differing number of wisdom teeth in people.
Why does my wisdom tooth have three roots?
It’s not unusual for wisdom teeth to have more roots than other teeth. Most of your teeth will have one or two roots, depending upon their location. While most upper wisdom teeth have three roots, the lower wisdom teeth typically have two roots. However, it’s not unheard of for there to be more roots on a wisdom tooth.
Can I have laughing gas during removal of my wisdom teeth?
As mentioned above, local or general anesthesia are used often during procedures to
remove wisdom teeth. Another option is nitrous oxide – also known as “laughing gas.”
It’s not very intense, and while you will be awake through the process, you will feel tingly and warm. The laughing gas will reduce the amount of pain you will feel, and because it can make you happy, you’ll laugh more easily – hence the name.
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