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wisdom teeth
As you may or may not be aware, adults can have a maximum of 32 teeth. The wisdom teeth are the last to erupt at the back of the mouth, usually between the ages of 18 and 22. However, in some cases wisdom teeth can erupt much later.
The shape of the human jaw has altered considerably over the centuries, and people now have jaws which are often too small for all 32 teeth. If all other teeth are present and healthy, there may not be enough space for the wisdom teeth to come through properly.
Are wisdom teeth always troublesome?
Not always. If there is sufficient room for them in the mouth they can satisfactorily stay there. However, if the gum gets sore, or they are tilted (impacted) and food collects around them, then it may be wiser to extract them rather than attempt to fill them.
If there is not enough room in the mouth for the wisdom teeth, they may partly erupt and get stuck or impacted against the next back tooth. This can cause food to collect around them, and as these areas are difficult to clean the tooth can decay rapidly, or the gums can become sore and swollen.
'Teething pains' for adults.
When the wisdom teeth erupt into the mouth they often hurt a little. Usually this is not too bad and the discomfort often goes when the tooth is fully erupted in the mouth. The sensation is akin to the teething troubles babies have.
How can such discomfort be relieved?
The old remedies are often the best. A mouthwash of hot water with a teaspoon of salt will help to relieve the swollen feeling, although the water should not be too hot. Paracetamol or Aspirin will also help to ease the pain, and it is recommended that these remedies should be used every 4-6 hours for a few days.
If the pain does not go away, or if you are finding it difficult to open your mouth, then we would suggest an appointment with Dr Lister. He will be able to clean the infected tooth, and, if necessary, prescribe antibiotics to fight the infection.
The extraction of wisdom teeth.
If the same tooth continues to cause discomfort over a period of two or three weeks, the home remedies and antibiotics having failed to alleviate the sensation, then Dr Lister may advise that the offending tooth be extracted.
Many people have no problems with their wisdom teeth, and therefore may not need to have them taken out. However, if it is found that decay is present or the gums are infected, Dr Lister may advise that the best course of action is to take out the wisdom tooth.
Dr Lister will initially take x-rays, to determine in which direction the roots lie, and how the wisdom tooth sits in relation to the next back tooth. If it does not sit properly, it may be impacted.
Are wisdom teeth difficult to take out?
This will depend on the position of the tooth and the shape of the root. Dr Lister will normally be able to assess the difficulty of the extraction after consulting the x-rays taken of the mouth.
Upper wisdom teeth are normally straightforward, and if these are biting on the gum over your lower teeth, it may be preferable to take these out first to see if all the problems go away.
Does the removal of wisdom teeth alter the mouth or face?
Removing wisdom teeth may produce some swelling of the face for a few days, but as soon as the area has healed there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, particularly if the teeth were impacted.
What about lower wisdom teeth?
These differ from upper teeth in the sense that they are often more impacted, and tend to give the patient more trouble. If it is necessary to extract one or both wisdom teeth, Dr Lister may use a local anaesthetic in the gum, numbing the area around the tooth. Alternatively, if it is deemed appropriate, Dr Lister might arrange for the extraction to take place under a general anaesthetic at a hospital. You might be admitted for a few hours, or for two or three days depending on the seriousness of the problem. This is an issue which would involve discussion with Dr Lister as to the best way forward.
Are there any problems with this procedure?
On occasion the mouth can be uncomfortable for a few days after the removal of the impacted wisdom teeth and there may also be swelling which usually resolves quickly. In some instances damage may occur to nerves supplying the lip and tongue, and this may result in a loss of sensation: this is, however, only temporary. In the case of possible nerve damage, Dr Lister will be able to advise as to suitable medication for any pain. Simple painkillers such as Paracetamol or Ibuprofen will suffice.
To seal the area where the wisdom teeth were prior to extraction, stitches are normally used, and these will need removing after a week. This is an easy, painless procedure, and the mouth will usually heal completely after two or three weeks.
We are grateful to the British Dental Health Foundation for their inspirational leaflet, "Wisdom Teeth"