Wisdom teeth sooner or later become a source of many problems. The decision to remove a wisdom tooth sometimes comes at you suddenly, in other cases you have the choice and you often postpone the procedure. Fear of the treatment and the pain prevents countless people every day from taking the plunge and having the dentist or dental surgeon take the pliers…
Wisdom teeth often cause complaints
Wisdom teeth are the last of the 32 erupting teeth in humans. They come through in the phase after puberty. About half of the young people don’t even make a breakthrough. People who do have them have a 50% chance of developing problems with these molars.
Wisdom teeth often cause complaints and usually lead to removal. In some cases, these molars have difficulty erupting due to lack of space or have an abnormal position in the jaw. Cleaning then becomes difficult and the risk of inflammation increases. Remaining food residues damage the molars and gums and cavities easily form in the molars. A chronic, painless inflammation of a wisdom tooth progresses slowly and unnoticed, but can progress into an acute form where the surrounding gums swell and the area becomes painful. Expansion of inflammation to the depths can become dangerous, necessitating admission to hospital with treatment under anesthesia. The lower wisdom teeth usually cause the biggest problems.
Why wisdom teeth need to be removed
- Inflammation of the gums that often partially cover the wisdom tooth.
- Not breaking through completely or breaking through at an angle, which deteriorates jaw function and increases the risk of infection.
- Tooth decay, which is not useful/possible to fill due to the difficulty or location or function of the wisdom tooth.
- Gum inflammation (periodontitis) with bone loss around the wisdom tooth.
- Preventing damage to the tooth in front of it due to the wisdom tooth pushing against it.
- Preventing the development of a cyst or even tumor, although fortunately the chance of this is small.
Prevention of problems
It is best to remove a questionable wisdom tooth between the ages of 15 and 25. This prevents complaints. At this young age, removal is also easier and wound healing is better. Waiting until complaints arise sometimes makes removal problematic because the mouth cannot open wide, or because the area is then almost impossible to anesthetize and, despite an anesthetic injection, there is still excruciating pain during extraction. Such a wisdom tooth problem is also always inconvenient, which is why it is often recommended to extract them as a precaution . In some cases it is desirable to leave them in place and this occurs in people where the wisdom teeth play an important role in the chewing function.
Removing fresh teeth from both the left and right sides at the same time would require anesthesia of the entire throat, which is very unpleasant. That is why usually only the left wisdom teeth are extracted and the right molars another time or vice versa. They can also all be drawn individually in separate sessions. If only the molars on one side have been removed, the patient can still eat on the other side.
The treatment
If the dentist is able to remove the tooth himself, he will do so. This is the case if the molar looks the same as normal molars, so it is clearly visible and can be grasped with pliers. If the tooth is deep or crooked, the dental surgeon will be involved. First, several anesthetic injections are given into the soft tissues surrounding the tooth to be removed. For the upper molars, an injection is also given in the palate. If the tooth is out of sight under a gum layer, it is first pushed aside. Sometimes the tooth is further exposed, split and extracted with the drill. If the anesthetic works well, which usually takes about ten minutes, you will not feel any significant pain during the extraction itself. It does feel like a tree trunk is being ripped out of your mouth, and as if everything seems to be very difficult. Sometimes you also clearly hear a loud cracking sound and feel as if everything is going wrong. This is not the case, but only your own perception. You can prepare by taking two paracetamol in advance and, if you have it, some oxazepam or another tranquilizer. This means you can care less and be much less nervous in the waiting room.
After treatment
Count on heavy discomfort for at least three days. Sometimes you can still suffer from symptoms for weeks. What matters is that things get a little better every day. The wound is sutured with material that dissolves on its own. To promote bleeding and healing, you will be given a gauze pad on the cavity that you have to bite down on hard. You usually have to do this for an hour. If the wound is still bleeding after that hour, the gauze should be left in place a little longer. Rinsing with water is not desirable during the first few hours because the body has to close the hole itself and water can only flush it away. Drinking is allowed, albeit with caution. Swelling of the cheek is possible immediately and can be controlled by placing an ice pack on the cheek for an hour and a half.
After-pain is possible and you will usually be given painkillers for a week. Sometimes also medication against inflammation, as a precaution. There may even be a temperature increase. The mouth may remain quite closed and swallowing may be difficult.
There are no restrictions on eating and drinking, although this is usually not easy in the first days after treatment. Gradually you can switch to normal food from liquid food. Keeping the mouth clean is important for proper healing. You can brush your teeth in the normal way, but spare the affected area. In the first days after treatment, you should rinse your mouth with 0.1% chlorhexidine or a similar solution, whether or not using a special syringe. You will receive this on prescription.
Complications
Loss of sensation in half the chin and lower lip can occur after the removal of a wisdom tooth from the lower jaw, because the roots of the tooth can lie against the nerve that provides care. The feeling does return, but sometimes only after months. It is worse if the feeling is lost in half of the tongue. This is because the nerve has been punctured during anesthesia or because the tissue that was held aside during the removal of the wisdom tooth has been stretched or damaged. Recovery usually occurs spontaneously, there is no permanent damage.
When removing a wisdom tooth from the upper jaw, it is not always possible to avoid opening the jaw cavity. This opening must be closed to prevent inflammation of the maxillary sinus. The dental surgeon or dentist has a trick for this to test whether the area is closed. Sometimes bleeding occurs . This happens in 1 in 200 patients. In this case you must contact the practitioner. If pain occurs at the site of the wound 2 – 4 days after treatment, accompanied by a bad taste and a very unpleasant odor, then the clot has become dirty. This condition (alveolitis) goes away in about a week. In case of severe pain, the practitioner can syringe the wound clean and adjust the pain relief. Sometimes an inflammation is developing and in that case, for example, penicillin is given.
The name ‘wisdom tooth’
A wisdom tooth would be called that because wisdom teeth come in late, just like some say the mind. In older Dutch people also spoke of wisdom teeth . And in Belgian Dutch, wisdom tooth is still a common word. Wisdom tooth, wisdom tooth and wisdom tooth go back to the Latin dens sapientiae, ‘tooth of wisdom’.
“What if wisdom teeth really unlock wisdom when removed?”