Wisdom teeth, also known as third molars, are permanent teeth that can be found right at the back of your mouth. These third molars erupt later on in life, usually in your late teens or early 20s. Not all wisdom teeth cause dental problems. What determines whether they should be removed or not, depends on how well they erupt into your mouth. If wisdom teeth become partially or fully impacted and infected, based on your dentist’s advice, they may have to be removed.
Do you have to remove wisdom teeth?
Wisdom teeth have no proven benefits. For many people, wisdom teeth become impacted. This means that the teeth have not fully emerged, and may be growing at unusual angles. However, not all impacted wisdom teeth need removing. Those experiencing pain as a result of impacted wisdom teeth may find that removing them is the only cure.
What are impacted wisdom teeth?
When your jaw does not have enough space to accommodate the full eruption of your third molars, it can lead to impaction. This means that the wisdom teeth will grow in odd angles instead of erupting to the surface of the gum, as there is little space in the jaw for it to grow normally.
Types of wisdom teeth impactions
Wisdom tooth impactions can be classified as either soft tissue or hard tissue impactions. A soft tissue impaction refers to a wisdom tooth which has not fully erupted through gum tissue but has erupted through the jawbone. A hard tissue impaction, also known as a bony impaction, refers to a wisdom tooth which has not fully erupted through the jawbone.
Impaction of third molars is further categorised into four types:
- Mesial - the tooth is angled towards the second molar in front of it. This can lead to a partial eruption through the gums.
- Vertical - the tooth has a normal vertical orientation however it’s very close to the second molar and trapped under the gums.
- Distal - this is a rare type of impaction and the tooth is angled towards the back of the mouth.
- Horizontal - the tooth is horizontally facing the second molar and lies beneath the gum, parallel to the jawbone. This kind of impaction can be the most troublesome and cause damage to surrounding teeth, as well as pose a challenge for surgical removal.
What are the symptoms of impacted wisdom teeth?
You may experience a number of symptoms when your wisdom teeth are impacted. The following symptoms may occur:
- Pain in the jaw or face
- Feelings of pressure or discomfort
- Gum disease
- Ear pain
- Oral infection
- Tooth decay
- Damage to the second molar
- Crowding of teeth
- Jaw stiffness
- Bad breath
What are the complications of impacted wisdom teeth?
The angle at which wisdom tooth impaction occurs can be a predictor of the extent of complications it may cause.
Horizontal impaction can cause push against and cause damage to the second molar in front of it. If an impacted wisdom tooth grows into a sac of the jawbone, this can cause a cyst to develop. The resulting infection could cause tooth, nerve and jawbone damage.
When there isn’t enough space in the jaw, this can lead to crowding and misalignment of the teeth.
Partially erupted wisdom teeth are also difficult to clean and can cause dental health issues such as gum disease. If oral infection occurs, this can cause bad breath and severe pain. Nerve pain as a result of infection or pressure due to emerging wisdom teeth can be referred to other areas of the jaw, face and ears.
How can I get my wisdom teeth removed?
The first step is to consult your dentist on whether your wisdom teeth will require extraction. A dental X-ray will reveal the layout of your wisdom teeth in relation to your other teeth and gum tissues. A review of associated symptoms and conditions will also be conducted to guide your dentist in advising for wisdom tooth extraction.
Should you require wisdom tooth extraction, your dentist will explain the procedure to you beforehand. You may also be asked to stop taking blood-thinning medication such as aspirin, a week before the procedure, to avoid excess bleeding during or after the surgery.
How are wisdom teeth removed?
The procedure of surgical removal will depend on the kind of impaction and the severity. You will also be given the option to undergo the procedure under local or general anaesthetic based on surgical requirements. This will allow you to experience a painless procedure. Most uncomplicated wisdom tooth extractions can be done using local anaesthesia.
It may be necessary for a small incision to be made in the gum in order to extract the wisdom tooth. The tooth may also have to be sectioned and extracted piece by piece.
How long does it take to recover from wisdom tooth removal?
After the surgery, you might feel a bit drowsy due to the anaesthesia. You will begin to develop blood clots as a response to the incisions made during the extraction.
You will experience redness, swelling and bruising of the gums and surrounding tissues, however, this should begin to improve within 3 days. Due to the pain, your jaw movements might be stiff. Your cheeks and mouth may also appear swollen, however, this should resolve within a week.
Stitches may be required to close incisions and these will have to be removed after one week. Full recovery differs per individual case. It may take up to 2 weeks for a person to completely heal from surgery. You may be prescribed pain medication and antibiotics to help prevent infection and aid in the healing process.
What are the risks of wisdom tooth extraction?
As with any surgery, there are risks which must be discussed with your dental practitioner. After wisdom tooth extraction, a person may experience what is termed a dry socket. This happens when a blood clot is dislodged or incompletely formed and can be a result of poor aftercare, such as touching the affected area with the tongue or eating too soon after surgery.
Nerve injury can occur leading to numbness and paralysis of the tongue, lips or cheeks. This can be temporary or permanent, depending on the extent of the nerve damage. Although not common, some people may experience a nearby tooth or jaw fracture as a result of wisdom tooth extraction.
Whether or not you want to get your wisdom teeth removed, you need to book a consultation with a specialist in the field to make a full assessment of your dental health. This will allow both you and your dental practitioner to decide whether the benefits outweigh the risks of getting your wisdom teeth removed.
Not all wisdom tooth removals are covered by the NHS. Therefore, many dental patients have to consult private dentists to undergo removal. This can cost upwards of £1000, and depends on how many teeth need to be removed and so forth.
For many people, removing wisdom teeth can help alleviate severe pain and prevent any future health issues. For others, removal of wisdom teeth does not need to occur.
In some cases, impacted wisdom teeth left untreated can lead to infections. For example, cysts can form near the wisdom teeth, grow and later impact surrounding nerves and the jaw. It is best to consult a dentist if you are experiencing wisdom teeth pain.