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When is a Wisdom Tooth Removal Necessary?

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When is a Wisdom Tooth Removal Necessary?

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Some conditions require you to get your wisdom tooth extracted. This article discusses all the possible causes that make wisdom tooth extraction necessary.

Medically reviewed by

Dr. Chithranjali Ravichandran

Published At June 22, 2015
Reviewed AtMarch 11, 2024

Introduction:

Tooth removal, also known as tooth extraction, is a dental procedure where a tooth is removed from its socket in the bone. In other words, Surgical removal of the tooth from its socket is known as extraction. This may be necessary due to various reasons, such as severe decay, infection, crowding, or damage beyond repair.

What Is a Wisdom Tooth?

A wisdom tooth, also known as the third molar, is one of the four permanent adult teeth located at the back corners of the mouth. They usually emerge in their late teens or early twenties. Wisdom teeth can cause problems if there is not enough space for them to surface properly, leading to pain, crowding, and infection, often requiring extraction.

How to Know the Presence of Wisdom Teeth in the Oral Cavity?

The presence of wisdom teeth can often be determined through dental examinations, x-rays, and symptoms such as pain or discomfort in the back of the mouth. Dentists can assess the positioning, development, and potential impacts of wisdom teeth on oral health.

When Is Wisdom Tooth Removal Advocated?

Wisdom tooth removal is often advocated when they cause problems such as pain, infection, damage to adjacent teeth, or if they are impacted (unable to fully emerge from the gums). Additionally, preventive removal may be recommended by dentists or oral surgeons if there’s a high likelihood of future problems due to the size of the jaw or the angle at which the wisdom teeth are growing.

What Are the Problems Associated With Wisdom Tooth?

Problems related to wisdom teeth

Impaction:

  • Because wisdom teeth are the last teeth to erupt in our mouth, they do not find enough space to erupt.

  • So, they may be positioned in an angular manner, in a horizontal position, or submerged in the adjacent front teeth.

  • This kind of situation where a tooth is unable to erupt out properly because of the hindrance by other teeth is called impaction.

  • This occurs more often in our generations because of the lesser workload given to our jaws. We have shifted our food habits to eating more of softer foods, and hence, jaw size has started to decrease over generations. Hence, the teeth find a lesser place to accommodate in the jaws.

Decay/Cavity:

  • Decay can occur only in completely or partly erupted wisdom teeth.

  • Generally, because of their remote position, foodstuffs and debris can get caught and accumulate.

  • The natural cleansing effect of the tongue and cheek muscles also is not possible for these teeth.

  • Brushing also will not be able to fully clean up the food debris, as the head of the toothbrush cannot reach the wisdom tooth area.

  • So, decay can occur and spoil not only the wisdom teeth but also the adjacent teeth because food debris often accumulates in the gap between the wisdom tooth and the adjacent tooth.

Gum Problem/Swelling:

  • When food debris accumulates, the overlying gums can get infected.

  • Sometimes, injury to the gums while biting hard food can also cause swollen gums in the wisdom tooth area. This is called pericoronitis.

  • This situation will lead to severe pain while chewing food and while opening the mouth.

  • If this problem is left carelessly, it may cause pus formation and swelling and also an inability to open the mouth.

Jaw Problems: Impacted wisdom teeth can exert pressure on the jawbone, leading to jaw pain, stiffness, or temporomandibular joint (TMJ) disorders.

Sinus Issues: Impacted upper wisdom teeth can sometimes cause sinus pain, pressure, or congestion if they push against the sinuses.

Cysts or Tumors: Cysts or tumors may develop around impacted wisdom teeth, which can cause damage to the surrounding bone and tissues if left untreated.

In What Ways Can Wisdom Teeth Be Managed?

  • Earlier, tooth removal (extraction or surgical removal) was the only option to treat wisdom tooth problems.

  • With recent advancements, root canal treatment (RCT) is performed in case of decayed wisdom teeth, and hence, a chance to save exists.

  • When there is swollen gum concerning non-impacted wisdom teeth (pericoronitis), a surgical procedure called operculectomy is performed. In this way, the flap is removed, and the tooth is allowed to erupt.

  • Generally, most cases of wisdom teeth problems are treated by surgical removal only, as most of them remain impacted.

What Are the Points to Be Considered Before Undergoing Extraction?

Before undergoing a tooth extraction, there are several important points to consider:

  • Consultation With a Dentist: Schedule a consultation with a dentist to evaluate the need for extraction and to discuss the options. The dentist will assess the condition of the tooth and the overall oral health to determine if extraction is necessary.

  • Understand the Reason for Extraction: Make sure to understand the reason why the tooth needs to be extracted. This could be due to severe decay, infection, gum disease, crowding, or damage beyond repair.

  • Discuss Anesthesia Options: Talk to the dentist about anesthesia options for the extraction procedure. This may include local anesthesia to numb the area, sedation to relax during the procedure, or general anesthesia for more complex extractions.

  • Consider Potential Risks and Complications: Understand the potential risks and complications associated with the extraction procedure, such as bleeding, infection, dry socket, nerve damage, or damage to surrounding teeth or tissues.

  • Prepare for Recovery: Be prepared for the recovery process after the extraction. This may include pain management, swelling, dietary restrictions, and proper oral hygiene practices to promote healing.

  • Follow Pre-Extraction Instructions: The dentist may provide specific instructions to follow before the extraction, such as fasting before the procedure or adjusting medications. Make sure to follow these instructions carefully to ensure a smooth extraction process.

Conclusion:

The wisdom tooth is the last erupting tooth in the dental arch. Some people do not have a tooth since birth, which is called a congenitally missing tooth. For some, there will be a space in the jaw that can accommodate the erupting tooth in the future. In case of impacted or misaligned teeth, extraction of the teeth is indicated. With advanced technology, removal of the teeth became a common chair-side procedure performed in the dental office. For a quicker recovery, follow the post-extraction tips and follow-ups.

Frequently Asked Questions

1.

How to Identify Whether My Wisdom Tooth Is Coming?

A few signs can identify the eruption of wisdom teeth. They are:
- Bad breath.
- Bleeding of the gums.
- Difficulty in opening the mouth.
- Pain in the jaws.
- Alteration in the taste.
- Swelling of the gums. This is particularly noticed in the area surrounding the second molars.

2.

When Does It Become Necessary to Remove the Wisdom Tooth?

It is not mandatory to remove your wisdom teeth. Only if there is any infection like pericoronitis or any tumor associated with the tooth, the doctor will advise you to remove it. If the tooth has no possibility of coming out and is causing pain, it is considered a dental condition called impaction. In impaction also the patient is recommended to remove the tooth to avoid complications in the future.

3.

What Is the Duration of Wisdom Teeth Surgery?

The duration of wisdom tooth surgery might vary according to the pain tolerance level, the patient's cooperation, the severity of the condition affecting the tooth, and the skill of the dentist. In general, the removal of wisdom teeth might take 45 minutes to one hour.

4.

Can I Drink Water Before Wisdom Teeth Removal?

It is better to avoid drinking water a few hours before the surgery. This will help in the effective functioning of the local anesthesia. If you are in a situation to take any regular medications before the surgery, you can consume very little quantities of water.

5.

How to Overcome the Pain Caused by an Erupting Wisdom Tooth?

The pain caused by the wisdom tooth can be relieved only by the removal of the wisdom teeth. The surgery is usually not planned suddenly, and till then, the usage of pain killer medication is suggested for overcoming the pain. In some patients, the pain due to wisdom teeth will last for one week even after the removal of the teeth.

6.

Does Everyone Have Wisdom Teeth?

Most people will have wisdom teeth. In case it is missing, it can be due to some congenital defects or genetic reasons. It is not completely necessary to have wisdom teeth for chewing purposes. In the case of missing third molars, the process of chewing can be done with the help of the first and the second molars.

7.

Is Wisdom Teeth Removal a Painful Procedure?

Yes, the removal of a wisdom tooth can be a painful procedure, but the pain can be reduced or overcome by the usage of local anesthetic agents during the removal procedure. If you are allergic to any of the anesthetic agents, then it is necessary to inform your dentist before starting the procedure.

8.

Will Wisdom Teeth Removal Alter the Shape of the Face?

No, removing your wisdom teeth does not cause any changes in the shape of your face. Only when the teeth that are present in the front region are removed, drastic changes can be observed in the face. You need no fear of any facial changes after wisdom teeth removal.

9.

How Long Will the Wisdom Tooth Pain Be Present?

The pain after the surgical removal of the wisdom tooth can last up to one week. It is necessary for the individual to practice mouth opening exercises for better healing. If these exercises are skipped, then it can result in other complications like ankylosis of the joints.

10.

Will My Wisdom Tooth Be Infected Always?

Your wisdom tooth can get affected if the tooth has not erupted into the oral cavity completely. The gums in the third molar area might get swollen and red. This is mostly seen along with pain. This condition is known as pericoronitis, and it can happen on one or both sides.

11.

What Are the Preparations Required for Wisdom Teeth Removal?

There are no special preparations required for the removal of wisdom teeth. You need to be mentally prepared to remove the wisdom teeth. You might require one week to ten days of rest after the surgery. You should avoid driving before and after the surgery to stay calm. You should also refrain from smoking eight hours before and after the surgery.

12.

What Are the Triggers for Wisdom Tooth Pain?

The triggering factors for wisdom tooth are:
- Teeth grinding habits like bruxism.
- Infection in the gums.
- Abscess.
- Tooth fracture.

13.

Will the Wisdom Tooth Pain Increase at Night?

During night, the lying down posture of the person might increase the blood flow to the head region. This can also increase the pressure on the head, resulting in an increased level of pain. The tooth pain can elevate this pressure.

14.

What Are the Side Effects of Wisdom Teeth Removal?

The wisdom tooth removal surgery can cause the following side effects.
- Bad breath.
- Tiredness.
- Sensitivity in the teeth.
- Swelling and pain in the jaw.
- Difficulty in speaking and eating normal foods.

15.

What Happens if You Never Get Your Wisdom Teeth Pulled Out?

Not having wisdom teeth is not a serious issue until your 25 years of age. Most of them do not require the third molar as they can chew with the help of the first and second molars. If the third molar is present and is trying to erupt partially, only then the patient experiences pain. If the partially erupted teeth do not come out completely, then it can lead to the possibility of infections like pericoronitis.
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Dr. Senthil Kumar. K.
Dr. Senthil Kumar. K.

Dentistry

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