The Ultimate Guide to Wisdom Teeth
What are wisdom teeth?
Wisdom teeth or third molars are the last teeth in the very back of your mouth. They start to come through or erupt during late teenage years to early adulthood. Some people may not have all 4 wisdom teeth, or may have none at all.
What is an impacted wisdom tooth?
If there is not enough space in the mouth, wisdom teeth may start growing at an angle instead of coming through upright. If a wisdom tooth gets stuck under your gum or doesn’t have enough room to break through the gum, it’s considered “impacted.” Impacted wisdom teeth are more prone to disease, tooth decay, and other dental problems.
Why do we have wisdom teeth?
It is thought that our ancestors had much larger jaws and required more teeth to help chew rougher, coarser food like leaves, roots, nuts and meats.
Over time, as our diets evolved, and human jaws became smaller, the need for wisdom teeth became less useful.
What are the symptoms of an impacted wisdom tooth?
Not all people with impacted wisdom teeth will have any noticeable problems. Others however may experience obvious symptoms.
Impacted wisdom teeth may erupt partly through the gum and a small portion of tooth may be seen in the gum tissue. This is known as a partially impacted wisdom tooth. Due to the position, food can become trapped between the gums or the adjacent teeth, making cleaning more difficult, and leading to decay. When the tooth presses on the surrounding teeth and gums, it can cause pressure pain in the area.
If the tooth becomes infected or causes other issues, you may have symptoms such as:
pain or swelling around the jaw
red, swollen, or bleeding gums
bad breath
an unpleasant taste in your mouth
problems opening your mouth
In other cases, the affected tooth may never break through the gums and remains in the surrounding jaw bone. This is known as a fully impacted wisdom tooth.
What causes an impacted wisdom tooth?
When there is not enough space in the jaw for the tooth to erupt into, the wisdom teeth are likely to become impacted.
If the tooth grows at the wrong angle, it is difficult for it to erupt naturally in a functional position.
What are the risk factors for impacted wisdom teeth?
People with small jaw structure are more likely to have an impacted wisdom tooth. There is no way to prevent developing an impacted wisdom tooth.
How is it diagnosed?
In addition to an examination in the clinic, a dental x-ray, known as an OPG provides valuable information on wisdom teeth such as their position in the mouth, angle, roots and amount of impaction. This can indicate how difficult it will be for the surgeon to remove.
In some cases, if the wisdom tooth is in a difficult position, a second x-ray, known as a CBCT (cone beam CT) gives a 3D picture which can provide further information.
How is it treated?
If the wisdom tooth is causing symptoms such as pain or infection it may be recommended they be removed by your dental surgeon.
This can either be done in the dental chair in the clinic or in the hospital depending on the type of anaesthetic required, the difficulty of the procedure or patient factors such as anxiety.
Surgery to remove wisdom teeth is usually an outpatient procedure so you can go home the same day.
Will I be awake or asleep?
The types of anaesthesia include:
Local anaesthesia: medication is given to numb the mouth to prevent pain, and you will be awake during the procedure
Sedation: medication is given to relax you and prevent pain. This can be via gas through a face mask or given through the veins into the bloodstream. You will be semi-awake and have little memory of the procedure afterwards
General anaesthesia: medication is given to make you sleep and so you not be awake at all during the procedure and will not remember the procedure afterwards. This is carried out in the hospital.
How long does the procedure take?
Surgery can take anywhere from 30 to 90 minutes depending on the number of teeth extracted, the difficulty of the procedure and whether it is performed under local or general anaesthesia. If the teeth are completely impacted in the jaw bone, they may be harder to remove.