Overview of Wisdom Teeth: Problems and solutions

Wisdom teeth, or the third molars, are the last set of molars to erupt in the mouth. They are usually four in number, one on each side on the upper and the lower jaw. These are called wisdom teeth because they erupt around the time one supposedly becomes wise, around 17 to 25 years of age. As it is said, with much wisdom comes much pain! This applies to wisdom teeth too. Read on to know more about the problems associated with wisdom teeth and their solutions.

What are wisdom teeth?

Wisdom teeth are the last four permanent teeth to develop and come out (erupt) in the mouth. When healthy and properly aligned, these teeth can be a valuable asset to the mouth. But more often than not, they are misaligned, cause a great deal of discomfort, and must be removed. There are some people who do not develop wisdom teeth during their lifetimes. This is quite normal and if it happens, the condition is called ‘agenesis’. 

Common problems due to wisdom teeth and their solutions

Wisdom teeth, if present, may cause many problems in the mouth. Some of these are as follows.

1. Dental caries (decay)

Third molars are the most posteriorly placed teeth in the mouth. Hence, they may not be as accessible as the other teeth while brushing. So, there is a high chance of accumulation of food debris and bacteria. This eventually leads to tooth decay. 

Here is how dental caries progress.

• Initially, the tooth may show dark brown or black discolouration.

• As the decay advances, a cavity forms on the tooth surface.

• The decay, if left untreated, progresses to involve deeper layers of the tooth, resulting in sensitivity and pain. 

• Without treatment, this can worsen further and lead to deeper infection and pus discharge.

The treatment of a decayed wisdom tooth is dependent on the stage of decay at the time of diagnosis and the position of the tooth. 

• In some situations, the decayed portion is removed with dental instruments, and the cavity is filled with dental cement. 

• If there are signs of a deeper infection such as pain, pus discharge, or mobility of the tooth, then removal of the tooth (extraction) is usually recommended. 

• In certain cases, root canal treatment is also recommended. This procedure is followed by the placement of a dental crown to prevent further damage to the tooth.

2. Pericoronitis (Gum swelling)

Pericoronitis is the infection and swelling of the gum tissue around a wisdom tooth. This occurs due to the accumulation of food between tooth and gums resulting in bacterial infection. 

Pericoronitis is characterised by pain in the region, swelling, redness, and sometimes pus discharge from the area of infection. In severe cases, you may even experience difficulty opening your mouth. 

Pericoronitis usually resolves once the infection is removed through antibiotics. The loose gum tissue that is seated over the wisdom tooth is often removed through a minor procedure. Recurrent pericoronitis warrants the removal of the affected wisdom tooth.

3. Impaction (Partly erupted wisdom teeth)

It is possible for the wisdom tooth not to erupt fully in the mouth. It may also sometimes erupt at an improper angle. This condition is called impaction. If the tooth is entirely invisible in the mouth, it is called complete impaction; if part of the tooth is visible in the mouth, it is called partial impaction. This is further sub-categorised based on the direction in which the impacted tooth is aligned. Your dentist may recommend you to undergo removal of the impacted tooth to prevent damage to adjacent structures and to avoid the risk of future complications.

4. Damage to adjacent teeth and tissues

The position of erupted wisdom teeth and their relation to nearby structures (such as cheeks, tongue, and adjacent teeth) may sometimes cause problems. A wisdom tooth that grows towards the cheek or tongue can impinge on your tissues and can cause ulcers. An erupting wisdom tooth may impinge on the neighbouring tooth and cause decay in them. In such situations, a dentist may advise you to remove the wisdom tooth. 

5. Cysts and tumours

Occasionally, wisdom teeth are associated with cysts and tumours in the jaw. When a wisdom tooth is impacted, there is a higher chance of developing cysts and tumours. As cysts and tumours enlarge, they cause swelling on the face. These are removed through aggressive surgical procedures. 

To keep, or not to keep, that is the question!

If wisdom teeth are healthy and well aligned with the rest of your teeth, there is usually no reason why they should be removed. That being said, sometimes your dentist may recommend you to remove your wisdom teeth to create space for correcting other teeth that are poorly aligned. Some of the indications for wisdom teeth extraction are as follows.

• Partially impacted wisdom tooth

• No space in the jaw to accommodate the wisdom tooth

• Decayed wisdom tooth

• The wisdom teeth are positioned so far back that your toothbrush cannot reach them

• Wisdom teeth impinging on or causing injury to other teeth, cheeks, or tongue

• Recurrent infection of the gums around the wisdom tooth

• Damage to the ‘Temporomandibular Joint’ (TMJ). TMJ is the joint between your lower jaw and skull. You can feel the movement of this joint by placing your fingers right in front of your ears while you open your mouth.

Wisdom teeth can literally be a pain to some people. However, for a lucky few, they erupt properly and never give rise to any complications. If you have a problem with your wisdom tooth, consult your dentist at the earliest and do not hesitate to undergo the recommended treatment. 

Frequently asked questions

Here are some of the frequently asked questions related to wisdom teeth

How do I know if I have wisdom teeth?

Most people have four wisdom teeth in their mouth. However, in some cases, these may fail to erupt. If you are above twenty, have still not gotten your wisdom teeth, and want to know if you have them at all, you can consult a dentist. Your dentist would take a series of X-rays to understand the presence, location, and status of the eruption of wisdom teeth.

How do I maintain the health of my wisdom teeth?

To maintain the health of your wisdom teeth, you should brush your teeth twice daily, rinse your mouth after every meal, and floss between the teeth every day. It is also recommended that you consult your dentist at least once every six months to assess if there are any complications.

Is wisdom tooth extraction painful? 

Wisdom tooth extraction is performed under local anaesthesia. This means that you will be injected with an anaesthetic solution, which makes your tooth and surrounding areas numb. Hence you will not feel any pain during the procedure. However, you may experience slight pressure while your tooth is being removed. 

How long does it take for healing after wisdom tooth extraction?

It typically takes seven to ten days for the healing. The complete closure of the wound may take up to 6 to 8 weeks after the procedure.

Are there any complications to wisdom tooth extraction?

Wisdom tooth extraction is a relatively simple procedure. But, there are chances of complications during and after the procedure. These complications include bleeding, infection of the socket and poor wound healing, nerve damage leading to numbness in the area, damage and injury to nearby structures etc.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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