Problems and Solutions
Wisdom teeth are the third molar teeth which erupts in the oral cavity after all the teeth, in the age between 18-25 years. Although these teeth are commonly known as wisdom teeth, they are not associated with any wisdom rather are associated with few problems. The problems arise mostly because of evolution and dietary changes from raw foods to the processed food which leads to the decrease in the size of the jaws. Hence, there is insufficient space for the teeth to erupt.
Sometimes the wisdom teeth erupts in the oral cavity without the patient even knowing in other cases these may be associated with a number of symptoms like pain, swelling, infection, foul smell from the mouth, difficulty in chewing, difficulty in opening and closing the mouth.
The most common problems associated with wisdom tooth are:
Pericoronitis (swelling of gums around the wisdom tooth) this is the most common reason for a person to visit the dentist associated with wisdom teeth. The swelling of gums around the erupting teeth is mostly due to the improper cleaning of the associated area due to difficult position, due to food accumulation in the gums over the wisdom toot or from the injury to the gums from the opposite tooth.
- This can be treated by using following measures:
- Warm saline rinses
- Betadine irrigation
- Cholorhexidine rinses and irrigation
- Operculectomy : it is a procedure in which the gums covering the tooth is incised either using scalpel and blade or using lasers
- Antibiotics and painkillers.
Pain, swelling and stiff jaws is commonly associated with the wisdom teeth while eruption. Recurrent episodes of pain and swelling needs to be addressed immediately by the concerned specialist (oral and maxillofacial surgeon) and the tooth should be removed as soon as possible. For the temporary relief analgesics can be taken.
Damage to the Adjacent Tooth
Due the different positions of the tooth (titled towards the front tooth or away from the tooth or in aberrant angulations with respect to the second molar) the brushing and cleaning of the area becomes difficult and which in turn leads to more accumulation of the food and leads the bacteria to act and cause cavities in the adjacent teeth. Regular dental check up, cleaning and flossing is necessary.
A follicle (sac) is always covering the erupting tooth. There is space between the tooth enamel and the follicle which can be filled with liquid, semi liquid or gaseous substance and enlarge like a balloon and this is known as a cyst. Sometimes the cyst can be infected. The removal of cyst is of immediate concern along with the removal of the impacted wisdom tooth.
The upper wisdom teeth are near the maxillary sinus. The potential re-infection may lead to sinusitis and vice-versa.
Crowding of Teeth
A theory also suggests the growing wisdom tooth can cause pressure on the adjacent teeth and can cause crowding in the lower front teeth. If a patient has undergone orthodontic treatment, because of the wisdom teeth there can be relapse of the treatment. So patients should get the wisdom teeth removed before starting the orthodontic treatment.
Impaction and the problems cannot be kept from occurring but regular dental check up at an interval of six-months dental for cleaning and radiographic examination after the age of 18 years enables your dentist to monitor the growth and emergence of your wisdom teeth and may also indicate impacted wisdom teeth before any symptoms develop.
When the wisdom tooth should be removed?
The routine radiographic examination can lead your dentist to take a prediction whether the erupting wisdom tooth will be problematic or not to the patient. The dentist will let you know to get the teeth to be removed. The tooth at that may seem fine and wont be causing any pain or swelling or any problems. The tooth should be removed even it is asymptomatic. It is less difficult for the patient to get it removed even when the tooth is not fully developed.
So it is concluded if the wisdom tooth is causing any problem itself or to the adjacent tooth or the other vital structures it should be consulted to the dentist and get it removed.
The removal of the wisdom tooth is a general day care procedure which can be done under local anaesthesia. Removal of wisdom tooth can also be done under conscious sedation depending on the difficulty of the procedure and the patient’s apprehension. The removal of the impacted tooth is a minor oral surgical procedure.
Some tips for the first 3 days after surgery:
- Use an ice pack on your face to curb swelling or skin color changes.
- Gently open and close your mouth to exercise your jaw.
- Eat soft foods like curd, rice, or soup.
- Drink plenty of fluids.
- Brush your teeth starting the second day. Don’t brush against any blood clots.
- Take the prescribed medicines to ease pain or swelling.
- Warm saline rinses after 24 hours, 8-10 times a day for 1 week.
- Call your doctor if you have a fever, or if your pain or swelling doesn’t improve.
- Don’t drink through a straw. Sucking may loosen blood clots that help your mouth heal.
- Don’t rinse your mouth too harshly. Your doctor may suggest rinsing gently with saltwater.
- Don’t eat hard, crunchy, or sticky foods that may scratch your wounds.
- Don’t smoke. Smoking can slow your healing.
About the Author
Dr. Gunita Singh
Dr. Gunita Singh, B.D.S., M.D. Dental Lasers, is a practicing Cosmetic and Laser Dental Surgeon since 17 years. She is specialised in Smile design and focuses on cosmetic dentistry with latest technologies & equipments.