Every Thing You Want To Know About Wisdom Tooth Extraction
Wisdom teeth are the last teeth to erupt in the mouth. Technically they are called the 3rd molars, because they erupt behind the 2nd molars in the mouth. We have 4 wisdom teeth, two in the upper arch and two in the lower. The wisdom teeth are the ones least needed for good oral health. They may not erupt or emerge from your gums until your late teens or early twenties - if they erupt at all. Most often they are impacted or trapped in the jaw-bone and gums, usually because there is not enough room for them in your mouth.
- • Gum disease: Most people are aware of the pain experienced during the eruption of these teeth. This generally happens because these partly erupted teeth are difficult to keep clean, and the accumulated food particles cause the gums around the tooth to get infected. Such an infection is felt as swelling and pain around the area. Sometimes the tooth is trying to erupt, but has not yet broken through the gums. When the upper tooth bites down onto this gum, pain can be caused.
- • Impacted : It sometimes happens that there is not enough space in the mouth for these teeth to erupt. In such cases they may try to erupt in an abnormal direction, or may get locked into the jaw. This locking is known as impaction.
- • Decay : A wisdom tooth may decay unnoticed, as they are the most difficult teeth to keep clean, being so far back into the mouth.
- • Crowding : An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.
- • Cyst : If the sac that holds the crown of the wisdom tooth remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone.
What is an Impacted tooth?
Wisdom teeth are considered impacted when they are unable to erupt into their normal functional positions, mainly due to lack of space for their eruption. Approximately 20% of the population has impacted wisdom teeth. Less than 5% of the population has sufficient room to accommodate the wisdom teeth. Of the other permanent teeth in normal individuals, very few are found impacted except the canines.
What are the causes for impaction of wisdom teeth?
An underdeveloped jaw is not being able to accommodate all 32 teeth which reduce the space for the wisdom teeth, which erupt last, to erupt into place. Another important factor, which predisposes to development of impacted wisdom teeth, is heredity. It has been found that parents who have impacted wisdom teeth are likely to pass on the trait to children. However, this may only be a very small part of the evolutionary design. Certain disease conditions such as rickets, endocrine dysfunction, anemia, achondroplasia, cleidocranial dysostosis, Treacher Collins syndrome etc. have also found to be associated with impacted teeth. Here, impactions of teeth other than that of the wisdom teeth are also found frequently.
What are the problems associated with impacted wisdom teeth?
Infection is the most common problem encountered associated with impacted teeth. It may range from a localized gum infection to acute, extensive, life-threatening infections involving the head and neck. Localized gum infections tend to recur intermittently when complete eruption of the tooth is not possible. Recurrent infections (which may be subacute and not painful for the patient) will frequently lead to gum disease and decay on adjacent teeth, which can ultimately result in the loss of these teeth in addition to the wisdom teeth. Sometimes wisdom teeth erupt in abnormal positions and angulations making them non-functional, as they are unable to contact their corresponding opposing wisdom teeth. In such situations, frequent cheek biting or tongue biting can result from the abnormal positioning causing injuries to the cheeks and tongue while chewing. Besides this, the unsupported upper wisdom tooth also starts over-erupting, lengthening out from the supporting gums, thereby leading to food trapping, decay and gum infections in the region.
Symptoms Of Impacted Tooth:
- • pain or tenderness of the gums (gingiva)
- • unpleasant taste when biting down on or near the area
- • cheek biting or tongue biting
- • bad breath
- • redness and swelling of the gums around the impacted tooth
- • swollen lymph nodes of the neck (occasionally)
- • difficulty opening the mouth (occasionally)
- • prolonged headache or jaw ache
- • Pain in internal ear
Should the Impacted tooth be removed?
Not all impacted wisdom teeth give trouble to the patient. It is only the partially erupted wisdom teeth and the ones leaning on the adjacent normal teeth, which giving the maximum trouble. Trouble can be in the form of infection of the tooth and the gum, pain, swelling, inability to open the mouth and in extreme cases tumor growing on a trapped wisdom tooth. Therefore it is advisable to remove a potentially problematic wisdom tooth much in advance than actually waiting for the problem to occur. Removal of a tooth is much easier in a younger patient; therefore putting of the removal for a much later age is not a good idea.
