Wisdom tooth

About wisdom molar extraction, treatment, and recovery

The wisdom tooth certainly doesn't make you smarter or wiser. However, it can give you serious headaches if you don't give it the proper attention. To avoid complications, it's important to know whether it needs to be extracted or not, what complications can arise if you ignore certain symptoms, what an extraction surgery entails, and how to recover after such a procedure.

About the wisdom tooth – what it is, when it emerges, and its role.

The wisdom tooth is the third molar and appears in the furthest area of the jaw, both upper and lower. These molars need space on the mature dental arch to erupt normally. This is why they emerge at a later age than other permanent teeth, specifically when the dental arches are fully developed.

Generally, wisdom teeth appear between the ages of 17 and 21. However, there are exceptions. For instance, the Guinness World Records notes the case of a boy who had his first wisdom tooth extraction at age 9, while a 94-year-old man discovered during a routine check-up that a wisdom tooth was erupting at his age. Therefore, wisdom teeth can appear at virtually any age.

Normally, there are four such molars, two upper and two lower, which play a role in chewing, cutting, and grinding consumed food. However, some people have fewer than four wisdom teeth. Wisdom molars are only useful if they develop correctly and are healthy. Otherwise, they can lead to gum infections, damage to other teeth, and other issues, necessitating extraction.

Why the wisdom tooth needs to be extracted – causes, symptoms

Deciding to remove wisdom teeth is not always easy. It is recommended to consult a dentist or even a surgeon to examine the position and health of your molars, so they can decide what's best for you based on your specific situation. As the saying goes, "an ounce of prevention is worth a pound of cure." To avoid complications, you might consider that wisdom teeth are a valid reason to visit the dentist for regular check-ups.
 

Reasons for Wisdom Tooth Extraction

The issues that can arise with wisdom teeth primarily relate to their position and the way they erupt. The following situations are serious reasons why extraction might be recommended or even necessary:

• Partial Eruption (part of the tooth remains in the gum). Since they erupt in the farthest area of the oral cavity, it is hard to see what is happening there, and brushing is not easy. Consequently, partially erupted wisdom teeth can become open channels for food debris retention, which can lead to gum disease and other oral infections.
• Insufficient Space for Development. When wisdom teeth do not have enough space to develop normally, they can force their way in, pushing against the neighboring molars. This can cause overcrowded teeth or even damage to nearby molars, potentially leading to a general domino effect of dental misalignment.
   

Symptoms

The American Dental Association recommends the extraction of wisdom teeth if the following symptoms or conditions occur around these molars:

• Gum pain;
• Gum bleeding;
• Cysts or swellings around the molar;
• Repeated infections of the soft tissue behind the wisdom tooth;
• Tumors;
• Damage to neighboring teeth;
• Gum disease;
• Extensive dental cavities.
   

When Not to Extract a Wisdom Tooth

However, wisdom tooth extraction is not always necessary. If the tooth is healthy, has fully erupted from the gum, is correctly positioned, makes good contact with other teeth during chewing, and can be easily cleaned when brushing, extraction is not required. Additionally, extraction is not needed if the wisdom teeth are embedded in the bone and do not affect chewing.

A very important aspect is that some dentists recommend the extraction of wisdom teeth as a preventive measure because they can cause numerous problems once they develop. Many researchers and public health experts do not agree with this approach, especially if the wisdom tooth is healthy. Therefore, if your dentist suggests preventive extraction and you are unsure, it would be wise to seek a second opinion.

What does the extraction surgery involve?

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth. Most of these procedures do not involve significant risks or long-term complications, but much depends on the technique used. In cases where teeth grow into the gum, an incision and removal of bone may be necessary. Rare complications can include infections caused by bacteria or food debris, damage to adjacent teeth, nerves, sinuses, or the jaw.

Therefore, even though it appears to be a straightforward operation, it's essential to thoroughly research the clinic where you plan to have the procedure. Advanced technology can ensure safer conditions and help you recover faster. The duration of the surgery depends on the tooth and the difficulty of the extraction.

X-ray Examination

During a routine check-up, your dentist might notice something amiss but cannot determine the exact issue within your gums. Thus, they will recommend a dental X-ray to diagnose the problem and plan the surgery steps. Your mouth might be too small for the wisdom teeth to develop normally, or the teeth might be growing in the wrong direction, affecting the roots of other teeth or even the jawbone.

The decision to extract the tooth may not be immediate, as there are situations where monitoring the wisdom teeth's development is necessary, which can take several months. If you start experiencing pain, swelling, or notice an unpleasant smell from the tooth area, inform your dentist immediately.

Surgical Extraction

Before the surgery, the surgeon will choose an anesthesia type based on the extraction's complexity and your comfort level. They may use local anesthesia, intravenous sedation along with local anesthesia, or general anesthesia.

Here are the general steps the surgeon will follow during the extraction:

• An incision is made in the gum tissue to access the tooth or bone in the case of impacted or partially impacted molars.
• The bone blocking access to the tooth's root is removed.
• If it is easier to remove in pieces, the molar may be cut into sections.
• The wisdom tooth is extracted.
• The extraction site is cleaned of any tooth or bone debris.
• The wound is stitched, though this is not always necessary.
• A sterile gauze pad is placed to prevent bleeding and aid blood clot formation. Blood clots are crucial in the healing process as they prevent excessive bleeding, protect the wound from infections, and help new tissue growth.

Recovery after extraction

Wisdom tooth extraction is one of the most common dental surgical procedures. Recovery can take up to two weeks, and post-operative care is very important to help you recover more quickly.
 

Duration of Recovery

Sometimes stitches are needed to close the wound. Typically, the surgeon will remove the stitches about a week after the procedure. Post-operative symptoms can include wounds, swelling, and pain, which means it may take a bit longer for full recovery. Regardless of the situation, you will gradually return to normal, with improvement noted each day. Recovery time varies from patient to patient. If infections or bleeding occur, the recovery may take longer.

In summary, the recovery process can be outlined as follows:

• first 24 hours - Blood clots form.
• 2-3 days - Swelling in the mouth and cheeks should improve.
• 7 days - The dentist may remove the stitches.
• 7-10 days - Jaw stiffness and pain should subside.
• 2 weeks - Minor bruises on the face should heal.
   

Post-operative Care

For effective and speedy recovery, it's important to follow your doctor's advice, which may include:

• Bleeding - Some bleeding on the first day is normal. Avoid frequent spitting to prevent dislodging blood clots. Remove the gauze pad as directed by your doctor.
• Pain - Your doctor may prescribe a pain reliever, especially if a bone segment was removed. You can also apply an ice pack to your cheek to alleviate pain.
• Swelling and Bruising - Use an ice pack as directed by your doctor. Any swelling should subside within 2-3 days, while bruising may take longer to disappear.
• Activity Level - Rest for the entire day after the extraction. In the following days, avoid activities that might dislodge blood clots, which are crucial for healing.
• Beverages - Drink plenty of water. Avoid alcohol, carbonated, hot, or caffeinated beverages for the first 24 hours. Do not use a straw for at least a week to prevent dislodging blood clots.
• Food -  For the first 24 hours, eat soft foods like yogurt or applesauce. Gradually reintroduce more solid foods as you can tolerate them. Avoid hard-to-chew, very hot, or spicy foods as they can irritate the wound.
• Oral Hygiene - Proper brushing is very important. Brush three times a day, but after wisdom tooth extraction, avoid brushing, rinsing vigorously, or spitting for the first 24 hours. After 24 hours, gently clean your teeth, especially around the extraction site, and rinse with warm salt water every two hours or after meals for a week.
• Smoking - Avoid smoking for at least 72 hours after surgery. If you chew tobacco, refrain for at least a week.
• Stitches - The stitches may dissolve within a few weeks or may not be necessary at all. If stitches need to be removed, do not attempt this yourself; visit your doctor.

Therefore, wisdom teeth require more special attention than the other 28 teeth due to their difficult position, making it hard to control their condition or clean them properly. Regular dental visits are essential to prevent potential complications. If you do need an extraction, following your surgeon’s advice will help you recover as quickly as possible.