What are wisdom teeth?
Sometimes, wisdom teeth grow in properly and never cause any trouble. But often, wisdom teeth get stuck in your gums or jawbone and don’t grow in (impacted wisdom teeth). When this happens, it can result in infection, cavities, gum disease and other oral health issues. That’s why many healthcare providers recommend removing them.
Not everyone has wisdom teeth. Some people develop them, and others don’t. Both are a variation of normal.
Why do we have wisdom teeth?
If wisdom teeth erupt into their proper positions, they can provide support in the back of your mouth and preserve bone in your jaw. But in general, we don’t really need our wisdom teeth. In fact, most healthcare providers consider them vestigial. This means they served a purpose at one point, but don’t anymore.
Our ancestors’ primitive diet consisted of a lot of raw plants, hard nuts and tough meats — and wisdom teeth were necessary to grind these foods for proper digestion. Today, modern food preparation and eating utensils have eliminated our need for wisdom teeth. As we got used to these dietary changes, our bodies went through some small evolutionary changes. For example, our jaws became smaller. This is why many people don’t have enough room in their mouths for their wisdom teeth to grow in.
Where are my wisdom teeth located?
Wisdom teeth erupt in the very back of your mouth, just behind your second molars. People who have all four wisdom teeth have one in each quadrant — upper left, lower left, upper right and lower right.
How many wisdom teeth do you have?
One research study found that about 53% of the general population has at least one wisdom tooth. But some people never develop wisdom teeth at all.
What do wisdom teeth look like?
A wisdom tooth looks similar to any other molar. Most have two to three roots, but some can have four.
The shape of the roots can vary from person to person. Often, the roots fuse together, giving the appearance of one big, cone-shaped root. Other times, the roots can curl or splay out in different directions.
When do wisdom teeth come in?
Your wisdom teeth usually erupt (grow in) between the ages of 17 and 25. But keep in mind, you might not see fully impacted wisdom teeth when you look in your mouth.
What are the first signs of wisdom teeth coming in?
If you have a wisdom tooth coming in, there are a few telltale signs and symptoms. You may notice:
- Redness or swelling in your gums, behind your last molars.
- Jaw pain or tenderness.
- Facial pain, due to wisdom teeth putting pressure on nerves.
- White flecks behind your last molars. These spots are likely the tops of your new teeth erupting through your gums.
Conditions and Disorders
What are some conditions that affect wisdom teeth?
Some people develop complications due to impacted wisdom teeth or wisdom teeth that haven’t erupted properly. These complications may include:
- Wisdom tooth pain.
- Gum disease.
- Damage to neighboring teeth.
Impacted wisdom teeth don’t always cause symptoms. However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms:
- Red or swollen gums
- Tender or bleeding gums
- Jaw pain
- Swelling around the jaw
- Bad breath
- An unpleasant taste in your mouth
- Difficulty opening your mouth
- pus coming from the gum.
- swollen and sore lymph nodes underneath the jaw.
- food getting stuck and difficult to clean out.
Wisdom teeth (third molars) become impacted because they don’t have enough room to come in (erupt) or develop normally.
Wisdom teeth usually emerge sometime between the ages of 17 and 25. Some people have wisdom teeth that emerge without any problems and line up with the other teeth behind the second molars. In many cases, however, the mouth is too crowded for third molars to develop normally. These crowded third molars become trapped (impacted).
An impacted wisdom tooth may partially emerge so that some of the crown is visible (partially impacted), or it may never break through the gums (fully impacted). Whether partially or fully impacted, the tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
Impacted wisdom teeth can cause several problems in the mouth:
- Damage to other teeth. If the wisdom tooth pushes against the second molar, it may damage the second molar or increase the risk of infection in that area. This pressure can also cause problems with crowding of the other teeth or require orthodontic treatment to straighten other teeth.
- Cysts. The wisdom tooth develops in a sac within the jawbone. The sac can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Rarely, a tumor — usually noncancerous (benign) — develops. This complication may require removal of tissue and bone.
- Decay. Partially impacted wisdom teeth appear to be at higher risk of tooth decay (caries) than other teeth. This probably occurs because wisdom teeth are harder to clean and because food and bacteria get easily trapped between the gum and a partially erupted tooth.
- Gum disease. The difficulty cleaning impacted, partially erupted wisdom teeth increases the risk of developing a painful, inflammatory gum condition called pericoronitis (per-ih-kor-o-NI-tis) in that area.
What are common treatments for wisdom teeth complications?
The most common treatment is wisdom teeth removal. A dentist or oral surgeon usually does this procedure at their office while you’re under sedation. But a surgeon can also remove them under general anesthesia in a hospital when necessary.
People of any age can have their wisdom teeth removed. But to prevent future oral health complications, many people choose to remove their wisdom teeth in their late teens or early 20s.
Unlike other teeth, wisdom teeth don’t provide a lot of biting or chewing power. So, there’s no need to replace them once a provider removes them.
How Are Wisdom Teeth Removed?
The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position and stage of development. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Often, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
What Happens During Wisdom Teeth Removal?
Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic — the same type used to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain.
What Does Recovery Involve After Wisdom Teeth Are Pulled?
After having your wisdom teeth removed, the speed of your recovery depends on the degree of difficulty of the extraction (a simple extraction of a fully erupted tooth versus a tooth impacted into the jawbone). In general, here’s what to expect.
During the first 24 hours
- Bleeding may occur for several hours after tooth extraction. To control it, position a piece of clean moist gauze over the empty tooth socket and bite down firmly. Apply constant pressure for about 45 minutes. A moistened tea bag is an effective alternative. The tannic acid in tea helps healing blood clots to form (blood clots function similarly to scab over an open wound). Repeat this process if a small degree of bleeding continues; if heavy bleeding continues to occur, contact your dentist or oral surgeon. Avoid rinsing or spitting for 24 hours after tooth extraction, avoid “sucking” actions (for example, don’t drink beverages through straws or smoke) and avoid hot liquids (such as coffee or soup). These activities can dislodge the clot, causing a dry socket (see below) to develop.
- Facial swelling in the area where the tooth was extracted typically occurs. To minimize swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a schedule of 10 minutes on, followed by 20 minutes off. Repeat as necessary during this first 24-hour period.
- Pain medications, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil), can be taken for minor pain. Your dentist or oral surgeon may prescribe more potent pain relievers, if necessary.
- Antibiotics that may have been prescribed prior to tooth extraction (to treat any active infection around the wisdom tooth to be extracted) should continue to be taken until the full prescription is gone.
- Foods should be restricted to a liquid diet until all the numbness from anesthesia has worn off. Eat soft foods for a few days. Also avoid alcohol if you’re also taking narcotic pain medication.
- Continue to brush your teeth, but avoid the teeth directly neighboring the extracted tooth during the first 24 hours. On day two, resume the gentle brushing of your teeth. Do not use commercial mouth rinses — these can irritate the extraction site.
After 24 hours
- Facial swelling in the area of the tooth extraction should be treated with heat after the first 24 hours of ice. Apply a moist warm towel to the area on a 20-minute on, 20-minute off schedule. Repeat as necessary. Keep in mind that swelling usually peaks 2 to 3 days after the procedure.
- Rinse your mouth with warm salt water (1/2 teaspoon of salt in a cup of warm water) after meals and before bed. Do not use commercial mouth rinses unless your dentist directs you to.
- Stitches, if used and if not of the self-dissolving type, need to be removed by your oral health care provider in about 1 week. If you do require stitches, ask what type you have been given.
- Watch for signs of dry socket (described below). This condition requires treatment by your oral health care provider.
- Complete healing doesn’t occur for a few weeks to a few months following the extraction. However, usually within the first week or two, enough healing has taken place for use of your mouth to be reasonably comfortable in the area of the extraction. Your dentist will explain what to expect in your specific case.
What Are Potential Complications of Wisdom Tooth Removal?
Two of the more important complications after having your wisdom teeth removed include:
- Dry socket. Dry socket is a common complication that occurs when either a blood clot has failed to form in the extracted tooth socket or else the blood clot that did form has been dislodged. Without clot formation, healing will be delayed. When it happens, dry socket typically occurs 3 or 4 days following the extraction and is accompanied by pain (ranging from “dull” to moderate to severe) and a foul mouth odor. Your dentist or oral surgeon will treat the dry socket by placing medication in the socket.
- Paresthesia. Paresthesia is a rarer complication of wisdom teeth extraction. Wisdom teeth entrapped in the jawbone are often close to nerves. Sometimes these nerves can be bruised or damaged during the tooth removal process. The result is a numbness (called a paresthesia) of the tongue, lip, or chin that can last a few days, weeks, months, or may even be permanent.
How can I care for my wisdom teeth?
- Brush your teeth two to three times a day. It can be difficult to reach the back surfaces of your wisdom teeth. Take your time and make sure you’re cleaning all the hard-to-reach areas.
- Floss your teeth once a day. Use dental floss to clean between your teeth. For hard-to-reach areas, you can also use dental picks or interproximal brushes (tiny brushes that fit between your teeth).
- Use an antibacterial mouthwash. Make sure it’s alcohol-free. This helps reduce your risk of dry mouth.
Additional Common Questions
Do you have to get your wisdom teeth removed?
No, you don’t have to remove them unless they cause issues. In fact, there are benefits of keeping wisdom teeth in some cases. To find out if you should keep your wisdom teeth, talk to your dentist.
Can wisdom teeth grow back?
No. If you remove a wisdom tooth, it can’t grow back.
Wisdom teeth are vestigial (unnecessary) features of our bodies. Removing them has become a rite of passage for many teens and young adults around the globe. But if your wisdom teeth erupt in alignment with your other teeth and don’t cause any issues, you may not need to do anything. To learn more about your wisdom teeth — and whether you should remove them — talk to your healthcare provider
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