WISDOM TEETH

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Wisdom teeth, also known as third molars, are the last set of teeth to emerge in the mouth. They typically appear between the late teens or early twenties. Despite their name suggesting a mark of maturity and insight, wisdom teeth can often cause discomfort and complications, leading many individuals to seek their removal.

Wisdom teeth can either be beneficial when they’re healthy and well-positioned or problematic when they’re misaligned. Misaligned wisdom teeth often grow in various directions, such as horizontally, angled towards or away from neighbouring molars, or inward/outward. This poor alignment can lead to issues like crowding, and damage to nearby teeth, the jawbone, or nerves.

Moreover, wisdom teeth can become impacted. This means they’re trapped within the jawbone or soft tissue or only partially break through the gum. A partial eruption creates a space where bacteria can enter, causing infections characterized by pain, swelling, jaw stiffness, and overall discomfort. Additionally, partially erupted teeth are challenging to clean properly, increasing the risk of tooth decay and gum disease.

Identifying your wisdom teeth

Identifying the presence of wisdom teeth often involves monitoring oral development during adolescence and early adulthood. Signs that you may be developing wisdom teeth include the sensation of pressure or pain at the back of the mouth, difficulty opening your jaw fully, and swelling or tenderness in the gums.

To determine if you have wisdom teeth and whether they’re causing problems, consult your dentist. They may recommend periodic X-rays to assess the presence and alignment of your wisdom teeth. Sometimes, they might refer you to an oral surgeon for further evaluation.

Even if you’re not experiencing any issues with your wisdom teeth, your dentist or oral surgeon might advise extraction as a preventive measure. Removing them early can prevent more complicated extractions. Later in life when roots are fully developed and bone density is higher, the procedure will be more challenging and the recovery will take longer.

Wisdom teeth Extraction

Removing wisdom teeth can vary in difficulty depending on their position and development stage. Your dentist or oral surgeon will assess your wisdom teeth during a pre-extraction exam to give you an idea of what to expect. If a wisdom tooth has fully emerged through the gum, it can be removed easily, similar to any other tooth. However, if the wisdom tooth is beneath the gums and embedded in the jawbone, a more involved procedure is needed.

The extraction process generally involves the following steps:

1. Anesthesia Administration: Before the extraction procedure, your dentist will numb the teeth and surrounding tissue with a local anaesthetic, similar to what’s used for filling a cavity. Depending on your preference and the complexity of the procedure, you may also opt for sedation to manage anxiety. Sedation options include nitrous oxide (commonly known as “laughing gas”), oral sedatives like Valium, or intravenous sedatives administered through an injection into your veins. If nitrous oxide is used, you’ll be able to drive yourself home afterwards. However, if another sedative is chosen, you’ll need someone to drive you to and from the appointment.
2. Incision and Tooth Access: Once the anesthesia takes effect, the dentist makes an incision in the gum tissue to expose the wisdom tooth and underlying bone. In cases where the tooth is impacted or partially erupted, the dentist may need to remove overlying bone or gum tissue to access the tooth properly.
3. Tooth Extraction: Using specialized dental instruments, such as forceps or dental elevators, the dentist carefully loosens and removes the wisdom tooth from its socket. The tooth may need to be sectioned into smaller pieces for easier removal, especially if it is impacted or positioned at an angle.
4. Closure: After the tooth is extracted, the extraction site may be stitched to facilitate healing and minimize bleeding. Depending on the type of sutures used, they may dissolve on their own over time or require removal during a follow-up appointment.

Recovering from Wisdom tooth removal

Recovery after having your wisdom teeth removed varies depending on the complexity of the extraction. They range from simple removal of fully erupted teeth to more challenging extractions of impacted teeth. Here’s a breakdown of what to expect during your recovery process:

First 24 Hours:

• Bleeding: It’s normal to experience bleeding for several hours after the extraction. To control it, gently bite down on a piece of clean, moist gauze placed over the empty tooth socket for about 45 minutes. If bleeding persists, use a moistened tea bag as an alternative. Avoid rinsing or spitting to prevent dislodging the blood clot, which can lead to a dry socket.
• Swelling: Facial swelling around the extraction site is common. To reduce swelling, apply an ice pack wrapped in a cloth to the affected area for 10 minutes on, and 20 minutes off, as needed during the first 24 hours.
• Pain Management: Over-the-counter pain medications like acetaminophen or ibuprofen can help relieve minor pain. Your dentist may prescribe stronger pain relievers if needed.
• Antibiotics: If prescribed before the extraction, continue taking antibiotics until the full prescription is finished.
• Diet: Stick to a liquid diet until the anaesthesia wears off, then gradually introduce soft foods. Avoid alcohol while taking narcotic pain medication.
• Oral Hygiene: Brush your teeth gently, avoiding the area directly neighbouring the extraction site for the first 24 hours. Do not use commercial mouth rinses during this time.

After 24 hours:

• Swelling Management: Transition from using ice packs to applying moist, warm towels to the area in 20-minute intervals. Swelling typically peaks 2 to 3 days after the procedure.
• Oral Rinse: Rinse your mouth with warm salt water after meals and before bed. Avoid commercial mouth rinses unless instructed by your dentist.
• Stitches: If non-dissolvable stitches were used, they may need removal by your oral health care provider after about a week. Inquire about the type of stitches you have.
• Watch for Complications: Be vigilant for signs of dry socket, a painful condition that requires treatment by your dentist.
• Healing: Complete healing may take weeks to months, but within the first week or two, you should experience enough healing for comfortable use of your mouth in the extraction area.

Your dentist will provide personalized guidance on your specific case and what to expect during your recovery period.

Potential Complications of Wisdom Tooth Removal

After wisdom tooth removal, there are a couple of potential complications to be aware of. While wisdom tooth extraction is generally safe, there are potential complications that patients should be aware of, including:

1. Dry socket: a condition characterized by the inadequate formation of blood clots at the extraction site. This can lead to exposure of the underlying bone and intense pain. Dry sockets can delay the healing process and require additional treatment to alleviate symptoms. A dry socket typically occurs 3 or 4 days after the extraction, accompanied by pain ranging from dull to severe and a foul odour from the mouth. Treatment involves placing medication in the socket to alleviate discomfort.
2. Infection: Infection of the extraction site or surrounding tissues can occur if proper oral hygiene practices are not followed or if bacteria enter the wound. Symptoms of infection may include persistent pain, swelling, redness, or discharge from the extraction site.
3. Nerve Damage: In rare cases, nearby nerves may sustain damage during the extraction process, resulting in temporary or permanent numbness, tingling, or altered sensation in the lips, tongue, or chin. This numbness, known as paresthesia, can last a few days, weeks, months, or even become permanent. Patients experiencing prolonged or severe numbness should seek prompt evaluation by a dental professional.
4. Sinus Problems: Extraction of upper wisdom teeth can sometimes result in communication between the mouth and the sinus cavity, leading to sinus congestion or infection. Patients may experience symptoms such as nasal congestion, pressure in the sinus area, or drainage of fluid from the nose.

Cost of Wisdom Teeth Extraction:

Costs vary depending on the location and the dentist or oral surgeon. It’s advisable to inquire about specific charges from your dental care provider. Additionally, check with your dental and medical insurance providers. One or both types of insurance may cover a portion of the wisdom teeth removal cost.

Understanding these potential complications and costs associated with wisdom tooth extraction can help you prepare for the procedure and any possible outcomes. Always consult your dentist or oral surgeon for personalized guidance and information that is specific to your situation.