Treatments » Oral and Maxillofacial surgery » Wisdom tooth problems

Wisdom Teeth Removal

‘Wisdom teeth removal’ is one of the most searched topics about dentistry in google. There are various aspects of it such as when the teeth erupt, does it hurt if it grows in an improper direction, how difficult it is  to get it extracted, does it pain, etc. Well these are the questions commonly asked by any patients suffering from wisdom teeth problems. Well here is an in brief explanation to these questions.


The third molars also are known as ‘wisdom teeth’ are the last to erupt into the oral cavity. They erupt between the ages of 17-25. Since they erupt as the last teeth into the oral cavity, there usually isn’t sufficient space for the wisdom teeth to erupt, or even if it does, not in a proper direction and position.


So these may lead to conditions where the wisdom teeth are entirely unerupted (Impacted) or grow in a slanting direction into an abnormal position, leading to an inflammation of the overlying gums and subsequent wisdom tooth pain. When any of these situations arise, your dentist may decide that removal is necessary.


What is the need to remove wisdom teeth?



Extraction of wisdom teeth is mainly indicated when the following symptoms present:

  • the abnormal tilt of teeth leading to an impingement in the cheek or tongue

  • when not used in chewing food

  • the gum covering the tooth is inflamed and bleeding.

  • in case of severe wisdom tooth pain, leading to the reduction in mouth opening.


Wisdom teeth removal would be a surgical procedure, which is usually simple unless the tooth is completely impacted. It usually can be performed by a general dentist, but sometimes a need for a specialist such as an oral and maxillofacial surgeon would be required. The patients are initially anesthetized, tooth removal procedure is carried out, followed by suturing of the surgical site using resorbable or non-resorb able sutures. A course of antibiotic medications is administered postoperatively, especially in cases of infected wisdom teeth.


COMPLICATIONS OF WISDOM TEETH REMOVAL



There are certain disadvantages associated with wisdom tooth removal, in which case the dentist weighs the pros and cons and decides on the treatment modality.


The potential complications of wisdom teeth removal  would be the 

  • post-operative pain, 
  • bleeding, swelling. 
  • Persistent sinus presence,
  •  dry socket, and 
  • lower lip numbness.


Dry Socket 



Dry socket is a complication which can be quite painful. Dry socket mainly occurs due to the abnormal clot formation or can be due to clot disruption prematurely at the extraction site.


There are ways in which dry socket condition can be avoided.


  • · Avoid smoking post extraction
  • · Avoid using straws for as long as possible post extraction
  • · Improper food intake post extraction such as hard and spicy food can also interfere with clot stabilization and cause disruption.
  • · Hot liquids and foods to be avoided.


POST EXTRACTION RECOVERY:



Once the extraction has been performed, it takes around 5-7 days for the gums to heal initially and is usually completed within 3-4 weeks. If the bone has been damaged, then recovery may even extend up to 6 months. Recovery post wisdom tooth surgery depends upon the systemic health of the patients too.


Following are the steps one has to follow to ensure complete recovery post extraction:


In the initial 24 hour period, bleeding from the extraction site is usually anticipated. It is best to place a clean, moist gauze in the extracted site and maintain a biting force. A tea bag can also be used due to the added factor that it contains tannic acid that promotes clot formation. If bleeding persists post 24 hours, kindly contact you, dentist.


Facial swelling is another expected outcome from extraction, and most can be handled by placing ice wrapped in a cloth in the bleeding area. Ice should be applied for 10 minutes and removed for 20 minutes, then repeated.


As mentioned earlier, your dentist would have prescribed dosage of antibiotics before the procedure to reduce the existing infection, and you may be asked to continue such post extraction to prevent further infections and complications. In case of pain or any discomfort, painkillers such as ibuprofen can be used.


AFTERCARE



Post-extraction the following rules are to be followed strictly.


Rinsing with water is not advisable for the first 24 hours.


· A soft or a liquid diet is mandatory, and the nature of the food can be gradually improved as days progress. Try chewing away from the extraction site


· Brushing and flossing can be continued normally, but it best advised not to hinder the extraction site for at least 5-7 days. Instead, gentle rinsing of the region with warm salt water after meals and pre-bedtime may help maintain the hygiene.


How Much Does Wisdom Teeth Removal Cost?


The cost of wisdom tooth extraction depends on some factors, including:


  • · The experience of the dentist.


  • · The location of the dentist.


  • · The method of extraction procedure they handle.


  • · The extent of the procedure.


Wisdom teeth removal can cost anywhere in price from 2500 INR to 5000 INR per tooth. This price or cost range does not include fees associated with sedation, surgeon fees, X-rays, possible oral surgery necessities, or the positioning and depth of the wisdom tooth to surrounding teeth and nerves. This Extraction costs for impacted wisdom teeth are significantly higher than for erupted wisdom teeth.


Pros & Cons of Removal


It's better to get the  impacted wisdom teeth removed, if not  the below mentioned critical issues might  occur:


Teeth Shifting/Migration

Shifting of teeth surrounding the wisdom tooth, in turn, causing bite irregularities and pain is often aftermath of non-removal of wisdom teeth


Loss of bone and jaw expansion:

 loss of bone is usually associated with an impacted wisdom teeth. Bone expansion surrounding the impacted tooth is also typical. Cyst and tumors may also arise from the impacted tooth causing bone destruction and gum tissue infection.


Infection of surrounding region: 

 Headache and sinus infection can be a sequel on an impacted third molar.


Irritation of Gum Tissue: 

When the wisdom teeth grow in an improper direction, it irritates the overlying gum tissue. This leads to infection and inflammation of this flap leading to severe pain. Cleansing of the infected gum can also be difficult. This ultimately leads to the formation of gum pockets around the tooth, cavitations and bone loss.


Effect on orthodontic and prosthetic treatment: 

For children, wisdom teeth may adversely affect the results of orthodontia. For the elderly, wisdom teeth may undermine the functionality of dentures. In children, wisdom teeth can hinder orthodontic treatment and decrease the functional capacity of the dentures.


The Advantages of Keeping your Wisdom Teeth



Even though the wisdom teeth poses such challenges, it has its advantages too.

1) They can act as a support for the bridge.

2) Fill space left by a missing molar

3) Act as a reservoir of stem cells.


To Extract or Not to Extract?



This question is one thing that can be handled only by the dentist using a dental examination. Many assistive diagnostic aids such as panoramic and digital x-rays are used. The anatomical features around the tooth can also be studied using these methods and a precise method for surgery chosen. They are also used to help locate additional risks that may impact your dentist's approach to the procedure, such as the anatomical and physiological features of the tooth, root, and bone and surrounding structures.


The recommended age for wisdom tooth removal is now described at 18 years of age. Hence it is recommended to get your wisdom tooth removed as early as advised, to prevent potential complications.