Wisdom Teeth: They Do Not Make You Wiser

Every patient is unique, and the condition of a mouth changes over time. As part of each routine dental visit, Dr. Davis examines pre-teens’ and young adults’ teeth to determine if their wisdom teeth are healthy and properly positioned. He has kept his eye on my daughter’s wisdom teeth since she was about 13. During her recent dental appointment, he determined her wisdom teeth need to be removed and referred us to an oral surgeon. She is now 17.

What are wisdom teeth?

Wisdom teeth are third molars on each side of your upper and lower jaws. They usually erupt when you are in your late teens or early twenties, give or take a few years. Since they are the last teeth to come in and they usually arrive on scene during what we call the young adult years, these molars have been nicknamed “wisdom teeth.”

What determines the need for wisdom tooth extraction?

Removing wisdom teeth before age 20 is preferred because roots are less developed and fewer complications may arise. The American Dental Association recommends evaluation and/or removal between the ages of 16 and 19.

Wisdom teeth are just as useful as any other tooth providing they grow in properly and have healthy gum tissue around them. Dr. Davis watches for proper growth and healthy gum tissue to support the addition of third molars. If he sees signs and symptoms of any of the following problems, he will recommend removal to prevent problems.

• pain
• infection
• cysts
• tumors
• damage to adjacent teeth
• gum disease
• tooth decay

Most often there just is not enough room left in your mouth to accommodate these late comers. Impacted wisdom teeth (teeth below the gum line that have not erupted yet) will cause swelling and tenderness. Wisdom teeth that erupt partially or come in crooked can cause painful crowding and disease.

Ever hear of pericornitis? This is a dental infection that occurs when there is not enough room in a young person’s mouth to accommodate erupting wisdom teeth. If wisdom teeth erupt, but only partially, the gum tissue covers part of the top of the molar allowing food or plaque to lodge under the gum tissue. If the area becomes infected because of the trapped food or plaque, the tissue will swell and turn red. Pericornitis symptoms may include:

• a bad smell
• a bad taste in the mouth
• discharge of pus from the gum near the tooth
• swollen lymph lodes under the chin
• muscle spasm in the jaw
• swelling on the affected side of the face

Pericornitis is nasty, no doubt about it, but you can treat it yourself. Rinse with warm salt water and make sure that everything lodged under the gum tissue is removed. You may need an antibiotic. Depending on the extent of pericornitis, oral surgery may be necessary to treat the infection.

What can be expected with wisdom tooth extraction?

Extracting teeth is relatively common and routine. Your wisdom-tooth-removing specialist is called an oral maxillofacial surgeon. He or she will recommend local anesthesia for your teeth if they have already come in. They will recommend IV sedation or general anesthesia for impacted teeth.

If your wisdom teeth have erupted, they will be removed. If they are impacted and embedded in your jawbone, the oral surgeon will cut into the gums and remove the teeth in sections to minimize bone loss.

After surgery, you will be asked to bite down softly on a piece of gauze for at least 30 to 45 minutes after you leave the office. This helps stop bleeding and encourages the formation of blood clots in the sockets.

Pain, swelling, tenderness and bruising usually occur, but will go away after a few days. Applying ice packs or packages of frozen peas as instructed by your oral surgeon will help with swelling. Pain medication will be prescribed to help with pain. If you experience prolonged or severe pain, swelling, bleeding or fever, you should call your oral surgeon.

Are there complications with wisdom tooth extraction?

Yes, but not always. Only 2 to 5 percent of patients develop a dry socket. If they occur, dry sockets usually happen within the first 5 days following surgery.

After teeth are extracted, blood clots form in the tooth sockets. These blood clots seal the sockets so that healing can take place. If a blood clot breaks down or is dislodged, a dry socket occurs. When a blood clot goes MIA, the jawbone and nerves of the tooth are exposed. A dry socket is very painful!

If you experience a dry socket, call your oral surgeon right away. He or she will see you asap to rinse out and remove debris from the dry socket. Medicated dressings will be applied to protect the dry socket and ease the pain. An antibiotic and painkiller will be prescribed.

A dry socket should heal in 7 to 10 days with proper care and lots of rest.

I’m sure it goes without saying, but practicing good oral hygiene after surgery is vitally important. Keeping the mouth clean will help a mouth heal well.

Maintain good oral health. Brush twice a day and visit Davis Dental twice a year. Regular dental visits are important. Dr. Davis can evaluate your overall oral health and your wisdom teeth if you have them. Let Davis Dental help you prevent and manage dental disease and achieve optimal oral health. Call (307) 634-3488 today to schedule your routine checkups. We are open Monday through Thursday between 8:00am and 5:00pm.