The teeth that sit at the back of each jaw are called wisdom teeth. They can cause various problems by, for example, easily becoming inflamed and injuring the tooth in front and causing problems with the gums. In addition, it can be difficult to keep wisdom teeth clean.
For example, if you have a wisdom tooth that causes problems, you can:
- Get a toothache.
- Get hard to gap.
- Get a fever.
- Get swollen in the cheek or gums.
Treatment of the wisdom tooth
Wisdom teeth that cause discomfort are usually either pulled out with tongs or operated on. If you are worried about the treatment you may be given sedative medicine and if you are very worried you may be anesthetized.
In conjunction with the treatment, you will receive local anesthesia and painkillers.
After the treatment of wisdom teeth, you get sore and it can bleed a little when the anesthetic releases. If you have been stitched in the gums, you may need to visit the dentist one week after the surgery to remove the stitches.
When should I seek care?
If you are in pain and are swollen around a wisdom tooth, you can turn to a dentist or call the medical advice.
If the cheek swells, you have a hard time swallowing, you have a fever or if the swelling spreads down to your throat, you should seek care directly at a dental clinic, medical center or emergency room.
What happens in the body?
Adults usually have thirty-two teeth. Sixteen sit in the upper jaw and sixteen in the lower jaw. The teeth at the back of each jaw are called wisdom teeth in many countries. This is because they usually break out when you are between the ages of 18 and 25, an age when, according to the old belief, you have acquired a pearl of certain wisdom.
If you lack so-called dental implants for one or more wisdom teeth, you will never get those teeth. You can also have more dental implants than usual and then an extra tooth can grow up.
Lack of space when wisdom teeth come
The wisdom teeth are formed and break out last of all teeth. It is usual that there is no room left in the jaws when the wisdom teeth come up.
For a period, dentists considered that a wisdom tooth that did not emerge was a disease that should be treated. Nowadays, the attitude has changed, and now the wisdom tooth may be satisfied if it is not expected to cause problems in the future.
During adolescence, the dentist can sometimes use X-ray to predict whether wisdom can lead to problems.
Should the wisdom tooth be removed?
An operation can do more harm than good, especially when it comes to wisdom teeth that are deeply stored in the bones of middle-aged and older people. In those cases, the wound often heals badly after surgery. It can be difficult to keep clean as pockets in the gums are easily formed as the jawbone decreases.
If you are in your 25s or younger and have a wisdom tooth that has not emerged, it can in many cases be good to remove it to prevent future problems. The decision depends on the location of the tooth and the risk of future injuries. If you are older than about 25, the tooth is removed only if it causes you trouble.
Your dentist can advise on how to do it.
Symptoms and diagnosis of wisdom teeth
There are several problems that can arise in and around a wisdom tooth. Pain and swelling are common.
When a tooth breaks out, you often feel a temporary irritation in the gums around the tooth. For wisdom teeth, it can often take a long time to break out, and then you can sometimes get a longer-lasting inflammation of the gums.
If the wisdom tooth does not fully emerge, the gums around the tooth may have a different appearance than usual. Often pockets are formed in the gums where bacteria can accumulate. Sometimes some of the tooth’s chewing surface is covered with gums. When you bite together, a tooth in the opposite jaw can irritate the gums so that it becomes a bit sore. It swells up and then gets even more pinched. This usually happens in the lower jaw.
Inflammation around the teeth of wisdom
Acute inflammation of the gums around the wisdom teeth is very painful with swelling of the cheek, difficulty in gapping and sometimes fever. Sometimes the gums can become inflamed before the wisdom tooth has broken out.
The inflammation indicates bacteria in the area, that is, an infection. It can spread down the throat and cause breathing difficulties.
Holes can sometimes not be worth the repair
Wisdom teeth sit far back in the mouth. In addition, they are often partially covered by mucous membranes. Therefore, it is difficult to keep them clean and bacteria can accumulate in the teeth leading to the formation of holes.
It can sometimes be difficult to get the hole repaired because the wisdom tooth is difficult to access for the dentist. Maybe you don’t want to cost a dent either. Then the tooth may be pulled out instead.
Damage to teeth next to wisdom tooth
Wisdom teeth that do not have room to appear properly often have an inclined position inside the jawbone. Sometimes the wisdom tooth lies so that the crown of the tooth collides with the root of the tooth in front.
If the wisdom tooth has seriously damaged the tooth before, the wisdom tooth can sometimes remain because it is usually complete. Instead, the damaged tooth is usually removed. The wisdom tooth is then given more space and can in some cases be raised and replace the tooth that has been removed.
Many people believe that wisdom teeth are of lesser quality than other teeth, but they usually are not.
Difficult to detect cysts
Wisdom teeth that are embedded in the jaw bone without contact with the oral cavity are rarely affected by any disease. Often they can lie in the leg all their life without problems.
However, in some cases, the membrane surrounding the dental crown can be filled with liquid. This creates a fluid-filled cavity called a cyst. The cysts can push away the jaw bone so that it thins out or push away the wisdom tooth or any other tooth next to it to disrupt.
Dental cysts rarely cause symptoms and are therefore often detected by chance when the teeth are x-rayed. Occasionally, they cause problems, either by their size or by becoming infected. Then you may get sore and the area at the tooth may swell up, such as the cheek in front of the ear or the area down to the neck. You may also get a feeling that your chin or lower lip feels numb as the sensory nerve in your lower jaw can be affected.
Tooth and cyst are removed
If a cyst is formed, both the tooth and the cyst are usually removed during surgery. The jawbone then heals again. All cysts that are removed are examined under a microscope. If you have a particular type of cyst that recurs easily, you usually have to undergo regular checkups for a few years after surgery.
If there is a risk of problems, the tooth is removed
When you’re in your teens, your dentist usually examines wisdom teeth and takes x-rays of them. If any wisdom tooth seems to be able to cause problems, it can be good to remove it.
Care and treatment for wisdom teeth
If you come to the dentist for pain or swelling around any wisdom tooth, the tooth is examined and x-rays are taken. You may be told about your general health and whether you are taking any medication or are hypersensitive to any medication.
If the wisdom tooth is to be removed, a dentist can extract or remove the tooth himself. You may also be referred to as a pelvic surgery specialist.
Extraction with pliers
It is common for a wisdom tooth to be pulled out with pliers. But the tooth must then have come up so much that the dentist can get hold of it. In general, wisdom teeth in the upper jaw are easier to remove than those in the lower jaw. This is because the jaw bone in the upper jaw is not as hard as the lower jaw.
Regardless of whether the tooth is to be extracted or if you have to be operated on, the treatment sometimes starts with local anesthesia and painkillers.
When the tooth is removed
If the wisdom tooth has not arrived or has a slightly complicated appearance according to the x-ray, you may need minor surgery to remove it.
The surgery is done by the dentist cutting an incision in the gums so that the bone covering the roots of the wisdom tooth becomes visible. With a drill, so much of the bone is removed that part of the root system of the tooth is visible. Often, the dentist may also divide the tooth before it can be removed.
Local anesthesia most common
It is most common that you get local anesthesia either the wisdom tooth should be pulled out or operated on. Most people feel no pain during the procedure. However, it does press and tightens properly in the jaw at certain moments.
Some experience pain even though they have received local anesthesia. There may be different causes, but usually, it is because you are stressed out and afraid of the treatment. If you feel very anxious about the procedure, you may be given sedative medication, taken an hour before the treatment.
Painkillers when the anesthetic releases
Once a wisdom tooth has been removed, it is good if you keep your mouth as still as possible for a few hours. When the anesthesia starts to release you often get hurt. It can also bleed a little.
The pain can be attenuated by painkillers. Often you get a pain tablet already in conjunction with the procedure. If it bleeds, you can bite on compresses that you also usually bring with you.
The jaw often swells and it becomes difficult to gape the day after the treatment. Some suffer from painful pain for several days after treatment, while others only have minor symptoms.
Infection can delay healing
It is not uncommon for you to be trouble-free a few days after treatment, but for the third day, you get sore. This is usually because you have had an infection in the hole where the tooth was sitting. Normally, the hole is filled with blood that forms a lid, but sometimes the lump of blood is released. Then food residues accumulate in the hole which after a while begins to ache and the healing is delayed.
The infection is almost never dangerous and usually heals even without treatment. But you can get trouble-free faster if you let the dentist flush clean in the hole where the tooth has been sitting. Sometimes you may also need to get a small tampon with medicine put into the hole.
If you have been stitched in the gums, you usually have to come back to the dentist one week after the surgery for the stitches to be removed. Sometimes you get a type of stitch that disappears by itself.
If you have pain in the tooth that has not cleared after one to two weeks, you should go to your dentist for examination. If you get swelling down your throat, you should always seek medical advice directly from a dentist.
Bleeding that does not stop
After removing the wisdom tooth, it can bleed from the hole where the tooth was sitting. Then you have to bite on a small compress that stops the bleeding.
Sometimes serious problems arise
Sometimes, unusual and sometimes serious problems can be experienced when wisdom teeth are removed. Here is a description of some complications that sometimes occur.
A root can go off
When a wisdom tooth is pulled out, it can crack, making it difficult for the dentist to remove all parts of it. In some cases, the dentist may leave those parts of the root that have not been loosened, as they often heal into the jaw bone without any problem afterward. If it is found that the healing is disturbed by a leftover tooth or bone remnants, a new intervention may be necessary to remove them.
If you get nerve damage, which can affect the lower lip and tongue, for example, tell your dentist about your injuries. Thereafter, the dentist can make an assessment of the injury and report to dental insurance.