The Ultimate Wisdom Teeth Guide
Everything you need to know about Wisdom Teeth, Extraction, and Removal
Why do we have Wisdom Teeth?
As you age and enter your late teen years, you tend to become a little more mature and wiser. You can thank your wisdom teeth for that one.
Actually not really. Wisdom teeth have nothing to do with Wisdom. You would think we could create a better name, but that’s what we have to work with.
As we age wisdom teeth start to come in.
Wisdom teeth are the third molars that might grow in any or all four corners of your mouth. These are the last teeth to surface and usually appear between the ages of 16 and 23.
How do I know If I have wisdom teeth or not?
Every year millions of people get their wisdom teeth extracted. Thousands of dollars are spent on this purpose. The decision of extraction simply depends on the health of your wisdom teeth and how they might affect the surrounding teeth.
What you can do is maintain good oral hygiene and health and visit your dentist regularly. As mentioned earlier, you can get up to 4 wisdom teeth or third molars once you reach your late teen or early adult years.
When standing in front of the mirror, try counting your teeth and you might see that you have one or more of them in each corner of your mouth.
If you’re unable to see them, your dentist might suggest an X-ray examination. A panoramic X-ray view can show the presence, position, number, and alignment of wisdom teeth that you might see erupting out of your gums soon.
It is at this point that your dentist will also examine the health, position, angle, and development of your wisdom teeth.
Why do you need to get your wisdom teeth removed?
You might be wondering whether you should get your wisdom teeth removed or not. Well, the answer depends on the overall assessment of your mouth by a specialized professional.
If your dentist/oral surgeon sees that the growth or emergence of your wisdom teeth might put you at an increased risk of gum and teeth problems, he/she might ask you to get it removed.
Common teeth and gum problems include infections, bacterial growth, formation of cavities, not enough space for other teeth to grow, nerve damage, damage to adjacent teeth, wrong alignment of your teeth, formation of tumors and cysts.
Here’s what you should remember…
Wisdom teeth surface just like any other set of teeth in your mouth. Once fully out, they help you chew like other molars do. However, sometimes they don’t get enough space to come out properly and as a result, three things might happen.
One, they might affect the growth of your surrounding teeth. Two, they might come out but crooked. Third, they might stay impacted.
(Note: When your wisdom tooth is unable to break through the gums, it is called impacted. Similarly, when it erupts but partially, it is called a partially impacted wisdom tooth)
Usually, the process of breaking through the gums and the growth of wisdom teeth might cause mild discomfort or pain, which is normal. However, if the pain persists or becomes severe, you might need to see your dentist. This is because your wisdom teeth might be stuck, growing at an angle to the adjacent teeth, or getting impacted by the surrounding tissues and gums.
It is important to keep an eye out for the emergence or growth of wisdom teeth. Even if you don’t feel any pain or see any new molars coming in, it’s best to see your dentist in your late teens especially to get your wisdom teeth assessed. An X-ray of your upper and lower jaw can help your dentist in this regard.
Wisdom teeth that are partially impacted or come out at an angle can hinder the proper growth of surrounding teeth, crowd them, and can become difficult to clean and floss.
As a result, you become more prone to bacterial infections, inflammation, pain, cavities, and the development of a cyst. Therefore, it’s always best to get proper medical advice beforehand.
Who needs to get their wisdom teeth removed?
With the changing patterns of our diet and eating habits, our jaws are also changing. It is observed that human jaws are getting smaller. Moreover, wisdom teeth come in at a later stage when all your teeth have already surfaced and grown. Smaller jaws and 28 existing teeth make it difficult for them to emerge and grow in the right direction.
Your dentist might decide that you need to get your wisdom teeth pulled if:
Your wisdom teeth are causing severe discomfort, pain, or other problems for the adjacent teeth.
The eruption of your wisdom teeth might cause problems in the future.
You’re more likely to get your wisdom teeth extracted if…
Your wisdom teeth are coming in crooked!
Regular visits to your dentist, physical examination and X-ray might help your doctor in determining whether or not your wisdom teeth need extraction. If your wisdom teeth are at an increased risk of coming in crooked or causing misalignment of adjacent teeth, you will need to get them removed.
Wisdom teeth coming in crooked might result in crowding or erosion cavities.
Crowding occurs when wisdom teeth grow towards the adjacent teeth, putting pressure on them and dislocating them.
Similarly, when wisdom teeth come at an angle to the adjacent teeth, they might leave pockets or cavities where bacteria can grow. As a result, you might get an infection along with severe pain and swelling.
Your wisdom teeth are partially impacted!
When your wisdom teeth are able to break through the gums but don’t grow out enough, they are called partially impacted. In this case, your gum and the impacted tooth might facilitate the trapping of food particles and bacteria. As a result, you’re more prone to developing
Infections such as pericoronitis, gingivitis (inflammation of the gums) and cellulitis (inflammation of the cheeks, gums or tongue)
Tooth decay and damage
Pus in the area surrounding the wisdom teeth
Pericoronitis occurs when your teeth partially emerge out of the gum with just a layer of soft tissue covering the tooth. This layer is known as the operculum. Tiny food particles, bacteria, and plaque can enter this soft tissue and result in pericoronitis infection. Pericoronitis is also accompanied by severe pain and inflammation in the gums surrounding your partially erupted wisdom tooth.
Gingivitis occurs in the gums surrounding the base of the teeth. The common symptoms of gingivitis are inflammation of the gums, redness, soreness, and irritation in the affected gums.
Facial cellulitis or Cellulitis in the mouth occurs when bacterial infections in your mouth start to affect the nearby soft tissues of cheeks, gums, and tongue. It is considered to be a medical emergency and the common symptoms of facial cellulitis are – redness, pain, swelling, fever, and even blisters in the affected area.
It is more likely that your dentist will suggest you to get your wisdom teeth extracted if they’re partially impacted.
You have (an increased risk of) cysts or tumors growing under your gums!
Your wisdom teeth tend to grow in a sac-like structure under the gums. Sometimes, due to partial impaction or other reasons this sac can get filled with fluid-like substance.
When it is left untreated or unnoticed this fluid-filled sac might turn into a cyst. The cyst usually sits in the jawbone or soft tissues present around or on the top of the wisdom tooth.
What’s important here is that leaving this cyst untreated not only causes discomfort but your chances of developing a bacterial infection also increase significantly.
Very rarely, these cysts might also turn into benign tumors (non-cancerous).
How to get it done and what it takes?
The process of wisdom tooth extraction or removal starts with the assessment of the problem. A superficially impacted or partially impacted tooth can be removed by your dentist. However, an oral surgeon and complex surgical procedure might be your only choice if your wisdom tooth is deeply impacted.
The process of wisdom tooth extraction requires following steps:
1. Applying suitable anesthesia – Depending on the complexity of the problem your dentist might choose one of three types of anesthesia i.e., local anesthesia, sedation anesthesia and general anesthesia.
As the name suggests, local anesthesia is directly applied to the site of extraction via an injection. As a result, you won’t feel any pain but you’ll be fully awake during the procedure.
2. Sedation anesthesia is given to those who don’t wish to see, remember, or stay awake during the procedure. It is applied via an IV line to dull your senses along with a local anesthetic.
3. Lastly, if your surgery is going to be complex, difficult, and long, your dentist might suggest general anesthesia. General anesthesia will keep you asleep during the entire procedure, your vitals will be monitored via electronic devices.
Making an incision – After the application of a suitable anesthetic, your dentist or oral surgeon will make an incision in the gums. The length of the incision depends on how big your wisdom teeth are or how deeply impacted it is. Once the incision has been made, your tooth and the bone are now exposed.
Sometimes the bone over the tooth might make it difficult for the tooth to be extracted, in that case, your dentist will cut the bone as well.
Removing the wisdom tooth – The next step is to remove the wisdom tooth. This can be done by simply moving it a little bit to separate it from the surrounding tissues and pulling it. However, sometimes, it is easier to break the teeth into smaller pieces via surgical equipment and pull them out part by part.
Cleaning and stitching the wound – After the successful removal of your wisdom tooth, the extraction site is thoroughly cleaned to avoid any infections. You dentist/dental surgeon might stitch the wound for quick healing (stitches might not always be required). These stitches are dissolvable and can take up to 7 days to dissolve.
A surgical gauze is also placed on the wound to facilitate the formation of a blood clot on the site of extraction. This speeds up the healing process.
Recovery time after wisdom teeth removal
The recovery period after the extraction of wisdom teeth or tooth might last from 2 days to 2 weeks and vary from person to person.
During the recovery, you might experience the following symptoms.
1. Swelling – It is very common for people to have swollen gums and mouth after the surgery. It might take a few days to wear off and in the meantime you can either apply an ice pack or cold cloth over the swollen area to ease the discomfort.
2. Bruising – Bleeding or surgery in general might result in a bruise. This bruise can be visible on the outside of your cheek and unlike swelling, it will take longer time to heal. Your dentist or surgeon might recommend you to apply an ice pack or cold cloth over it.
3. Pain – Depending on the complexity of the surgery and whether your bone has also been removed or not, you might experience moderate to severe pain after the surgery. Your dentist might advise you to take OTC pain medications and in some cases prescription pain medications as well. Applying ice packs might also help.
4. Bleeding – Surgical gauze placed over the wound helps in the formation of a blood clot over the extraction site. However, excessive spitting, drinking hot fluids or not following your dentist’s advice might result in minor bleedings or dislodgment of the clot. Try to avoid it and change your gauze regularly, as directed by the dentist.
5. You might also experience a feeling of numbness, tingling sensations, mild pressure, or an unpleasant taste in your mouth. It is totally normal and a part of the healing process.
Just like any other medical procedure, wisdom tooth extraction should not be taken lightly. In order to avoid any complications, remember these dos and don’ts.
Avoid drinking any caffeinated, hot beverage, alcohol, and smoking for at least 1-2 days following the surgery. They might dislodge the blood clot or delay the healing process.
Avoid using straws as well, as sucking might remove the clot.
Do not spit too much, rinse aggressively, or brush immediately after the surgery.
Avoid any hard physical activity that can put a strain on the wounded tissues and dislodge the blood clot.
Avoid any solid, hard or spicy foods in the initial postoperative days.
Take OTC pain medications or prescription pain medications as advised by your dentist to relieve the pain.
Use an ice pack or cold cloth over your mouth to ease the pain, swelling, discomfort or any kind of bruising.
Drink lots of water.
Try taking semisolid or liquid foods in the initial days and rest well.
Rinsing off your mouth with a mouth wash can also help prevent any infections, However, it’s best to wait for a day or two after the surgery.
We human beings are designed uniquely and, in many ways, each one of us is different from the rest. Similarly, we can experience different symptoms after the surgery and complications can always occur following a surgical procedure… not necessarily because you did anything wrong or because the procedure wasn’t performed correctly.
However, you might need to see your dentist/surgeon immediately if you experience excessive bleeding after the surgery, puss building in the wound, pain that won’t go away even after you take your medications, worsening pain or swelling, difficulties in swallowing food, and/or fever.
Similarly, persistent pain or swelling might also indicate an infection even though it is mild to moderate. Therefore, it’s best to talk to your dentist if you experience anything out of the ordinary.
What are some of the possible complications of wisdom teeth removal surgery?
Just like in any other surgery, post-operative care and maintaining good oral hygiene are crucial to shorten the recovery time after you undergo a wisdom teeth removal surgery. However, sometimes complications can occur. Here’s what you can expect as complications following wisdom teeth removal.
Usually, a medical grade gauze is placed on your open or stitched wound to facilitate the formation of a blood clot. This blood clot is the first step in the healing process. However, certain things can dislodge this clot or delay its formation. For example, drinking hot drinks, caffeinated beverages, using a straw to suck any fluid, aggressive brushing, smoking, etc.
As soon as you’ll lose the blood clot formed on the site of extraction, your bone might get exposed and this condition is known as dry socket. As a result, you might feel intense radiating pain, bad breath and delayed recovery. This usually happens 3-5 days after the surgery.
Less common complication after a wisdom teeth removal surgery is nerve damage. The nerve which is usually damaged is called trigeminal nerve. Nerve damage interferes with your sensations and make it difficult for you to eat or drink. Common symptoms of nerve damage are numbness, pain and/or a tingling feeling.
Delayed healing and excessive bleeding
Not following your dentist’s or oral surgeon’s instructions might result in delayed healing or bleeding from the site of extraction. It’s always best to avoid hard food, alcohol, smoking, hot drinks, caffeinated drinks, use of a straw to suck anything. Strenuous exercises should also be avoided to make your that your blood clot stays in place. Furthermore, for good oral hygiene keep changing your gauze regularly as instructed by your dentist.
Your doctor might advise you to rinse your mouth gently with a mild mouth wash or salt water 3-4 days after the surgery. Taking soft foods or liquids might also help in immediate recovery.
How much does it cost to get your wisdom teeth removed?
Generally, the costs of wisdom teeth extraction depend of the number of teeth being extracted, type of anesthesia, and the complexity of the surgery.
The cost of extraction of one tooth might range from 175$ to 300$.
Similarly, IV sedation or general anesthesia might cost 250$-500$ more than the local anesthesia.
The cost of actual surgery varies based on how impacted your teeth are. For example, an erupted but broken or damaged tooth might cost lesser than the partially erupted tooth. Similarly, the cost of extraction of completely impacted tooth might be higher than the partially impacted ones. Lastly, the cost of extraction of impacted tooth with a bone covering it might be even higher.
To make it easier for you, the cost of wisdom teeth extraction might be divided into sub-costs such as examination fee, X-ray fee, per tooth removal cost, and anesthesia cost.
The fee for physical examination and X-ray might vary from none to 250$.
The average cost for the removal of one wisdom tooth might range from 175$ to 300$.
Next, IV sedation might cost somewhere between 200$ and 600$.
Lastly, the total cost of removal of 4 wisdom teeth might range from 1000$ to 3000$.