It’s hard to say who, why, and when called these teeth “wisdom” teeth. This is probably because they erupt after the age of 20, and a person becomes wiser with age. Apparently, that’s why they were called so.
Anatomically, a wisdom tooth is the third molar. Teeth are divided into incisors, with which we bite, canines, with which we tear the food away, and premolars and molars, with which we grind the food.
As the result of evolution, humans no longer need such a large tooth surface to grind food. The human lower jaw has gotten smaller, but wisdom teeth have been still sitting in the bone. Since there is little room for them to erupt, they have become rudimentary (useless, unnecessary). According to current statistics, 95% of people no longer have enough space in the jaw for the third molars to erupt.
When is it possible to avoid the extraction of wisdom teeth?
Wisdom teeth cannot be extracted when they are located not in the bone but upright and have enough space to erupt.
If a wisdom tooth does not erupt, but it does not bother you, should it be extracted?
Anatomically, an erupting tooth is located in a follicle (a “sac” filled with tissue fluid and enzymes). As it develops during human growth, the follicle pushes the tooth upward, and the tooth roots form. Then, the follicle ruptures naturally, the crown of the tooth emerges into the dentition, and the follicle forms the periodontal ligament (tissue around the tooth roots).
If the position of the third molar is atypical (not vertical), the developing follicle can transform into a follicular cyst or adamantine cyst (tumor-like cystic mass), which can destroy the jawbone around it. This is why such a quietly “lying” tooth is worth extracting, even though it is not bothering you now.
When do you need to extract wisdom teeth?
The main reason for removing a tooth immediately is chronic inflammation that occurs around that tooth. Signs of chronic inflammation include:
- recurrent pain
- swelling
- redness of the gum around an erupting tooth. This inflammation is called pericoronitis, and it occurs when a tooth moves upward while there are no conditions for its eruption.
At what age can wisdom teeth be extracted?
It is recommended to remove the third molars as preventive measures after the end of jaw formation and growth, i.e., when a person reaches the age of 17-18 years.
What are the consequences of late extraction?
One of the most severe consequences is a bad bite. Wisdom teeth directly or indirectly affect the formation and position of the remaining teeth in the mouth. Wisdom teeth should be removed to prevent bite problems.
Local inflammation of a wisdom tooth can lead to more severe forms of inflammation, such as abscesses, phlegmons, cysts, and neoplasms.
What are contraindications to the extraction?
In fact, there are no contraindications. But there are other issues, which are complications after surgery. We should note right away that atypical tooth extraction is a surgical operation. And it is better to perform such an operation prior to the manifestation of the above-described symptoms (“cold” period of the disease).
How does the extraction take place?
There are a lot of videos on the Internet about how the extraction is done. They clearly show that there is bone tissue covering the tooth, and it must be carefully removed, preferably using piezotome, which “removes” the bone with ultrasonic vibrations. It will not damage the mucosa or the soft tissues inside the mouth.
There are many anatomical formations near wisdom teeth, which can be traumatized easily, and using piezotome prevents possible trauma. Such a gentle surgical procedure allows avoiding undesirable complications while shortening the patient’s recovery period.
What problems can occur after removal?
A common complication after the eighth tooth extraction is infection and inflammation of the bone in the area of the extracted tooth. We can manage this complication in time by monitoring the patient during the recovery period. This condition is called aseptic traumatic local osteomyelitis. For treatment, we prescribe anti-inflammatory drugs for general and local use. It usually disappears within a week, although it is accompanied by some discomfort.
Wisdom teeth are almost always a problem for a patient
But there are also more severe complications following the tooth extraction, when surrounding tissues become infected. There are many fibers and muscle attachments in this area, and the mandibular nerve is located near the tooth roots. Infection in the surrounding tissues can lead to abscesses and phlegmons, and such complications are treated surgically.
Injury to the mandibular nerve leads to paresthesia (numbness) affecting a part of the jaw, a lip, and the corner of the mouth. This complication disappears on its own under the influence of anti-inflammatory and stimulating medications.
How does recovery after the extraction take place?
To avoid the most frequent complication, a blood clot must be formed in the cavity of the extracted tooth and the extraction site must be sutured.
On the first day after surgery, you should avoid hot food, physical activities, and intensive mouth rinses.
On the following days, you should observe oral hygiene, such as gentle brushing (2 times a day), and do oral hygiene baths. It is also necessary to take medicines prescribed by the doctor (antibiotics, anti-inflammatory drugs) to avoid secondary infections. These are all the recommendations.
