What’s the point of wisdom teeth if so many people must have them removed?
We get this question a lot at Your Community Dental. Indeed, it seems a cruel trick that these molars are able to cause so many problems. As is often the case, wisdom teeth, which tend not to erupt until patients are in their early 20s, can crowd other teeth and threaten to undo years of careful dental care and orthodontic work.
What gives? Why do we have them? Wisdom teeth, so named because they arrive once a person is supposedly older and wiser, are a third set of molars that anthropologists have learned were useful to our very early ancestors. Hunters and gatherers, our early counterparts had not yet mastered the fine art of cooking. According to the Smithsonian’s National Museum of Natural History, a third set of molars helped early humans grind down tough, uncooked foods to be more digestible.
Once fire gave way to roasted meat and potatoes, humans’ jaws gradually began to change. With less need to gnaw, our third set of molars had little use. Smaller jaws meant more crowded dental quarters, and wisdom teeth began pushing their way up through the gum in any that way they could. Since making our jaws bigger isn’t very practical (it would require extensive, complicated surgery!), dentists decided to make it common practice to remove the troublesome molars. These days, wisdom teeth removal is almost a rite of passage into adulthood!
Some people are lucky enough to have the genetic combination to produce a jaw large enough, and teeth small enough, to allow wisdom teeth to erupt without too much trouble. This way the teeth come in at a bit of an odd angle, but they don’t cause excessive pain. These teeth may still need to be removed. According to the American Dental Association:
- Wisdom teeth that aren’t in the right position can allow food to become trapped. That gives cavity-causing bacteria a place to grow.
- Wisdom teeth that haven’t come in properly can make it difficult to floss between the wisdom teeth and the molars next to them.
- Wisdom teeth that have partially come through can give bacteria a place to enter the gums and create a place for infection to occur. This may also lead to pain, swelling, and stiffness in the jaw.
For other people, wisdom teeth can cause significant pain. The teeth may linger just below the surface of the gum line, making it difficult to chew without pinching the gum’s sensitive tissue. In some cases the wisdom teeth have formed incorrectly and are misshapen and stuck in the jaw. A tooth that is stuck is called an impacted tooth. The ADA explains that an impacted wisdom tooth usually results in a cyst that may damage tooth roots or the jawbones that hold the teeth in place.
It’s important to remember that wisdom tooth pain will most likely not just go away, and ignoring the issue will only prolong the pain and make the situation worse. If you’re experiencing pain, swelling, sensitivity, or stiffness in the back of your mouth near the hinge of the jaw, see a dentist! An exam and X-ray can help diagnose whether wisdom teeth are part of the problem.
Having Your Wisdom Teeth Removed
In some cases, albeit rare ones, removing wisdom teeth can be much like any other tooth extraction. For a standard tooth extraction, a dentist will take X-rays to see below the gum line and examine tooth roots and how they are positioned in your jaw and in relation to other teeth. On the day of the procedure, the dentist will use an anesthetic to numb the area around the tooth. At Your Community Dental, we offer our patients both local anesthetic and, in the event of extreme anxiety, sedation to help alleviate fears. Your dentist will loosen the gum tissue around the tooth and then use forceps to apply pressure to the tooth. You will feel pressure but will not feel any pain as the tooth is pulled from its socket. How easily the tooth is removed will depend on a variety of factors, including whether the tooth is a baby tooth, for which the root has already begun to dissolve, whether the tooth is broken or diseased, or how tightly wedged the tooth is between its neighbors.
Once the tooth has been removed, the dentist will place a piece of gauze over the area in the gum from where the tooth was pulled, as well as, have you bite down to apply pressure in order to stop the bleeding. Your dentist will review specific recommendations for your case before you leave the office. You most likely will need to change the gauze once getting home. It is very important to keep gauze in place and apply pressure until the bleeding stops, even though it may feel and taste strange. The gauze may become very wet due to saliva, which some patients may find to be an unpleasant sensation.
After bleeding has stopped, you must take care not to eat any foods that could cause you pain, such as crusty bread or spicy salsa until you have healed more. Soft foods like soup, yogurt, pudding, oatmeal, and mashed potatoes are recommended for the first few days. Each time after you eat, you should gently rinse out your mouth with warm salt water. This process helps clear any food debris, as well as, prevent the dreaded dry socket.
Dry socket occurs when a blood clot either does not form or falls out or dissolves too soon after an extraction. This blood clot is supposed to serve as a protective layer over the underlying bone and nerve endings in the empty tooth socket. Without the clot there, the nerves are exposed. Nerve pain is an intense and unique kind of pain that does not respond to traditional over-the-counter medicines. Dry socket is the most common complication after wisdom tooth removal. According to the Mayo Clinic, signs and symptoms of dry socket include:
- Severe pain within a few days after a tooth extraction
- Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
- Visible bone in the socket
- Pain that radiates from the socket to your ear, eye, temple, or neck on the same side of your face as the extraction
- Bad breath or a foul odor coming from your mouth
- Unpleasant taste in your mouth
Removing wisdom teeth often is more complicated than a standard extraction because the teeth have usually not erupted fully. These teeth may require surgical removal. Depending on how hard it is to access the teeth, you may receive local anesthetic and light sedation, or more complete sedation through an IV. The dental surgeon will make an incision into the gum to reveal the tooth and, if necessary, cut away gum tissue or bone obstructing the tooth and/or break the tooth into smaller, easier-to-remove pieces. Once the tooth is removed, the surgeon is able to stitch that area of the gum closed.
After care will be much the same as for a standard tooth extraction, although you may be instructed to apply ice packs or a warm compresses to the outsides of your cheeks to reduce swelling and help control pain. Plan to take it easy the day of the procedure and, if possible, the day after. Your dentist may be able to provide documentation to help excuse any school or work absence.
Tips to Remember
Always discuss your medical history with your dentist. Certain conditions such as hypertension, diabetes, autoimmune diseases, cancer or even the cold and flu have an effect on your dental care. Your dentist may instruct you not to take certain medications like blood thinners in the days immediately before surgery. Your dentist may also want you to take a medication like an antibiotic prior to the procedure.
Here are a few good things to remember about any tooth extraction:
- Plan ahead: don’t wait until after your procedure to pick up some soft foods and salt for that salt water rinse. Chances are good that shopping isn’t what you’re really going to want to do right after leaving the dentistal office.
- Wear comfy clothes: anything you can do to put yourself at ease is encouraged. Make sure that any shirt you wear isn’t so tight around the neck as to cause difficulty getting it over your head, because your mouth and jaw may be sore.
- Have someone available to drive you home: stress and anesthesia are don’t make for safety behind the wheel.
- Take some time for you: self-care is a good thing. Maybe you want to just go home and take nap. Maybe it’s time to sit down and watch a few game shows.
- Distract yourself: ruminating on the pain isn’t good. Listen to music, read, watch tv, organize the junk drawer, imagine what you’d do if you won the lottery. Keeping yourself occupied will help you take only the pain medication you need and nothing more.
- Keep tabs: if you are prescribed pain killers, only take them as directed and make sure that no one else has access to your medication.
- Don’t use a straw: though it may make sense, it’s actually dangerous. Suction can dislodge the blood clot that formed after extraction, which may lead to dry socket.
- Follow up: be sure to visit your dentist for any post-procedure check-ups and call if you have any questions or complications.
How Your Community Dental Can Help
Your Community Dental, located in Wilmington, NC, cares for patients from across the coastal Carolinas region, including Carolina Beach, Kure Beach, and Wrightsville Beach. Whether you have just moved to town, are transferring your care from another practice, need to establish care with a dentist, or find yourself suddenly in need of dental service, we look forward to partnering with you to better your oral health. Our aim, from front desk to dental chair and back, is to make you as comfortable as possible and perform our work with a focus on quality and efficiency.
Your Community Dental accepts most major insurance plans. We recommend you ask one of our associates for specific information about your policy before initiating treatment. Your Community Dental has serviced the Medicaid community consistently since 2000 with the specific objective to provide quality dental and oral hygiene services to members of every segment of the area population. We believe everyone deserves quality dentistry at fair and affordable prices. We also offer an in-house dental health savings plan for those patients who do not have dental insurance. This plan allows patients to receive treatment at a discounted cost. Approval for the in-house dental plan is required prior to treatment.
Please call us today to discuss your dental care needs and set up an appointment with one of our dentists. You can reach us at 910.342.9210, or go online to book an appointment at yourcommunitydental.com. Our office is open from 8 a.m. to 5 p.m. Monday through Thursday and 8 a.m. to 2 p.m. on Friday.