Keeping Or Removing Wisdom Teethwisdom Teeth - Keep Or Remove?what Are Wisdom Teeth?problems With Wi

What are wisdom teeth? The terminology comes from the fact that they emerge much

later than the other teeth, when you theoretically are "wiser" than when the earlier teeth grew. Normally, these large molars show up when a person is between the ages of 17 and 25. You normally end up with four of them, on each side at the back of the top and bottom rows. However some people have grown more than four.

What is so special about wisdom teeth? What you may hear about them is that they have to be removed and there is pain involved. However, this is not a regular occurrence; most people don't need to have them removed.

There are several ways they can give you trouble. Some of the main ones are outlined as follows:

Impaction: In dental terminology, an impacted wisdom tooth is jammed under the gums, i.e. it has not emerged out of the gums. That means it is wedged sideways against a barrier, usually the root of another tooth; thus, it is not able to erupt through the gums. There are three ways this may occur (with the most common listed first):

1. The tooth is angled toward the front of the mouth.

2. The tooth is angled toward the back of the mouth.

3. The tooth is growing at a right angle, bumping sideways into the next molar over.

Partial Eruption: Partial eruption means that a molar emerges only partly through the gums. The main problem here is that the gums are firmly attached only at the lower part of the tooth. The upper part of the tooth is covered by loose gum tissue, which is formed like a flap, also known as an "operculum." Food gets lodged in there, but it's hard to access the pocket by toothbrush, so infection or decay (or both) may result.

Infection: Infection or, worse, an abscess is usually marked by swollen gums and redness around the tooth, difficulty in opening the mouth, a bad odor or taste in the mouth, or jaw pain, which can also run down the neck.

Even if a difficulty like one of the above happens with any of your wisdom teeth, it is not necessarily a reason to remove them. Your dentist or dental surgeon will make that determination, depending on whether he believes it is going to cause more harm than good to keep the wisdom teeth. The loose gum (operculum) could be surgically sliced off, but this operation is usually not recommended, due to possible nerve damage in the cheek or tongue.

Removing Wisdom Teeth: Some reasons to remove wisdom teeth are:

* They can cause pain from rubbing against cheeks or tongue.

* They can be infection-prone, resulting in major discomfort or worse.

* They can put pressure on your other teeth and force them out of place, causing crowding.

* They can cause severe pain and medical problems.

Extraction dental surgery is very delicate. Since a wisdom tooth is a large molar, usually embedded deeply in the gums and sometimes still stuck to the bone of the jaw, a great deal of care is taken to ensure the entire tooth is removed. Also, close to the wisdom teeth, there are a number of nerves that run through tongue and cheeks. It is important not to disturb these at all, because the harm that could be done would be permanent.

Post-Operative Care:

Following surgery, after-care instructions are given and must be followed so there won't be future problems. A post-operative appointment with your surgeon is necessary and usually takes place about seven to ten days after the extraction. The surgeon will want to ensure that the healing from the surgery is going well with no complications.

Usually the bleeding doesn't end completely for two to three days, but the amount of blood is less after the first day. It is usually best not to rinse the mouth, as this might hinder the clotting and healing processes. Gauze pads are usually supplied, but if you run out, you can substitute wet tea bags; tannins in the tea reduce bleeding. If you are still bleeding heavily after the first day, the surgeon should be notified as soon as possible.

You may also notice an unpleasant odor coming from the surgical site for one to two weeks. This is normal and should disappear.

A socket that used to hold a tooth can get clogged with dirt or food. The surgeon can clean out the socket so it won't get infected.

A "dry socket" is an inflammation of the bone next to the socket. It is not completely known why this occurs, but some suggest that the condition might be brought on by pressure (such as suction or blowing) on the healing wound. Ibuprofen, or another anti-inflammatory, reduces the inflammation and pain, usually fairly quickly - within weeks, not months.

You can expect some swelling. However, it should not last more than a week or so. If the surgical area swells up again later, your surgeon should be informed immediately.

Provided by Greenway Dental Group, MA

by: Alex Shklyar

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