As if the transition between high school and college wasn’t difficult and exciting enough, it is commonly around this time that the last teeth begin trying to emerge. These last teeth are your wisdom teeth, and they happen to be the biggest teeth you have. Situated behind the last molar, these teeth have large, complex crowns and roots that reach as far up as the sinus and as far down as the primary nerve in the lower jaw. How do these teeth find the space they need to erupt? The answer may explain why so many young adults are having all or some of their four wisdom teeth removed.
Before wisdom teeth, the available space along a dental arch is typically fully occupied by the teeth that came before them. Still, the wisdom teeth will exert pressure on the other structures as they try to make their way into the mouth. Try as they might, though, these teeth are often unsuccessful at finding their place. Instead, they become stuck in the tissues of the bone, gums, or both. This is referred to as an impacted tooth. Impacted teeth can do harm to the roots and bone of the neighbouring teeth or cause serious infection. When wisdom teeth show signs of impaction, your dentist is likely to recommend that the teeth be extracted.
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There are two common causes of infection in wisdom teeth. In the first case, the wisdom teeth never fully make it out from under the gum tissue and a portion of the teeth remains covered by a flap of tissue. A digital X-ray will help determine whether the tooth is finished emerging by checking its placement against the teeth next to it. If the teeth show the same height but the gum tissue remains, there is a risk to leaving the wisdom tooth in place.
The flap of tissue partially covering the tooth will move during chewing, allowing food and bacteria to be packed under the tissue. Over time, the bacteria under the gum flap will begin to show signs of infection. Because wisdom teeth are located close to important structures like the sinus cavity, infection here needs to be addressed quickly.
The second cause of infection in wisdom teeth is severe decay. Because the teeth are so far recessed in the mouth, they are very difficult to clean effectively. Food debris can become stuck in these far away areas and cause a cavity that eludes the patient until infection develops inside the tooth.
Pain is usually a good indication of a problem in the mouth, like a cavity. But, when pain becomes unbearable, an infection is likely present. It may become difficult to open and close the mouth, particularly when you wake up in the morning, and you will likely have a bitter taste in the back of your mouth that won’t go away. If this occurs, we recommend emergency treatment. Call your dentist to book an emergency dental appointment. Your infection may require a round of antibiotics to make extraction safe. Take the antibiotics until you have completed the full course of treatment, and make plans for your extraction appointment before you leave the clinic with your prescription.
Your dentist will assess digital images of your wisdom teeth and their root placement to determine how complex the removal could be. In situations where the upper roots are reaching too close to the sinus, or when lower roots risk doing harm to the primary nerve, your dentist may refer you to a specialist for extraction. However, most cases your wisdom teeth can be removed in your regular clinic.
Extraction will require local anesthetic just like a regular tooth extraction but accessing an impacted tooth could require an incision into the soft tissues. If this is required, your dentist will let you know that you have sutures in your mouth to be mindful of when eating and cleaning the teeth. These sutures will dissolve with time and there is no need to have them removed unless your dentist directs you to do so.
After a wisdom tooth extraction, it is very important to protect the wound by not using any suction motion whatsoever. This means that for several days, there should be no smoking or using straws for drinking. Sucking motion has the potential to remove a large blood clot from your wound which would expose your nerve to the air – a very painful condition that requires intervention called ‘dry socket’. Follow your dentist’s directions as to how to reintroduce texture to your diet after the first 48 hours of liquid diet. You can expect to be eating normally again in approximately ten days.
For questions about this or other services offered by our general dentist, contact our clinic today.
