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Wisdom tooth removal is advised routinely by dentists around the world. What exactly are wisdom teeth and why do we have to get them removed? Here is everything you need to know about the process.

Having your wisdom teeth removed is the most common type of oral surgery that is done around the world [1]. Most people have at least one wisdom tooth that has to be removed and in most cases, dentists end up removing all four of them at the same time.

So, what is the real deal? Do you need your impacted wisdom teeth to be removed?

What are wisdom teeth?

Let’s start with the basics. A wisdom tooth is the same as any other tooth in our mouth. It is just so named a wisdom tooth because it was the last tooth to erupt out in the mouth and colloquially signified that a person had reached a certain stage of development.

There is nothing to associate them with any actual wisdom of any kind!

Dentists refer to the wisdom teeth as the third molars. These wisdom teeth or third molars were a functional part of our jaw many thousands of years ago [2]. Our changing diet resulted in us evolving and having smaller jaws, so these teeth are no longer functionally needed by human beings to chew [3].  

What causes impacted wisdom teeth?

Since the wisdom teeth are the last teeth to erupt into the mouth, they often struggle to find the space to do so and can be blocked out by other previously erupted molars. Any tooth that is ‘stuck’ inside the jaw is called impacted. The wisdom teeth are not the only teeth that can be impacted but they are the ones to most often be impacted.

The simple reason for the occurrence of impacted wisdom teeth? Jaws that are too small to accommodate them into the mouth [4].

Symptoms associated with impacted wisdom teeth

It is human tendency to ignore something which may not be showing immediate signs or symptoms. Your wisdom teeth clearly don’t like being ignored because they demand your attention through some very clear symptoms.

  • Pain: Partially erupted wisdom teeth are the ones that can cause pain most often. The teeth end up being half-in, half-out which can make them perfect for food lodgment. As a result, the gums around the wisdom teeth can get inflamed and cause pain [5].
  • Decay: It can be difficult to clean the area around the partially impacted teeth. The disease-causing bacteria flourish in such a region and cause the tooth to get decayed. Once the decay gets sufficiently advanced, it can again lead to severe pain [6].
  • Bad breath: Disease-causing bacteria that cause decay also include sulfur releasing bacteria that are at the root of bad breath [7].
  • Swelling and difficulty in opening the mouth: Partially impacted wisdom teeth can cause a swelling in and around the wisdom tooth. This can be visible even from the outside and make talking, swallowing, or opening the mouth itself difficult [8].

How are impacted wisdom teeth diagnosed?

Wisdom teeth that are completely impacted may not show any symptoms at all. These are diagnosed through the use of X-rays. Partially impacted teeth can be diagnosed through a combination of X-rays and clinical symptoms.

What problems can impacted wisdom teeth cause?

Wisdom teeth that are completely impacted may not cause any apparent problem whatsoever. They are, however, routinely removed because they can be associated with a jaw tumor called Ameloblastoma [9].

In some cases, the impacted wisdom teeth can put pressure on the neighboring teeth and cause their roots to start getting destroyed as well [10].

In the event of a jaw fracture, the wisdom teeth can act as weak spots and worsen the injury manifold.

Can impacted wisdom teeth be prevented?

The position in which the teeth are going to erupt and the size of the jaws is controlled through each person’s genetic makeup. This cannot be controlled and thus it is impossible to prevent impacted teeth from occurring.

Treatment of impacted wisdom teeth

The treatment of impacted wisdom teeth, whether symptomatic or asymptomatic is the same: Extraction. The removal of impacted wisdom teeth is done through a surgical approach [11]. It involves the cutting of some bone surrounding the tooth after which the wisdom tooth is most often removed in sections.

The surgery to remove the lower wisdom teeth is almost always more complicated than removing the upper wisdom teeth because of the density of the lower jaw bone.

The entire procedure is done under local anesthesia and is painless. All four wisdom teeth are routinely removed during the same appointment.

Recovery and precautions after wisdom tooth surgery

The healing process is expected to last for around 1-2 weeks after which any stitches placed will be removed. Some amount of pain and swelling can be expected after the surgery. The swelling is more in cases where the bone cutting required to be done is extensive [12].

Patients may also experience discomfort in talking, opening the mouth wide, or swallowing for a few days after the procedure has been completed.

It is very important to take the entire course of medication as prescribed by the dentist and to avoid any strenuous physical activity for a few days after the surgery.

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