Questions & Answers

What are wisdom teeth? Why we call them wisdom teeth?

A third molar tooth is named as the wisdom tooth. The third upper and the third lower molar situated at the very back of the oral cavity, are known as the wisdom teeth. They are termed as the wisdom teeth on the basis of their average eruption age in the mouth. Wisdom teeth has no connection with the individual’s wisdom or intelligence. The average age group in which the wisdom teeth normally erupts is between the late teens and the early twenties (ranging from 17 to 25 years). In addition to this, there is another reason regarding this age group due to which the third molars are named as wisdom teeth. The reason is the association of this particular age group with the growth and development of the learning and intelligence skills in the young individuals.

Why wisdom teeth are usually removed from the mouth?

The wisdom teeth or the third molars are located in a region where they commonly remain hidden inside the socket bones or the gums. The reason is the limited availability of the space and constant hindrance in the process of eruption. These molars are the most commonly impacted teeth followed by the second premolars and the upper lateral incisors. There are large number of individuals which usually lacks the wisdom teeth. On the other hand, there are cases in which wisdom teeth erupts within the limited spaced and small sized jaw bones. Such situations results in the tilting, drifting and rotation of the wisdom teeth. This condition, in addition to the wisdom teeth itself, also severely affects the other adjacent teeth, the jaw bone and the nerves passing near the roots and the crowns. Additionally, it also results in the spaces accumulation of the food debris which causes tooth decay, multiple mouth infections and diseases in the gums.

Why wisdom teeth erupt late in the mouth or become impacted?

The late eruption of the wisdom teeth is associated with the restricted growth of the jaw bone because the reduced jaw size is incapable of accommodating all the teeth in the oral cavity. As, the third molar or the wisdom teeth are positioned at the back end of the mouth so it do not find the proper space for eruption. As a result, its growth remains restrict in between the jaw bones and the gums. The wisdom teeth are comparatively large sized, so limited or no space does not allow its eruption.

What are the symptoms and signs associated with impacted wisdom teeth?

There are number of symptoms and problems which are associated with the third molars or wisdom teeth. There are:

  • Pericoronitis is a condition in which the growth of gum tissues may possibly be occur over the partially impacted tooth which causes hindrance in the usual eruption and the lodgment of the food debris in the respective area of swelling and the pain. It leads to the limited and painful opening of the mouth,
  • The eruption of the wisdom teeth may naturally be titled or crooked in the abnormal of wrong direction. It may also damages the tooth adjacent to it,
  • The stiffness or the pain may also be possibly caused in the region surrounding the respective impacted tooth,
  • The buccal tilting of the wisdom teeth may also cause the cheek bite, specially the upper ones,
  • Malocclusion and the crowding of the other teeth,
  • Can be resulted in the tooth decay of the adjacent second molar tooth.

Why is it necessary to remove wisdom teeth from the mouth in majority of cases?

The third molars or the wisdom teeth which are tilted, drifted and rotated abnormally causes the infections, food impaction, and the swelling in the gum tissues nearby these teeth. In this situation, it becomes difficult to clean the food debris from such narrow spaces and the pockets surrounded by the wisdom teeth. This problem causes the redness, swelling and the infection in the soft tissues, which results in the painful opening of mouth. In the severe conditions, the usual mouth rinsing and tooth brushing do not prove beneficial. The common outcomes are the infection, severe pain, fevers and the difficulty in the wide opening of the mouth. The difficulty in eating and talking occurs. Additionally, the performance of daily activities affects badly in this condition. To prevent the infection from further spreading, it becomes essential to remove these affected teeth. It may also require the exposure and the removal of the nearby gums and jaw bones. According to the American Dental Association, the in depth, comprehensive and the proper consultation concerning the condition of the wisdom teeth buds in the infants and the subjects ranging from the age of 16 to 19 years is recommended. The early removal of these are used as a preventive approach in order to save the further complications in the future.

Can I keep my wisdom teeth if these are harmless?

Yes. If the eruption of your wisdom teeth is totally normal with your respective jaw bones having the enough space then the removal of the wisdom teeth are not required. There is another possible situation in which the removal of the wisdom teeth is not required. If the wisdom teeth are suppressed down deeply inside the bone and the respective removal of them can possibly results in the loss of the healthy bone which can further cause danger of weakening and the fracture of the jaw bone.

Which problems can occur if impacted, partially eruped, tilted, drifted or rotated wisdom teeth are not removed?

There are multiple serious concerns present regarding this situation. These are:

  • The possible danger of discomfort, pain and the swelling of gums around the wisdom teeth,
  • The wide opening of mouth can be limited or reduced,
  • The consistent or repeated infection can be caused in the region behind the wisdom molars,
  • Cysts formation can also be resulted nearby the third molars,
  • Tumors,
  • Pericoronitis (the infection in the soft tissues surrounding the wisdom teeth),
  • The tilted wisdom teeth can also proves to the harmful for the adjacent teeth causing its decay (most commonly the second molars),
  • Stiffness can be caused around the impacted tooth,
  • The chances of cheek bite may increase in case of the tilting of upper wisdom teeth in the direction of the cheeks,
  • Crowding and the malocclusion of the other nearby teeth,
  • Bone loss can occur,
  • Results in the Inflamed gums,
  • Sinus problems can be caused,
  • The chances of jaw damage increased.

Is it safe to undergo wisdom tooth removal surgery?

The surgery regarding the removal of the wisdom tooth requires the services of an experienced oral surgeon. The complete and comprehensive evaluation and the examination is required before the surgery. It requires the use of the X rays, CT scan CBCT scan, which ensured the least chances of trauma, injury or any other damage. Normally, the recovery time period after the wisdom tooth removal surgery is about 7 to 10 days. In addition to this, it also depends upon the condition and severity level of the tooth impaction, the portion of tooth inside the jaw bone and the nearness of the tooth with the other adjacent tooth.

What complications can occur after wisdom tooth removal surgery?

There are number of possible complications that can occur after the surgical removal of the wisdom tooth. Most commonly occurring complications are as follows:

  • The discomfort and pain occurs,
  • Post-operative swelling can be caused,
  • Chances of fever,
  • Mouth opening can be restricted,
  • Prolonged bleeding can occur,
  • Healing cab be slow or delayed,
  • The chances of nausea and vomiting are present,
  • Nerve damage can be caused which leads to the loss of the sensations and can cause the numbness in the related area.

What should be done to promote speedy recovery after wisdom tooth surgery?

There are few important instructions which must be followed after the surgery of the wisdom tooth are as:

  • It is recommended to firmly bite down on the pack of gauze placed by the oral surgeon over the empty space of the third molar tooth socket for the time period of at least 30 minutes,
  • Ice cream must be taken soon after the removal of the gauze pack from the mouth,
  • Ice cream must be taken without peanuts, because the peanuts can be lodged and acts as the foreign body and can delay the healing of the wound,
  • The swelling chances can be reduced by placing the packs of ice over the concerned area for the first 24 hours,
  • Painkillers must be used as directed by the oral surgeon, as they prevent the pain and possible discomfort when the effect of the local anesthesia wears off,
  • Vigorous sneezing, coughing and spitting must be avoided,
  • Smoking must be prohibited after surgery,
  • Straw must not be used for drinking juices or the milkshakes. It avoids the dislodgment of blood clots,
  • The foods taken after surgery must be Soft, non-spicy and cold,
  • The physical movement or activities must be restricted,
  • Proper bed rest and complete care must be ensured for at least the period of one week,
  • The constant or repeated licking and touching of the empty tooth socket should be avoided,
  • Mouth rinsing should be done with the lukewarm saline water for at least 4 to 5 times a day after a day to flush out the food debris for preventing infection and ensure the soothing effect,
  • Oozing out of few blood drops for a few days can be considered normal. Do not panic in that particular condition.
  • If the bleeding remains persistent, firmly bite on a damp tea bag/cotton and visit your oral surgeon immediately,
  • Visit the oral surgeon for the removing of the silk sutures after one week, if advised.

How old do I need to be to undergo wisdom tooth surgery?

Usually, the eruption of the wisdom teeth occurs between the age group of 17 to 25 years. If it erupts normally inside the oral cavity, it may not require a surgical removal. If the wisdom teeth causes a threat to their adjacent second molars due to the presence of tilting or drifting in them, it is recommended to visit your oral surgeon regarding the wisdom tooth surgery. In addition to this, the wisdom teeth which are partially erupted and causing the spacing between the second molar and the third molar in which food debris lodgment can occur, are required to be removed in order to save the gum and avoid the alveolar bone disorder in the future. Taking all the future severe and adverse consequences under consideration, the removal of the wisdom tooth must be done as soon as possible. There are some countries in the world where the oral surgeons recommends the wisdom teeth buds removal surgery of the infants and toddlers to avoid all the future problems.

Do I need to undergo wisdom teeth removal surgery  if they are completely impacted within the bone?

It is recommended that, if any individual’s wisdom teeth or third molars are completely stuck and properly impacted inside the bones of the jaw then it will be healthy to leave these teeth inside the bone. In such cases, the surgical treatment for removing the full bony impaction can cause the serious and severe complications and the harm will be greater in comparison to the advantages. The reason is that the removal of wisdom tooth of this type through the surgery demands an excessive removal of the healthy and normal bone of the jaw, which in return can cause the weakening of the particular area surrounding the concerned tooth. The chances of jaw bone fractures is high in such conditions during the process of chewing, biting and the mastication in the future. The oral surgeons mostly recommends to avoid the removal of such teeth. Though, the regular routine dental checkups and the follow up will be important to avoid the serious future dental complications.

What will be the recovery time after surgical removal of wisdom teeth?

The time period of 7 to 10 days are considered as the normal recovery time of the surgery regarding the removal of the wisdom tooth. It also depends upon the seriousness of the tooth impaction, the part of the molar inside the bones of the jaw and the space between the respective molar and its adjacent tooth. Moreover, the pain, discomfort, swelling and the difficulty in the mouth opening will reduce or eliminates eventually in the time duration of maximum one to two weeks.

Is it normal for me to get anxious before my wisdom teeth surgery?

Yes. It is typical and perfectly usual for an individual to get nervous and anxious in anticipation to a surgery regarding your wisdom teeth removal. It is a proper surgical process which involves the use of local anesthesia and mostly the cutting of the jaw bone surrounding the tooth. Though, the selection of an expert oral surgeon is necessary. A good surgeon will explains all the procedural steps before the surgery to the patient before getting the consent. He/she will also deal with your anxiety issues and may possibly add some antidepressant to your medication before starting the surgery to make you comfortable. The anxiety reduction protocol is also a necessary and important part of the wisdom teeth extraction surgery.

How long should I take off from my work following wisdom teeth surgery?

The time duration of complete recovery or rest period after the wisdom teeth extraction surgery is not fixed. The resting period may changes depending upon the amount of the removed jaw bone and the degree of severity of the respective procedure. Usually, the healing time of socket ranges from 7 to 10 days. It is wisely recommended to at least take a week off from the work.

Is it necessary to get all 4 wisdom teeth removed?

The necessity regarding the extraction of your all the four wisdom teeth will be calculated and decided by your oral surgeon after examination. There are different cases regarding this question. There are cases in which all the four teeth will be extracted. Similarly, there are cases in which a surgeon advises on the extraction of wisdom teeth from merely one side of the mouth. In general case, whenever a wisdom tooth from upper side is extracted, the lower one of that side is also extracted. It avoids the over-eruption or the drifting problem and vice versa.

How much time will the whole surgical procedure take?

Usually, the time span of 30 to 60 minutes is required for the completion of the whole surgical process. Further more, it depends upon the seriousness and the degree of severity of the impaction, the angulations of the stuck teeth, the extent of the bone coverage and the amount and level of the infection surrounding the tooth. On the other hand, in some cases pericoronitis can cause the limited mouth opening and this in return can increase the time period of the surgery.

What is dry socket?

Dry socket is known as the condition occurs during the extraction of impacted teeth. It is a complication that can possibly occur during the process. It is also termed as the local alveolar osteitis whose development proceeds the absence or detachment of the clot from the healing extraction after the process of surgical removal of wisdom teeth. It results in the constant discomfort and dull pain after the time of 2 to 3 days of the surgery. It can be handled easily by the help of dressings and the socket cleaning using the normal saline.

Which are the most commonly impacted teeth in the oral cavity?

The following list shows the most commonly impacted teeth,

  • Mandibular third molars,
  • Maxillary third molars,
  • Maxillary canines,
  • Mandibular premolars,
  • Maxillary premolars,
  • Mandibular canines.

What are the different steps for the surgical management of impacted wisdom teeth?

The main important steps for the surgical management of the procedure are as follows:

  • The use of anesthesia,
  • Incision and the mucoperiosteal flap,
  • The process of removing the bone,
  • Removing the concerned tooth,
  • The debridement of the wound,
  • To control the post-operative bleeding,
  • Closing the wound or suturing,
  • The important post-operative instructions and the follow up.

How much does wisdom teeth removal cost, with or without insurance?

The cost of wisdom tooth removal surgery varies differently depending on the particular patient’s specifications. In normal circumstances, the average cost of a single wisdom tooth removal ranges from 75$ to 900$ generally in the US. For a simple wisdom tooth removal, the cost ranges between 75$ to 200$. Whereas, the impacted one may cost from 225$ to 600$. Some oral surgeons suggest to remove all the four wisdom teeth at once which costs about 300$ to 3000$. Such discount packages offered by few oral surgeons can save almost 1000$ or even more. In case of having the insurance facility, the maximum cost of the wisdom teeth extraction surgery can be covered depending on an individual’s benefits, deductible and the annual maximum. Normally, most of the good insurance companies in the US cover 15% to 50% of the total cost of the extraction surgery. Besides the expense of the surgery, there are also few additional associated costs with the surgery. Such as, there is a required panoramic X-ray prior to the surgery which costs about 60 to 150$. In some cases, the dental cone beam CT scans are also necessary and their cost ranges from 250$ to 600$. Post operative care expenditure is also included in the surgery cost.

When is the best time to remove wisdom teeth? 

It is recommended that the wisdom teeth must be removed before they cause any serious issues, such as inflammation or severe infection. Oral surgeons mostly suggest the removal of wisdom teeth between the ages of 14 to 18 years. The reason behind this is that in the individuals of this age group the roots formation of the wisdom teeth or third molars is not yet complete. So, the risk is less and healing is fast in this age. While in the older age, the third molars are completely formed which makes the bones hard and extraction becomes complicated and difficult. It also slows down the healing process.

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