Wisdom teeth and their importance in teeth anatomy have been a common discussion among dentists for quite some time now. While it is considered a dental milestone for many adults, for some, it can be a rather painful experience, requiring removal.
In this blog, we’ll answer common questions about wisdom teeth, including What are wisdom teeth exactly? Do you really need them to have a healthy oral function? Why do some people have trouble with them? Should they always be removed or extracted?
We have gathered expert insights from our panel of dentists at Invisalign Center to provide a detailed guide to wisdom teeth, function, location, anatomy, conditions affecting it, and removal procedure.
What Are Wisdom Teeth?
Wisdom teeth, also known as “third molars,” are the last teeth that grow and emerge, usually during our adult years. They are located in the very back of your mouth.
Wisdom teeth grow in two ways. One is where they form completely and properly, not causing any trouble. The second way, which is also problematic, is when it gets stuck in the gums or jawbone, limiting proper growth. This condition is known as “impacted wisdom teeth.”
When wisdom teeth don’t grow completely, it can result in infections, cavities, gum diseases, and other oral health issues.
People with impacted wisdom teeth can find it very uncomfortable and may also experience pain due to pressure from crowding, infection or gum inflammation (pericoronitis), tooth decay or cavities, cyst or tumor formation, jaw pain, and stiffness, headaches or referred pain, sinus pain. In these cases, dentists recommend and deem it necessary to extract wisdom teeth.
When understanding what are wisdom teeth, it is important to emphasize that not everyone has them. Some people can develop them as they grow, while some may not. That said, not having wisdom teeth is not a cause for concern.
Anatomy and Appearance
A wisdom tooth erupts and grows at the very back of your mouth, just behind the second molars. Those who have all four wisdom teeth will have one in each quadrant- upper left, lower left, upper right, and lower right.
The anatomy of a wisdom tooth looks similar to a molar. Generally, they have two or three roots, but some can have four, and its shape varies from person to person. These roots tend to fuse together, giving the combined appearance of one big, cone-shaped root. For some, these roots can curl or splay out in different directions.
Purpose and Function of Wisdom Teeth
If the wisdom teeth grow in the right position, they can provide solid support to the back of your mouth and preserve the structure of the bone in your jaw. However, not having them will not deprive you of these supportive benefits.
Generally, there is no special need for wisdom teeth. This is why many healthcare professionals consider them vestigial, which means they had a purpose or function at one point in time, but that purpose is no longer inherent. This conclusion is mainly based on the evolution of dietary habits and the need for wisdom teeth to grind food and assist with digestion.
Our ancestors' primary diet was based on raw plants, hard nuts, and tough meats. Wisdom teeth were essential to help grind this food for easy digestion. But today, with modern food, dietary patterns, preparations, and eating utensils, there is no real need for wisdom teeth.
As we got used to these dietary changes, our bodies adapted to meet and respond to our evolving needs. For example, our jaws became smaller. This is why many people don’t have enough room in their mouths for the wisdom teeth to grow.
Age of Growth
Wisdom teeth typically start to grow between the ages of 17 and 25.
When understanding the concept of wisdom teeth, it is important to remember that not everyone will be able to see full-grown wisdom teeth, as in the case of impacted wisdom teeth, which get stuck to the gum–failing to completely develop or emerge.
On average, 53% of the general population gets at least one wisdom tooth. This also means that some may not have it at all.
Do You Have Wisdom Teeth?
To know if you have wisdom teeth, get it checked by your dentist for proper diagnosis and treatment. Sometimes, they might ask you to take an X-ray to periodically evaluate the presence and alignment of the wisdom teeth.
Depending on the evaluation, your dentist may also refer you to an oral surgeon for further evaluation.
Based on the findings of the dental X-ray or advice from the surgeon, you may be recommended to have your wisdom teeth extracted before problems develop. This is to avoid the need for more painful and complicated extraction a few years later.
It is also important to note that extraction is relatively easier among young people who have just developed wisdom teeth, as they are not fully grown and the bone is less dense. On the other hand, the extraction process can be more complicated, and recovery may take longer for older adults.
First Signs of Wisdom Teeth Growth
There are a few signs and symptoms that could indicate the growth of wisdom teeth :
Redness or swelling in your gums behind your last molars.
Jaw pain or tenderness.
Pain in the face due to wisdom teeth putting pressure on nerves.
White flecks behind your last molars, which are likely the tops of your new/ wisdom teeth erupting through your gums.
If you feel you are experiencing the first signs of wisdom teeth development along with pain or discomfort, consult your dentist to get them checked.
Care and Management for Wisdom Teeth
If you have wisdom teeth, your dentist can conduct routine exams to make sure they are healthy and do not pose any problems in the future.
Another way to care for wisdom teeth is to practice general oral hygiene, like brushing two times a day. Also, ensure you are devoting enough time to thoroughly brush all sides of your teeth, especially those at the back that are hard to reach.
Flossing is also highly recommended to help wisdom teeth grow normally. You can use ordinary flosses or opt for dental picks or interproximal brushes (tiny brushes that fit between your teeth). Moreover, gargling an alcohol-free antibacterial mouthwash can help reduce your risk of dry mouth, which triggers wisdom tooth pain.
Conditions and Disorders That Affect Wisdom Teeth
Wisdom Tooth Pain
Discomfort caused by the eruption or impaction of wisdom teeth, often leading to swelling and sensitivity.
Infection
Bacterial infection around the wisdom tooth, typically due to gum irritation or trapped food, causes pain, swelling, and redness.
Cavities
Wisdom tooth decay often occurs due to difficulty cleaning the back molars, leading to holes, soft spots, or issues in the enamel that trigger pain.
Gum Disease
Inflammation or infection of the gums around the wisdom teeth often caused by plaque buildup, leading to bleeding, tenderness, and swelling.
Damage to Neighboring Teeth
When impacted wisdom teeth push against adjacent teeth, they can cause misalignment, damage, or even cavities in the neighboring teeth.
Cysts
Fluid-filled sacs that can form around an impacted wisdom tooth, potentially leading to bone damage, infection, or swelling.
Tumors
Rare, abnormal growths around impacted wisdom teeth, which can lead to discomfort, swelling, or even bone damage if left untreated.
Impacted Wisdom Teeth
This is one of the most common types of wisdom tooth complications where they don't have enough room to grow properly. In such conditions, they can get stuck beneath the gum line or grow at an angle, leading to many other issues.
Here are the most common types of impacted wisdom teeth:
1. Partial Impaction: The wisdom tooth partially erupts through the gum but is blocked by bone or soft tissue.
2. Full Impaction: The wisdom tooth is completely trapped beneath the gum line and does not emerge at all.
3. Angled Impaction: The wisdom tooth grows at an angle, either toward the neighboring teeth or the back of the mouth, which can cause pressure and damage.
Symptoms of Impacted Wisdom Teeth
Red or swollen gums.
Tender or bleeding gums.
Jaw pain.
Swelling around the jaw.
Bad breath.
An unpleasant taste in your mouth.
Have a hard time opening your mouth.
Impacted wisdom teeth can cause many problems in the mouth, such as damage to other teeth, cysts, wisdom tooth decay, and gum diseases.
Common Treatment for Wisdom Teeth Complications
When wisdom teeth develop any complex conditions or disorders, such as the situation of impacted wisdom teeth, removal is the most common treatment.
The approach and complexity of the procedure depend on the position and stage of wisdom teeth development. Rest assured, our dentists will give you an idea of what to expect from the treatment during the consultation and pre-extraction exam.
A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. Wisdom tooth decay, or one that is underneath the gums and embedded in the jawbone, can make extraction a little more difficult. Generally, in such a situation, the wisdom tooth is extracted in small sections to reduce the amount of bone that needs to be removed.
While wisdom teeth can be extracted at any age, many people choose to have them treated or removed in their late teens or early 20s to avoid complications.
Unlike other types of teeth, wisdom teeth are not essential to support biting or chewing. So, even if they are removed, they don’t need to be replaced. Book a consultation with our dentists for more personalized advice on the condition and treatment of your wisdom teeth.
Wisdom Teeth Removal Procedures
Advancements in technology and anesthesia have made wisdom teeth extraction a comfortable procedure. The complexity of the extraction will determine whether you need local or general anesthesia (sedation):
1. Pre-Procedure Evaluation
First, our dentists will conduct a thorough examination and request relevant X-rays to determine the position of the wisdom teeth. This includes checking for wisdom tooth decay, cavities, positioning, or any other underlying conditions.
2. Anesthesia Options
Before the extraction procedure, the teeth and the surrounding tissues will have to be numbed with local anesthesia. In addition to this, our dentists will also decide on a sedative to control anxiety. All these are tailored to your comfort and procedural demands.
3. Extraction Methods
The extraction method varies on the condition and position of wisdom teeth–forceps are generally used for fully erupted teeth and surgical options for impacted teeth, which may include bone removal and sectioning of the teeth.
Recovery After Wisdom Teeth Removal
First 24 Hours:
Use a moist gauze or tea bag for 45 minutes to control bleeding.
Avoid rinsing, spitting, straws, smoking, and hot liquids to prevent dry sockets.
Apply an ice pack or cold compress (10 minutes on, 20 minutes off) to reduce swelling.
Use over-the-counter pain relievers or prescribed medication as directed.
Stick to liquids or soft foods until numbness subsides.
Avoid alcohol if on narcotic pain medication.
Brush gently and avoid the extraction site.
Do not use mouthwash for 24 hours.
After 24 Hours:
Switch to a warm compress (20 minutes on, 20 minutes off). Swelling peaks in 2-3 days.
Gargle warm salt water after meals and before bed. Avoid commercial mouthwashes unless advised.
Check if stitches need removal or are self-dissolving. Follow your dentist's guidance.
Watch out for dry socket symptoms and consult your dentist as needed.
Note: Full healing may take weeks to months, but comfort improves significantly in 1-2 weeks.