Wisdom teeth (third molars) - are the last set of back teeth to emerge into the mouth. Some people have four (two top and two bottom) while other people have none. They usually emerge into the mouth at 18-25 years.

Things to know:

1. Why do I have Wisdom Teeth?

There are many theories as to why. What we know is that human diets and lifestyles have changed and so have the processes for making food. Diets are much easier to chew and have become softer. The human jaw appears to have become smaller with time. However, our genetics are still designed for the larger jaw with many jaws no longer have the room for wisdom teeth. 

Wisdom teeth often become impacted meaning that the wisdom teeth fail to emerge properly into the mouth rather become trapped with soft gum tissue, by another tooth or bone. This can lead to inflammation, infection or pathology to develop (cyst growth). 

2. When do wisdom teeth cause problems?

Wisdom teeth emerge into the mouth about the age of 18-25 years when most problems start to occur. 

Some of the common issues are:

1. Impaction - wisdom teeth become trapped within the jaw and fail to emerge into the mouth through bone or gum. The reason is not always clear and wisdom teeth can change direction sometimes over a 12 month period from a normal vertical pathway to horizontal. This can lead to bacteria tracking to the un-erupted tooth and leading to inflammation and infection (pain).

2. Crowding - wisdom teeth can cause crowding and misalignment of teeth. This is contentious. However, back teeth appear to tilt and/or over erupt mis-aligning to create space for wisdom teeth. This can lead to increased plaque accumulation and decay risk as well as periodontal pocketing that can contribute to gum disease around adjacent teeth. 

3. Discomfort - wisdom teeth that are impacted can allow food and bacteria to be trapped leading to inflammation and infection causing soreness on opening the jaw wide, facial swelling and in extreme situations narrowing of the airway. Should someone feel like they cannot open there jaw and/or have difficulty breathing, swallowing or eating then they should immediate see their nearest emergency department at local hospital as this can be deadly.

4. Infections - wisdom teeth are difficult to clean and debride. This leads to a build up of bacteria around the area causing gum disease with time and infections called periocronitis. 

5. Pathology - wisdom teeth that do not emerge normally into the mouth have a skin around the crown (top of tooth). This can develop into pathology in time and grow to cause a tumor/cyst to develop. 

6. Decay - wisdom teeth can be difficult to clean effectively. With plaque accumulation (bacteria) there is a higher risk of decay in the wisdom tooth or adjacent teeth that may be poorly positioned to the tooth leading to the potential need for more complex dental treatment or premature loss.

7. Damage to adjacent teeth - wisdom teeth can be impacted partially below the gum and can lead to food trapage with the tooth in front. This can lead to decay in adjacent teeth or autoimmune resorption. This can lead to premature loss of teeth. 

3. I have been told I have impacted wisdom teeth. What does impacted wisdom teeth mean?

Wisdom teeth can be impacted meaning trapped within the jaw, often causing it to fail to emerge into the mouth through bone or gum. The reason is not always clear and wisdom teeth can change direction sometimes over a 12 month period from a normal vertical pathway to horizontal. This can lead to bacteria tracking to the un-erupted tooth and leading to inflammation and infection (pain).

If you have been told that you need your wisdom teeth out, it is likely you need them out. We also encourage second opinions from a qualified dental practitioner.

4. Do I need my wisdom teeth out?

This is conversation you need to have with your dental health practitioner. If they are not familiar with this area of dentistry they will refer you to someone that can advise you. This may be another dentist or a specialist. In most cases one or more of your wisdom teeth may need removal. Sometimes early intervention is advised to limit development and growth of the wisdom tooth into important structures like nerves. We are always available to have a conversation with you or recommend someone that is qualified. 

5. What kind of recovery do I need if wisdom teeth are removed?

Wisdom teeth removal is different and more complicated than normal dental extractions. Wisdom tooth removal often require a surgical method involving lifting of gums, exposing of bone, bone removal and stitching of gums back down over the bone. This process produces a cascade of messaging systems of your body leading to inflammation and swelling and pain. The healing time for wisdom teeth are longer (up to a week) and stronger pain relief is usually required. We will inform you the appropriate recovery time but it should be around 4 days. So, you may need to ask your employer for some days off work. 

6. Can I have wisdom teeth removed while asleep?

We provide the option of being asleep for your wisdom teeth removal. We will advise you on whether your case can be done while awake but for more complicated cases we recommend removal under sedation whether Intravenous or general anesthesia. We provide both options to our patients. Please check out our Wisdom Teeth Removal Adelaide website for more information. 

7. I was told by my previous dentist I didn't need my wisdom teeth removed and now my dentist tells me I need them out.

Wisdom teeth that appear to emerge into your mouth can often change with a short period of time. So, normal vertical eruption of wisdom teeth can changed to impaction within a year. If your dentist thought that wisdom teeth are erupting normally this can change quickly especially with a developing jaw during your growth spurt. 

8. Is there optimal time for wisdom teeth removal?

Wisdom teeth start to emerge into the mouth at around 18 years. Sometimes, due to the proximity of the tooth to very important structures in your jaw such as nerves that provide sensation to your lower teeth, gum and lip, it may be suggested that early removal can limit potential disrupt to the nerve and altered nerve sensation including tingling, burning sensation and numbness. Further to this, there is a nerve which passes through the gum tissue on the tongue side of the lower wisdom teeth that provides sensation to the tongue (which may be a concern to those who work as chefs, wine tasters). From the literature, it appears that nerves heal less predictably the older a person gets. Hence, the risks of permanent nerve damage increases with age. 

9. What complications could I expect?

Wisdom teeth removal is by nature surgical and you should expect the normal process of healing with swelling, brusing, pain, discomfort and jaw and muscle soreness. 

The following complications are for your information, not to alarm you and are not exhaustive.

Altered or absence of sensation

Teeth may be close or touching nerves such as the inferior alveolar nerve. Sometimes on removing wisdom teeth, the nerve may be traumatized, bruised or impinged causing numbness, tingling, burning sensation and/or loss of feeling in teeth, gums, cheeks, lips, chin, tongue and around the upper or lower teeth. This may be temporary lasting several weeks, in some cases can be permanent.

Nerve damage causing pain

This is a rare situation but an injured nerve may not heal properly despite the surgery being performed successfully and nerve pain may persist or recur. The exact reason is not fully understood and the pain can be difficult to treat.

Fragments

Wisdom teeth removal may lead to bone and tooth root fragments being left in the gum/jaw. In a rare situation an upper tooth root fragment(s) may be dislodged into the sinus. If this occurs we will attempt to retrieve the fragment immediately. If this is not possible, you may need to undergo further treatment to retrieve the fragment. This may cause further discomfort and cost.

For further information on visit Wisdom Teeth Removal Adelaide

It is important to recognize that not everybody needs their wisdom teeth extracted. This needs to be assessed and we encouraged you to get a second opinion.*