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Wisdom Teeth

When wisdom teeth start to come through you may feel some pain or discomfort. The reason for this is because they begin to push against the teeth that are already there and thus may sometimes come through at an angle. Also there may not be enough room in your mouth for your wisdom teeth.

A visit to the dentist is advisable. An x-ray will be taken to find out if it is your wisdom teeth and how they are coming through. From the x-ray the dentist will make a judgement on whether to take them out or not. Sometimes, no treatment is required and the pain will ease. However, sometimes extraction is required but this can be done under sedation.

Why do we have wisdom teeth?

Adults can have a maximum of 32 teeth. The wisdom teeth or third molars are the last to come through, right at the back. They usually appear between the ages of 17 and 25. Although sometimes they appear many years later.

Nowadays people often have jaws that are too small for all 32 teeth – 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough room for the wisdom teeth to come through properly.

Do they always cause problems?

No. If there is enough room they will usually come through into a useful position and cause no more problems than any other tooth. Often there will be some slight discomfort as they come through, but this is only temporary and will disappear once the tooth is fully in position.

What is an impacted wisdom tooth?

If there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as ‘impacted’.

What problems should I be prepared for?

If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. Food particles and bacteria can collect under the gum edge, and it will be difficult to clean the area effectively. This is known as pericoronitis. This is a temporary problem that can be dealt with by using mouthwashes and special cleaning methods and possibly antibiotics. If the problem keeps coming back, it may be better to have the tooth removed.

What can I do to help myself?

A mouthwash of medium hot water with a teaspoonful of salt will help to reduce gum soreness and inflammation. (Check it is not too hot before using it.) Swish the salt water around the tooth, trying to get into the areas your toothbrush cannot reach. This should be done several times a day. An antibacterial mouthwash containing chlorhexidine can also reduce the inflammation. Pain-relieving tablets such as paracetamol or asprin can also be useful in the short term, but consult your dentist if the pain continues. These should always be swallowed and in no circumstances placed on the area.

But if it does not help?

If the pain does not go away or you find it difficult to open your mouth, you should see a dentist. They will be able to see the cause of the problem, and advise you accordingly. It may be useful to clean around the tooth very thoroughly, and an antibiotic may be prescribed.

Are x-rays needed?

The dentist will usually take x-rays to see the position of the root, and to assess whether there is room for the tooth to come through into a useful position.

What are the reasons for taking wisdom teeth out?

Far fewer wisdom teeth are now taken out than in the past. If the tooth is not causing problems, your dentist will not want to remove it.

They will only remove wisdom teeth:

  • when it is clear they will not be able to come through into a useful position because there is not enough room, and they are also causing pain and discomfort
  • If they have only partly come through and are decayed, such teeth will often decay as it will be difficult to clean them as thoroughly as your other teeth
  • If they are painful

Are wisdom teeth difficult to take out?

It all depends on the position and the shape of the roots. Your dentist will advise you as to how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often more straightforward to remove than lower ones, which are more likely to be impacted. Your dentist will advise you whether the tooth should be taken out at the dental practice, or whether you should be referred to a specialist (oral surgeon) at a hospital. Very occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth – your dentist will tell you if it is possible in your case.

Either local anaesthetic – as you would have for a filling – or sedation will probably be recommended. A general anaesthetic (where you would be asleep) can also be used, but this will only be given in a hospital.

Will it make any difference to my face or mouth?

Removing wisdom teeth may produce some swelling for a few days but as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the teeth are impacted.

What should I expect after a wisdom tooth is taken out?

The amount of discomfort will depend on how easy the removal of the tooth was. There is usually some swelling and discomfort afterwards, and it is important to follow any advice you get about mouthwashes etc, to help with the healing. Some people also find homeopathic remedies help to reduce discomfort. Usual pain-killers such as paracetamol, asprin or ibuprofen will usually deal with any pain. It is best to stay fairly quiet and relaxed and avoid smoking and drinking for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over – your dentist will probably want to see you again about a week later to check on the healing, and to remove any stitches.

What does it cost?

The cost of removal of wisdom teeth will vary according to the difficulty of the procedure and whether it is being carried out in a dental practice or hospital. It is always recommended that you get a written estimate before starting treatment.