The Ultimate Wisdom Teeth Guide

Posted by NSOMS on Thursday, June 13, 2019

wisdom teeth

One of the most common teeth to cause dental issues, and known to induce nervousness and anxiety in a lot of adults - the wisdom tooth. It's the last of your 32 teeth to develop in your mouth, and with its late arrival comes many complications.

We've taken the time to put together a single source of information surrounding wisdom teeth, in the hopes of debunking some myths around them, clearing up any confusion or questions, and putting your mind at ease when it comes to extraction.

Contents

  1. All you need to know about wisdom teeth
  2. Signs you need your wisdom teeth removed
  3. Wisdom teeth complications
  4. Wisdom teeth pain or growing pains?
  5. Deciding between sedation, local or general anaesthetic
  6. Wisdom tooth aftercare tips

All you need to know about wisdom teeth

wisdom teeth xray

We’ve all heard of wisdom teeth - the deep rooted, large teeth in the back corners of your mouth that erupt later on in life than the rest of your teeth. For many people, the thought of wisdom teeth can induce anxiety and nervousness - but what do you really know about wisdom teeth?

What are wisdom teeth?

Sometimes referred to by dentists as ‘third molars’, people develop wisdom teeth on both sides of the upper and lower jaw. While some people have a set of four wisdom teeth, others have none at all. They’re the final set of teeth to emerge in a human’s life, and are subsequently named ‘wisdom teeth’ as you’re presumably wiser when they emerge!

Why do we have wisdom teeth?

Once necessary in human ancestors for grinding down a diet of roots, leaves, meat, and nuts, these flat molars are no longer required. Humans now cook and soften food, as well as cut and crush food with utensils, making wisdom teeth redundant.

Does everyone have wisdom teeth?

No! Some anthropologists believe that humans have evolved beyond needing wisdom teeth, and as a result some people never get any. However, genetics do cause most people to grow wisdom teeth when they become young adults.

Just because you can’t see all of your wisdom teeth doesn’t mean they’re not there. Sometimes wisdom teeth never erupt through the gums - a quick x-ray will show you whether or not your wisdom teeth are there.

How do I tell if my wisdom teeth are coming through?

While a pain in the back of the mouth can mean your wisdom teeth are coming through, this isn’t always the case. It can be difficult to differentiate between wisdom teeth causing the issue and another problem.

Some quick-fire signs that your wisdom teeth are on their way:

  • Pressure or throbbing in your gums
  • Swollen or visible cuts at the back of your mouth
  • Earaches, headaches or pressure in your sinuses

Signs it’s probably not your wisdom teeth:

  • Non-lingering sensitivity to sweet things, heat or cold - this could indicate an exposed root
  • A mild, sharp pain when you bite down
  • Visible hole in your tooth or staining

Want to know more? Check out our Wisdom Teeth Fact Sheet.

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Signs you need your wisdom teeth removed

If you’re experiencing pain and discomfort at the back of your mouth, you might be worried that your wisdom teeth could be the cause. This is a source of anxiety for many people, as the idea of having your wisdom teeth removed seems like a terrifying feat.

Here are some of the most common signs that it could, in fact, be your wisdom teeth at the source of your oral pain.

Inflamed Gums

When wisdom teeth emerge, they often grow sideways or at an angle, which can impact other teeth and cause friction in your mouth. Sometimes, as a result of impacted teeth, your gums will swell.

Wisdom teeth erupting through gum can result in food particles and debris becoming trapped under the gum. Left untreated, this buildup can cause pericoronitis, which is a hot-bed of bacteria that abscesses and causes a sack of fluid and pus.

Sinus Issues

Believe it or not, cold and sinus symptoms such as headaches, sinus aching and general stuffiness can be a sign that your wisdom teeth are coming through - not a bug!

As your wisdom teeth grow and develop, the roots can push against your sinuses that are located right about your teeth. If you’re experiencing pain and pressure, as well as cold symptoms, you could be experiencing wisdom teeth related issues rather than sinusitis.

Persistent Jaw Ache

As your new wisdom teeth come through, if your jaw isn’t big enough to accommodate them, you may feel an associated jaw ache. If you have an impacted tooth or infection, it’s also likely that your lymph nodes will be swollen, adding to the overall stiffness and pain felt in your jaw.

Damage to Adjacent Teeth

Often, dental surgeons opt to remove wisdom teeth from younger people's mouths before they completely come through and begin to cause problems. If you're a young adult or adult with a full set of teeth, you might start noticing changes in your mouth as your wisdom teeth come through.

These are just a few symptoms that may help you determine whether your wisdom teeth need to be removed or not. For more information, we’ve put together a blog on the matter which you can read here: 4 signs you need your wisdom tooth extracted.

As always, book an appointment with an oral surgeon for diagnosis and extraction.

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Wisdom teeth complications

There are many reasons why wisdom teeth have grown a reputation for being particularly problematic and require extraction more often than not. We’ve put together a quick list of some of the main issues experienced both before and after extraction.

Pre-surgery

  • Wisdom teeth partially emerged: this is a common problem with wisdom teeth - as they begin to emerge through the gum, often there are other teeth or bone that prevent them from fully erupting. This can wisdom tooth diagramcause flaps of gum tissue that can trap food residue and other bacteria. The result of this is pericoronitis, which is an infection causing painful and swollen gum tissue around the area of the affected tooth.
  • Impacted teeth: often wisdom teeth may become twisted, tilted or displaced as they try to emerge into a mouth that has no room to accommodate them. There are a few types of impacted teeth:
  • Mesioangular impaction: the tooth is angled towards the front of the mouth.
  • Distoangular impaction: the tooth is angled towards the back of the mouth.
  • Horizontal impaction: the tooth is angled sideways at a full 90 degrees, and it is growing into the roots of the molar next to it.







 

Post-surgery

  • Dry socket (alveolar osteitis): after your tooth is extracted, a blood clot forms to heal and protect the tooth site. If this blood clot dislodges, dissolves or doesn’t form at all, food particles and bacteria can get lodged in the gap. 
  • Paraesthesia: dental paraesthesia is a rare complication associated with wisdom tooth removal, where nerve trauma from a complex surgery can result in the onset of parasthesia. The change in sensation that’s noticed may be permanent, or partially resolved.

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Wisdom teeth pain or growing pains?

There are two kinds of pain that are commonly experienced when it comes to wisdom teeth, both of which can be difficult to distinguish from the other.

Growing pains

Wisdom teeth usually begin to erupt in young adults between the ages of 17 - 25, in both women and men. Most people grow a set of four wisdom teeth in total, and as each of these come through later in life, there are common pains lumped in with ‘growing up’.

Sometimes (if you’re lucky) wisdom teeth will erupt without any issues and little pain. However, more often than not, adult jaws are not large enough to accommodate four new, large teeth. As the tooth breaks the gum and the pressure of your new tooth pushes through, there are some normal aches and pains to be expected.

A bigger problem

Unfortunately, as your wisdom teeth are such latecomers in life, significant and persistent pain can mean there’s something wrong. If there’s not enough room in your mouth for your new teeth to grow, this can bring on a myriad of issues.

If a tooth is impacted (growing sideways and impacting with another tooth), this can cause swelling of the gums, jaw aches, fevers, and abscesses - all of which may indicate that you need to have your wisdom tooth surgically removed.

How long does a wisdom tooth take to grow?

Unfortunately, there’s no real measure of how long it will take your wisdom tooth to grow and begin to erupt in your mouth. The timelines can range from a few months, years - or in some cases, not at all!

Your oral surgeon will be able to advise the placement of your wisdom teeth through observing an x-ray.

For a full list of signs of common complications from impacted teeth, visit our blog on Wisdom Teeth Issues - Symptoms and Causes.

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Deciding between sedation, local or general anaesthetic

wisdom tooth anesthetic

Most people are familiar with the nervousness that comes hand in hand with a trip to the oral surgeon clinic. When it comes to wisdom teeth, in particular, this can cause severe anxiety in some patients. Most surgeons will tell you, the most common question they’re faced with is ‘will it hurt?’

Understanding your options for managing pain and choosing the best solution to suit your needs will put your mind at ease, and allow you to relax and have a positive experience.

There are three main types of sedatives and anaesthetics your surgeon may offer you, all of which are safe and carefully monitored during the process.

Local anaesthetic

This comes in the form of a numbing injection directly into the gum at the site of the tooth, similar to what you may have previously had for a filling. You’ll be completely conscious, but don’t worry - you’ll feel no pain at all. Most of the discomfort experienced when using a local anaesthetic is the feeling of foreign dental equipment in your mouth. It’s likely that your tongue and lips may remain numb for a few hours after anaesthetic.

Intravenous Sedation

When you’re sedated during oral surgery, you’ll be in a semi-conscious, sleep like state. You’ll still be able to respond to your surgeon, but it’s likely that your recollection of the surgery will be a little fuzzy. Typically, you’ll be administered an IV medication before the procedure that will help you feel relaxed and less nervous. Make sure to book yourself a ride home after your surgery as you’ll feel too drowsy to drive.

General anaesthetic

A general anaesthetic is the other end of the spectrum, where through a mixture of inhaled and intravenous medications you’ll be completely unconscious throughout your surgery. Your medication levels will be monitored throughout the procedure by the anaesthetist to ensure you remain unconscious, and when you come to consciousness after the surgery you won't remember anything.

Which option is best for me?

When deciding which option is best for you, make sure that your surgeon and yourself take into account levels of anxiety, the complexity of the surgery and the cost of the procedure.

As always, the best way to determine the option that is ideal for your extraction is to consult with your oral surgeon. However, for more information on what to consider when selecting your anaesthetic/sedative options, take a look at our blog on the topic: How to decide between sedation, local or general anaesthesia.

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Wisdom tooth aftercare

post op care

Many people focus heavily on their nervousness and the ins-and-outs of their wisdom tooth extraction procedure and completely overlook what happens afterward.

Making sure that you know what to do when you get home after surgery is essential in reducing the chance of unnecessary pain, swelling, bleeding and other complications.

How do I reduce pain?

Unfortunately, pain is to be expected after wisdom tooth extraction. Your mouth and gums will have experienced a significant amount of trauma, and pain goes hand in hand with this while you recover.

After surgery, your surgeon will prescribe you with pain relief to help you during recovery. Make sure to follow the pharmacist's instructions correctly.

The amount of pain experienced depends entirely on the severity of the tooth impaction and surgery, and it can take anywhere from two days to one week to recover.

How do I stop bleeding?

Immediately after surgery, a gauze pad will be placed over the surgical site to apply pressure and reduce bleeding.

When you get home, gently wipe away any excess blood from your mouth and avoid any excessive rinsing or exercise that may increase blood flow. The bleeding will naturally reduce as your gums heal.

How do I minimise swelling?

Often after wisdom tooth surgery, swelling extends to the mouth, cheeks, eyes, and face, especially if more than one tooth was removed.

There are a few things you can do to minimise swelling:

  • For the first 2-3 days, apply an ice pack to the swollen areas
  • If swelling persists, apply moist heat by using a wet flannel with warm water
  • Take the correct anti-inflammatory medication as prescribed by your oral surgeon

What can I eat?

The number one question oral surgeons are asked after surgery: what can I eat?

First and foremost, it’s important to stay hydrated post surgery to give your body the best chance at recovery. Drink lukewarm water, and avoid using straws (as the sucking motion can dislodge the clot and cause bleeding).

When it comes to post-surgery food, anything that could easily get lodged in the surgical site is a bad option. This could include; popcorn, nuts, and pasta, as any fragments could leave residue behind and cause infection.

Eating soft food is okay, such as soup, eggs, and mashed potato - it helps if you try to chew away from the site of surgery.

For more information on post-surgery care, visit our blog dedicated to the topic: What to do after Wisdom Tooth Extraction.

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Topics: Wisdom Teeth