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Wisdom Teeth

More than half the people of the world have suferred at some time because of wisdom teeth. But what are wisdom teeth, and why do wisdom teeth cause problems?
I shall try to explain about wisdom teeth in brief through these wisdom teeth faqs

Impacted wisdom teeth

Impacted Wisdom Teeth

What are wisdom teeth?
Wisdom teeth are the third molars. These teeth normally erupt between the ages 18-25. It is generally believed that we achieve wisdom at this age, hence the name wisdom teeth.

What are impacted wisdom teeth?
Wisdom teeth are the last teeth to erupt. The other erupted teeth occupy all the available space in the jaw bone, and so the wisdom teeth do not have enough space to come out completely. In such cases, the wisdom tooth does not come out through the gums at all; or in many cases only a small part of the tooth erupts and a major part of the tooth remains inside. Such an unerupted or partially erupted wisdom teeth are trapped in bone and are called “impacted wisdom teeth”

Why do impacted wisdom teeth cause problems?
When wisdom teeth are unerupted or partially erupted, there is a flap of gums above the tooth. There is a small space between the flap and the tooth. Every time you eat some food material gets inside this small space. So this space between the gum flap and the impacted wisdom tooth and the second molar becomes a fabulous resort with free lodgding and boarding for bacteria. The bacteria use this food material to cause decay of the wisdom tooth and/or the second molar tooth. They also cause the tooth-supporting bone between the second molar and wisdom tooth to get absorbed, leading to increased space  and more bacteria.  It is this bacteria which cause the wisdom teeth symptoms

What are the wisdom teeth symptoms?

  • Extreme pain and swelling of the gum flap above the impacted wisdom tooth. This swelling can spread and be visible on the face. This is known as ‘pericoronitis’ in medical language and has the potential to transform into a serious infection if not treated in time.
  • Severe pain due to decay of the wisdom tooth or the second molar.
  • Restriction of mouth opening
  • Headache, ear-ache

What complications can the wisdom teeth cause?

As discussed above, wisdom teeth can cause infection, swelling and pain.
There is another serious but a silent complication of impacted wisdom teeth: cyst. Cysts are something similar to a tumor, but whereas a tumor is solid, the cyst has a thin capsule and is filled with fluid. This cyst keeps on expanding painlessly without giving any symptom, and we have seen cases in which the cyst has expanded into half of the jaw. Eventually such a cyst will thin out the bone, and sometimes the bone fractures or there is an infection in the cyst. A cyst is something pathological and requires a surgery to remove it. Sometimes such a cyst can recur (re-occur) after surgery.

What is the treatment for wisdom teeth?

There are 2 treatments that can be done for wisdom teeth:

1) PCF removal surgery: We do this procedure if the tooth has erupted out of the bone, and is trapped only in soft tissue. In such a case the flap of gum tissue over the wisdom tooth is removed and the problem is solved. PCF surgery cannot be done in all cases of wisdom teeth. If the tooth is trapped in bone along with soft tissue, then removal of PCF alone is not adequate. The problem will recur.

2) Wisdom Tooth removal: We need to remove the wisdom tooth in most of the cases. The procedure of removal of the wisdom tooth is not similar to removal of other teeth. This is a surgical procedure which involves cutting of the soft tissue and removal of the bone. In many cases the tooth is cut into small pieces first and then removed piece-meal.

Is this a painful procedure?

No, we use different types of anesthesia methods depending on the type of case and the nature of the patient to make it a painless procedure. To know more details about the types of anesthesia used for dental surgery go to our other article:

Who are the wisdom teeth specialists?

All dentists are not equal. Some are general dentists and then there are the dental specialists. You must be aware that an MD doctor may be of different specialties such as physician or surgeon or gynecologist. Similarly there are 7 dental specialties. The dental specialists who are expert in taking care of wisdom teeth problems are ‘Oral and Maxillo-facial Surgeons’

Dr Madan’s final comments: My wife Dr Sonal Madan and I, Dr Gautam Madan are both ‘oral and maxillofacial surgeons’. We have devised special protocols to treat wisdom teeth. We use hi-tech method: a laser to do PCF removal surgery. The laser makes the procedure fast, simple and painless.

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