Are you experiencing unbearable tooth ache including pain in jaw/ear/neck? -- This could be due to an erupting wisdom tooth!!

Know more about the symptoms, effects and managing this dental condition.

What is wisdom tooth -

It is a 3rd molar in oral cavity and present at the back most posterior in dental Arch. That makes it more difficult to be regularly cleaned & maintained.

The wisdom usually erupts at the age ranging from 16-25 , sometimes in late 30s as well .

The number of wisdom teeth varies from person to person. One usually has 4 of them but many people may have 3 , 2,1 & some also have none.

Often, there is not enough space in the arch( mouth) for the wisdom to erupt. That causes impaction or tooth eruption at an abnormal angle .

Picture showing wisdom tooth eruption 
X-ray showing wisdom eruption 

Effects of Wisdom Eruption at abnormal Angles - 

  • Tooth Ache :- As any other tooth wisdom also has it's own eruption force & makes way to come out. That may be associated with some symptoms like the following:- 

                 Jaw pain sometimes including ears too with headache & mild fever 

                 Limited mouth opening 

                 Cheek biting 

                 Radiant on & off pain usually comes & goes in 3-6 months interval 

  • Tooth Decay/ Loss :-  Wisdom eruption at abnormal angles may damage the adjacent healthy tooth ( 2nd Molar) .That may lead to severe decay & tooth loss if not treated at right time .
Picture showing how wisdom is damaging the next healthy tooth 
X-ray Showing wisdom damaging the next healthy tooth 
  • Infection:- When wisdom tooth partially erupts in oral cavity , its position & space availability may lead to a pocket formation between the wisdom tooth & gums. This makes a favorable place for food accumulation which further leads to infection .
  • Inflammation between wisdom tooth & Gum       
  • Risk of Cyst/Tumor :- Delaying the wisdom tooth treatment for longer duration may lead to infection spread deep into face & neck. In rare cases may lead to formation of cyst & Tumor. ( https://www.wjpps.com/Wjpps_controller/abstract_id/13316  - DENTIGEROUS CYST ENUCLEATION AND BONE GRAFTING - A CASE REPORT - Dr. Barkha Jain et.al .)
  • X-ray showing Cyst formation with wisdom tooth 
  • Management of impacted wisdom tooth:-

Impacted wisdom tooth has no functional role. The best way to manage  is removal  .

Due to the location & tight contacts, the wisdom tooth usually requires a complex surgical procedure to be performed by a Oral Surgeon .

Risk associated with wisdom tooth surgery 

It is a very common & regular dental procedure , usually a Dentist will suggest you to get it done under local anesthesia & it takes around 30 mins or more depending on the position of the wisdom tooth .  

Since most of the cases involve  surgical extraction of tooth, one might expect some or all of the following:- 

  • Pain & Discomfort
  • Swelling  
  • Jaw Stiffness 
  • Limited mouth opening 
  • Food Restrictions

These usually lasts not more than  7-10 days and usually all are manageable by medication .

Rare Risks- 

  • Dry Socket - Infection after the extraction that leads to a persistently painful tooth socket. One may observe slow healing & may need further treatment. Usually occurs in smokers. Your dentist will advise not to smoke until the Socket /Gum heals completely.
Dry socket causes sever pain & need further management 
  • Nerve Injury :-  This occurs if one's lower wisdom roots are very close to nerve , which may lead to Numbness, Tingling & altered sensation on lip , chin, tongue, gum & back tooth because of the proximity of the nerve supply to the wisdom. If this takes place it may last for months & rarely gets permanent . Your dentist will discuss with you if that is your case or not & will take decision accordingly.  
  • Proximity of nerve with wisdom  

Post Treatment Home Care - DOs & DONTs

Bite on cotton which has been placed after the procedure for atleast 30 mins to 1hr.

Do not spit after surgery. That may lead to bleeding.

No Hot ,Hard & Spicy food after the surgery for a day or two. Only Cold, Soft & Liquid diet.

Cold compression on the surgery side 

Warm salt water gargles after 24hrs of the surgery for atleast 4 times a day. This fastens healing.

Do not Brush upto first 8hrs after the Surgery.

Do not Touch the treated area with tongue or fingers. This may lead to infection & Swelling.

  • Cold Compression helps to reduce pain & Swelling                                                                                                         

Conclusion :-

Usually patient is not aware about the wisdom eruption, until it is not causing any trouble. It can be managed & detected in early stage during your regular dental check-up. If wisdom tooth is erupting straight & not causing any problem, your dentist will inform you but if it is erupting at an angle which might affect the adjacent tooth, an early detection may help to save the healthy one.

Dentist will require an Intra oral X-ray /OPG (full mouth X-ray) or CBCT in some cases according to wisdom position. 

All Cases differ from patient to patient & so does their management. Post treatment, most wisdom are managed well by Medication & Proper Home care whereas, some might need minor adjustment of gum & tooth.  

Wisdom tooth does not hurt itself but it potentially hurts its adjacent healthy tooth. So consult your dentist for any queries regarding this on your next visit .