Articles on wisdom teeth

Wisdom teeth- The Problems & Their Solutions

Dr. Prasanth Pillai, Dentist
What are impacted wisdom teeth?Wisdom teeth are molar teeth, which are the last to erupt into the mouth, usually after the age of 15 years, or even much later. They are four in number – one each situated in the four corners of the mouth, behind the second molar teeth and have no clearly defined shape or form unlike the other permanent teeth. They are often called wisdom teeth as they erupt at an age when the person is in the transition phase from childhood to adulthood. The remaining 28 teeth normally erupt into the oral cavity by the age of 13 years.Wisdom teeth are considered impacted when they are unable to erupt into their normal functional positions, mainly due to lack of space for their eruption. Approximately 20% of the population has impacted wisdom teeth. Less than 5% of the population has sufficient room to accommodate the wisdom teeth. Of the other permanent teeth in normal individuals, very few are found impacted except the canines.What are the causes for impaction of wisdom teeth?It has been found that during the process of evolution, the jaws are progressively becoming smaller in size and the braincase is expanding at the expense of the jaws. This is said to occur because with the passage of time, man is increasingly using his brain whereas the use of the jaws for chewing has been progressively on the decline, as the diet we are having has become refined and soft. Hence the chewing efficiency of the jaws is not put to full use. Masticatory force (force exerted while chewing) has been found to be contributory to jaw growth. Soft diet thus adversely affects jaw growth. An underdeveloped jaw will not be able to accommodate all 32 teeth. This reduces the space for the wisdom teeth, which erupt last, to erupt into place. Evolutionary trends also point to a gradual reduction in the number of teeth, though this may occur only over a considerable period of time.Another important factor, which predisposes to development of impacted wisdom teeth, is heredity. It has been found that parents who have impacted wisdom teeth are likely to pass on the trait to children. However, this may only be a very small part of the evolutionary design.Certain disease conditions such as rickets, endocrine dysfunction, anemia, achondroplasia, cleidocranial dysostosis, Treacher Collins syndrome etc. have also found to be associated with impacted teeth. Here, impactions of teeth other than that of the wisdom teeth are also found frequently.What are the problems associated with impacted wisdom teeth?Infection is the most common problem encountered associated with impacted teeth. It may range from a localized gum infection to acute, extensive, life-threatening infections involving the head and neck. Localized gum infections tend to recur intermittently when complete eruption of the tooth is not possible. Recurrent infections (which may be subacute and not painful for the patient) will frequently lead to gum disease and decay on adjacent teeth, which can ultimately result in the loss of these teeth in addition to the wisdom teeth.Sometimes wisdom teeth erupt in abnormal positions and angulations making them non-functional, as they are unable to contact their corresponding opposing wisdom teeth. In such situations, frequent cheek biting or tongue biting can result from the abnormal positioning causing injuries to the cheeks and tongue while chewing. Besides this, the unsupported upper wisdom tooth also starts over-erupting, lengthening out from the supporting gums, thereby leading to food trapping, decay and gum infections in the region.There are situations when the wisdom teeth do not erupt at all into the mouth. They lie buried within the gum tissue or bone. Often, patients do not experience problems in such situations. There are also instances where wisdom teeth are totally absent in certain individuals.What can happen if impacted wisdom teeth are not treated?Serious problems can develop from partially blocked teeth such as infection, which may turn life threatening and possible crowding of, and damage to adjacent teeth and bone. Another serious complication can develop when the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst causing an enlargement that hollows out the jaw and results in permanent damage to the adjacent teeth, jawbone and nerves. Left untreated, a tumor may develop from the walls of these cysts and a more complicated surgical procedure would be required for removal.Rare instances have been found when the impacted wisdom teeth remain asymptomatic without causing any problems. However, no prediction can be made as to when an impacted molar will cause trouble, but trouble will probably arise, and that too at inconvenient times. When it does, the circumstances can be much more painful and the teeth can be more complicated to treat. Here, the tooth cannot be removed until the infection or other complications have been treated. This means loss of more time and added expense along with some added risk. It's best to have impacted teeth removed before trouble begins.How are impacted wisdom teeth treated?X-rays of the wisdom teeth are made to help assess the positions, shapes and sizes of the crowns and roots, the surrounding bone and the nerve, which usually runs below the roots of the teeth. X-rays also help in identification of associated disease conditions such as cysts and tumors in relation to the teeth, apart from aiding in planning of the surgical procedure.In certain cases of impacted teeth, where there seems to be adequate space available for eruption, the dental surgeon may advise a pericoronal flap excision (removal of the gum tissue overlying the impacted tooth) and observation. In such cases, the tooth may erupt into place after the procedure. However, in many cases, infection of the overlying gum tissue has been found to recur. Here, there is no other choice other than the removal of the offending wisdom tooth.In light of the clinical experience that most impacted teeth will ultimately give rise to some type of problem or disease, it is generally felt that preventive removal of impacted third molars is indicated. Because complications are significantly reduced when the impacted tooth has no associated disease conditions, and because difficulty of removal increases with age, it is recommended that impacted teeth be removed early. It is best done as soon as it becomes apparent that there is insufficient space or that they are not positioned for normal eruption. Generally, this will occur somewhere between the ages of 16-18. At this age, the roots of the developing tooth are usually between one half to two thirds formed and the bone is less dense, which makes their removal easier and the post-operative recovery smoother. A young patient usually is also in optimal general health, which facilitates safe anesthesia and rapid, complete healing. In older patients, removal before complications develop is key to shorter recovery and shorter healing time, besides minimizing discomfort after surgery.Before the removal of the impacted wisdom tooth, the patient is normally put on a course of antibiotics and anti-inflammatory drugs to eliminate existing infection and inflammation in the area. The removal of an impacted tooth is normally a minor surgical operation, lasting 10 - 45 minutes. It often requires incision of the gum, cutting the tooth and probably some removal of bone too. The oral surgeon may provide anesthesia options of local anesthesia, intravenous sedation, or general anesthesia to make the procedure more relaxing for the patient. The surgical wound is often sutured with silk (non-absorbable) or with absorbable suture materials. Some surgeons advise extraction of the corresponding upper wisdom teeth also during the same sitting.When taken up under local anesthesia (LA), removal of impacted teeth is done on one side at a time. This allows a patient to chew on the other side, facilitates faster healing and recovery. In certain situations, impacted wisdom teeth on both sides are removed under general anesthesia (GA) as a single procedure. If the impacted teeth are very deeply situated, or if they have abnormal shapes and forms making the procedure difficult to undertake, GA may again be required for surgical removal. If the surgical procedure is found to be complex, then the dental surgeon may refer the patient to an oral and maxillofacial surgeon, who is trained in surgical treatment of such problems.After the surgery, the patient is asked to continue the antibiotics and anti-inflammatory drugs which should be meticulously taken by the patient without break in order to facilitate better wound healing without complications. The patient is given pressure packs to bite on over the surgical area and ice packs to be placed over the jaw, immediate post-operatively. The patient is advised to rinse the mouth with ice-cold water about half an hour after the procedure, after the gauze/cotton pressure dressings in the area are removed. After 12 hours have elapsed, the patient may start having warm foodstuffs. However, it would be ideal if the patient has semi-solid or liquid food (yogurt, eggs, fruit juice, milkshakes, protein supplements etc.) for about a day or two after the surgery, after which he/she may have normal food, without disturbing the surgical area. The patient should also abstain from smoking and drinking during the post-surgical phase, to facilitate better healing and to avoid complications. The patient may also rinse the mouth with luke-warm saline twice or thrice a day after the 24-hour period.

Words of Wisdom About 'Wisdom Teeth'

Dr. (Maj) Varun Nischal, Dentist
Wisdom teeth or Third Molars are the last teeth to erupt in the oral cavity and probably the ones which cause the most discomfort. The normal age for eruption of wisdom teeth is 18-25 years. If they don't fully erupt within this time period, there are a lot of chances that they are never gonna fully come out. With passing years, evolution and change in our dietary habits, the size of our jaws has decreased, hence they are unable to accommodate the third molars. As a result, the third molars often erupt partially, tilted, rotated or do not erupt at all (stay impacted). But this doesn't mean that unerupted teeth do not cause any problems. Impacted wisdom teeth often lead to caries and infection in adjacent second molars and disturb the occlusion (relation of upper and lower teeth). On the other hand, partially erupted third molars cause recurrent episodes of PERICORONITIS causing pain which also radiates to ear and head, infection because of improper cleaning and food accumulation around swollen gums, bad breath, caries and swelling in the jaw.If you're suffering from these symptoms, consult your dentist immediately who can then decide whether to remove it or not. Rinsing your mouth with warm salt water or beta-dine solution also helps.The ultimate solution is to get these teeth extracted in time to avoid all these long term complications. Removal of impacted or partially erupted wisdom teeth does not have any effect on our chewing. It avoids unnecessary problem to adjacent teeth. It's a chair side minor surgical procedure performed under local anesthesia with no dire side effects.So spare yourself the pain and act WISELY! 

Myths and Facts About Wisdom Tooth

Dr. Vijita Mehta, Dentist
Myth 1: Wisdom teeth must always be removed.  Fact: Wisdom teeth don’t always cause trouble when they do show up. In fact, there may not even be a need for extraction if they are healthy and properly aligned. However, wisdom teeth often pose complications such as partial eruption then they only partially break through the gums. This allows bacteria to form around the tooth and result in pain, jaw stiffness, swelling, and other dangerous complications.Myth 2: We get our wisdom teeth when our other adult teeth come in. Fact: Wisdom teeth don’t come in until age 17-25, which is commonly known as the “age of wisdom”.  But that’s only if they come out at all. About 35% of us never get wisdom teeth!Myth 3: Ice cream and milkshakes are great after an extraction. Fact: The fact that they’re soft makes it easy to ingest and the fact they’re cold helps soothe the pain and the swelling. However, it’s important not to use a straw because suction can dislodge the clots resulting from the surgery.Myth 4: It is best to remove wisdom teeth before starting orthodontic treatment. Fact: This varies from case to case. While there is some concern that wisdom teeth may cause the other teeth to move, thus hindering the effects of the treatment.Myth 5: You can tell if you have wisdom teeth. Fact: Not being able to see your wisdom teeth does not mean they’re not there. That’s because wisdom teeth can be enclosed within the soft tissue or the jawbone. Therefore, an x-ray must be taken   to reveal any hidden teeth, as well as any potential problems with their growth.

The Problematic Wisdom Tooth

Dr. Pranay, Dentist
Let's get down to see some of the common facts and myths associated with the wisdom teeth...Myth: You increase the risk of disease if you wait to have them removedThey are way back there in the mouth. You can’t clean them as easily.  Of course they are going to become infected and be a breeding ground for disease throughout the mouth, right?Myth: Everyone has wisdom teethSurprisingly not everyone actually has wisdom teeth. In fact, some people have them beneath the gums that never erupt. Some people have one or two and some people don’t have any at all. All of these scenarios are perfectly acceptable unless you have symptoms indicating something is wrong.Myth: Everyone needs their wisdom teeth removedThis is probably the greatest myth of all. Not everyone needs these teeth removed. They are only extracted when they are impacted or causing other issues. If the teeth are not erupting in the proper position and putting pressure on the existing back teeth or in some cases causing infection or cysts your dentist will advise they be removed.Myth: Smoking and drinking don’t really cause harm following extractionsYou will be told you cannot smoke or drink alcohol following the procedure. Many people believe this is just a precaution mentioned by dentists. However if you smoke or drink alcohol following extractions you are opening yourself up for a whole world of hurt. Following the extractions it is important that the clots that form at the site of the extractions stay intact. If they are not allowed to heal properly and become dislodged, you will form a very painful infection called dry sockets. Smoking and drinking alcohol raise the chances of you getting dry sockets substantially so this is definitely not a myth.Well that's all for today for the fascinating wisdom teeth but hear the good news too as we are anticipating that as a process of we humans going through a phase of evolution, we might even start seeing extinction of wisdom in few decades.

Top 10 Reasons Wisdom Teeth Need to Go!!!

Dr. Bala Vignesh, Dentist
3rd Molar ImpactionLet’s be wise about wisdom teeth. You can wait for a possible problem, or have them removed as a precaution.Dentists are committed to helping their patients keep their teeth for a lifetime. At times, however, an extraction is deemed the best course of treatment. Some people are born without wisdom teeth, some people have enough space in their mouth to accommodate wisdom teeth, but some people end up getting their wisdom teeth removed as a precaution. Then there are the majority of people who wait until they’re in pain before seeing their dentist. There are several factors that dentists take into account before recommending treatment, and all depend on the severity of the case.Impacted Wisdom TeethWisdom teeth are often impacted, meaning that they’re not able to fully erupt through the gum line due to limited space. If you’ve had braces or Invisalign prior to your wisdom teeth coming in, this could ruin your straight teeth by pushing your bottom and top rows of teeth forward, causing overcrowding, crooked teeth and bite problems (and additional future work to re-straighten).Overcrowding can ruin a healthy smile because teeth that are too close together can become breeding grounds for plaque and bacteria. Crooked and crowded teeth are more difficult to clean when you brush and floss your teeth, allowing trapped food to remain in place. Built-up bacteria might not be removed until you have a professional cleaning, allowing plenty of time for tartar to form, increasing the chances of tooth decay and gum disease.Gum Disease or Tooth DecayWisdom teeth are some of the most difficult teeth to clean, simply because of their location in the back of your mouth, making it more complicated to reach with your toothbrush and floss. They’re also difficult to clean if they don’t actually erupt through the gum line, and their suspended state can lead to gingivitis, or the beginning phase of gum disease.Gingivitis is a swelling of the gums caused by the buildup of plaque around the gum line. Without proper care and maintenance, your gums will eventually recede, you may lose bone density in your jaw, and your teeth might need to be extracted. Gum disease can spread and lead to tooth decay and increase the potential need for extractions.If your wisdom teeth are impacted, they could irritate the surrounding gums and cause painful cysts. These cysts need to be treated by your dentist as they can hollow out your jaw and damage nerves. Due to the high possibility of infection, irritation and pain, many people choose to get their wisdom teeth removed before any of these problems arise.They can also cause headaches or migraines, in addition to jaw or facial pain, and make it harder for you to chew.Studies show that wisdom teeth will cause complications over your lifetime, and although they may not be causing symptoms that you feel or aware of, there could be issues going on under the surface that are problematic. If you’re not sure about the status of your wisdom teeth, or just want more information, make an appointment to see your general dentist and oral and maxillofacial surgeon. Getting your wisdom teeth removed is a personal decision and your dentist will take a look at your X-rays and work with you to ensure a happy, healthy smile.KEEP SMILING!!!

Impaction of Wisdom Teeth

Dr. Rajat Sachdeva, Dentist
Impaction of Wisdom TeethThe third molars also known as wisdom teeth are the last tooth in an adult (17-25) to erupt. When a wisdom tooth is not able to erupt due to lack of space in the jaw is called an ‘Impacted tooth’.’Why Wisdom Tooth Is a ProblemDue to evolution the jaw side is decreasing so the wisdom tooth may emerge partially as tilted or trapped half into bone and half outside out of gums. Sometimes they pose a problem when they push the adjacent molars causing pain and damage to them. Sometimes these areas are very difficult to clean because of their location. There are incidences when the wisdom tooth does not erupt at all get trapped in a sac within the jawbone filled with fluids that may cause damage to the nerves of adjacent teeth.How do I know if my wisdom teeth are impacted?Difficulty in opening your jawSwelling or Pain in the gums or jaw boneHeadacheSwollen lymph nodes in the neck areaBad breathPain while chewing or bitingA bad taste in the mouthTruth about the Wisdom ToothPain caused by the wisdom tooth is extreme, agonizing in nature. Most people have suffered the agony of wisdom teeth. Here are some Myths and facts regarding eruption of wisdom teeth.  Who are they? Our wisdom teeth are our last or “third molars”.Why called wisdom teeth?  The teeth generally erupt at the age of 18-25 years when a person is considered when a person is wiser than when they were younger. Why Do they Cause Problems? Our ancestors had a jaw of a bigger size to accommodate all four sets of three molars. They used these molars to chew and grind the food. Now in today’s time, the human jaw is no longer large enough, to give wisdom teeth the space to erupt in the mouth. It causes some difficulties like food impaction between partially erupted third molar and gum causing infection and inflammation of that area, bad breath, of caries of wisdom tooth or decay and damage to the neighbouring teeth.Should The Wisdom Tooth To Be Removed? More than 60% of wisdom teeth extractions are not actually advised. When they are partially of fully erupted causing problems to the gums, adjacent teeth, jaw bone and nerve only then they need to be removed. When should the wisdom tooth be removed?Some dentists advise to remove the wisdom tooth before they start to cause problems. As in the younger individuals, the teeth are not developed completely; it’s easier to get the extraction of the wisdom tooth. When older people are concerned, the recovery time after the extraction and the healing may take a little longer.   Better to remove wisdom teeth before orthodontic treatment? When the third molars erupt after an orthodontic treatment, it teeth may cause other teeth to move, but it is not that common. Is it very painful to undergo wisdom tooth extraction? It’s not true every time. It is mostly painless in many cases and it sometimes depends on the position of the tooth in jaw. The only concern is the post extraction pain and swelling and discomfort for which you are advised to take the medications by your dentist.#Healthy Teeth#Restorative #Dentistry#Dental Implant#Human #Tooth   

Truth About Wisdom Tooth

Dr. Revath Vyas Devulapalli, Dentist
MYTHS AND FACTS ABOUT WISDOM TOOTHWhen people talk about excruciating pain from natural causes, probably top of the list would be child birth. Depending on the person and their medical history, passing a kidney stone, suffering from an intense migraine, or severe back pain may also make it into their personal top three. Another cause of extreme pain however, which many of us are unfortunately able to relate to, is the agonizing toothache associated with wisdom teeth problem. If you’ve never suffered the agony of wisdom teeth, you may be one of the evolutionary lucky ones. Let us see various Myths and facts regarding this wisdom teethWhat are our wisdom teeth?Our wisdom teeth are our “third molars” Why are they called wisdom teeth? As the teeth don’t emerge until a person is in their late teens/early twenties, they appear at a time (18-25 years) when a person is wiser than when they were younger.Why Do they Cause Us Problems?Our human ancestors had four sets of three molars. This gave us a total of 12 ‘grinding teeth’ – six in the upper jaw and six in the lower jaw. We used these molars to help chew and grind food. We humans underwent a period in which our brains greatly expanded in size. This created an architectural problem; with a much larger brain case, the jaw had to become narrower so that it could still connect to the lower part of the skull.  And over the course of thousands of years, this has led to a mismatch. Today the human jaw is no longer large enough, in many cases, to give wisdom teeth room to erupt through the gums and sit properly in the mouth. This resulted in several problems like food impaction between partially erupted third molar and gum covering the tooth, resulting in infection and inflammation of that area, halitosis/ bad breath, decay of third molars and some times even decay or resorption of second molars. Because of insufficient space, it may also cause incisal crowding. Upper third molar malposition has also its role in temporo mandibular disorders.Do Wisdom teeth must always be removed?More that 60% of wisdom teeth removals are not needed. Wisdom teeth only need to be removed if they are fully or partially impacted under the gum, or if they will cause damage to surrounding teeth, jawbone or nerves.Is it better to remove wisdom teeth when you’re young?Many dentists recommend having wisdom teeth removed before they begin to cause problems. Removal is easier in younger people because the roots of the teeth are not fully developed and the bone is less dense. For older people, recovery time and healing may take longer.Is it better to remove wisdom teeth before orthodontic work?The eruption of wisdom teeth may cause other teeth to move, but some studies show this is rare.Is it very painful to undergo wisdom tooth extraction?Not always. Most of the cases, the procedure will be painless. But you may have post operative pain, discomfort and swelling, which subsides by using medication.

Wisdom Teeth Removal: Not a Painful Process

Dr. Shikha Goel, Dentist
Wisdom teeth normally erupt between the age of 18 to 24 years, time at which we are supposed to acquire wisdom, hence the name wisdom teeth. Only a few lucky people have their wisdom teeth erupted in place and most of others requires extraction. Wisdom teeth or third molars usually don’t find enough space in our jaw bones to erupt normally and thus are impacted in jaw bones.So thus all wisdom teeth needs extraction, absolutely not. We follow a basic rule if it is not hurting you and no significant radiological sign of complication is visible, we do not extract it.Wisdom teeth needs extraction in following conditions:Caries It is difficult to keep hygiene in area of wisdom teeth so a cavity may develop in top part of tooth and progresses fast enough to cause pain associated with swelling and redness of gums. A wisdom tooth by virtue of its malposition may impinge on normal healthy tooth and cause cavity in that normal tooth. Such cavities are usually not accessible unless wisdom tooth is extracted. A cyst may develop along with infection in wisdom teeth. If this cyst continues to grow it may damage bone, other teeth and cause serious complications.Removal of wisdom teeth is a small surgical procedure and a well-trained oral surgeon can accomplish it in 15-20minutes. If post-operative instructions are followed and medications are taken on time most of them can resume routine activities very next day. Infection in adjacent toothA wisdom tooth by virtue of its mal-position may impinge on normal healthy tooth and cause cavity in that normal tooth. Such cavities are usually not accessible unless wisdom tooth is extracted.CystA cyst may develop along with infection in wisdom teeth. If this cyst continues to grow it may damage bone,other teeth and cause serious complications.Most of people ask can I go to office tomorrow after extraction!Removal of wisdom teeth is a small surgical procedure and a well-trained oral surgeon can accomplish it in 15-20minutes. If post-operative instructions are followed and medications are taken on time most of them can resume routine activities very next day.

Happy Teeth or Snappy Teeth: A List of Best & Worst Foods for Your Teeth

Dr. Ragini Parmar, Dentist
The world is full of these incredible deliciously mouthwatering foods, don’t you agree? Some are good for your mouth and some are terrible for oral hygiene. Let’s have a closer look at what makes your teeth happy and what makes them snappy.GOOD FOODS!Foods good for your mouth help prevent tooth decay and work towards destroying plaque buildup.Dairy ProductsMilk and other dairy products contain calcium and phosphates. Consumption of dairy products makes teeth stronger. Cheese is a saliva maker as well, which is important because saliva helps reduce the effect of acids and harmful enzymes.Fruits and VegetablesFruits and vegetables that are rich in fiber are also good for the mouth. They get saliva flowing and act as a detergent in the mouth, cleaning out unwanted bacteria. They are the best home remedy for prevention of tooth decay and cavities.Sugarless Chewing GumGum is a saliva maker and helps remove leftover food particles in the mouth. The lack of sugar in the gum is simply an added advantage for prevention of cavities. Also the chewing action helps develop facial muscles. This creates a good jaw line and tones the face helping get rid of double chins. Lots of actors use this trick to enhance their facial features. However, one must practice caution as too much gum is not the healthiest option.TeaGreen tea and black tea contain polyphenols, which are an organic chemical and considered as micronutrients in our diet. These destroy plaque and bacteria, and hence are an asset in the mouth. However, watch the quantity, as too much tea could stain your teeth too.Fluoride FoodsAny kind of food with fluoride helps your teeth. Dehydrated soups, powdered juices, powdered cereals, commercially prepared poultry products and even sea food - all contain fluoride.BAD FOODS!Foods bad for the teeth are easy to spot as they encourage tooth decay and plaque buildup.Carbonated DrinksOther than the obvious high sugar content carbonated drinks contain phosphoric and citric acid both of which wear down tooth enamel.Dry Mouth FoodsAlcohol dries out the mouth which means there is less saliva and hence a weaker fight against bacteria. Some medicines dry the mouth too. A fluoride rinse for your mouth will help.StarchFoods that have high starch composition like tapioca,potato chips or soft breads are to be avoided as they get lodged between the tiny gaps in teeth and are hard to take out.SweetsWhen opting for sweets, go for those that don’t stick to your teeth and are easy to wash off. You can opt for cacao, which has proven to have some health benefits.Choosing the right kinds of food is important as it helps promote oral health. You should choose food that encourage production of saliva, as saliva keeps the teeth moist. So be careful what you eat, because everything you put in your mouth has numerous consequences. Each time you are up in the middle of the night and find yourself starving be mindful and choose the food that offers you a health benefit.