Wisdom Teeth

What are wisdom teeth?

Wisdom teeth are the third molars in your mouth and are the last, most posteriorly placed permanent teeth to erupt. They typically erupt between 17 and 25 years of age but can also appear many years later.

Space for wisdom teeth to erupt can be limited compared to other teeth. They therefore often fail to erupt or erupt only partially, often due to impaction or the front second molars blocking their path. An impacted wisdom tooth is called asymptomatic if the patient does not experience signs of pain or discomfort associated with this tooth.

How could they create health problems?

Impacted wisdom teeth may be associated with pathological changes, such as swelling and ulceration of the gums around the wisdom teeth called pericoronitis. Chronic recurrent pericoronitis can cause mild episodes of recurrent infection and pain. If pericoronitis is left untreated, it can lead to damage to the roots of the second molars, dental decay or cavities, gum and bone disease around the second molars, or, in rare cases, cyst formation and tumours.

An impacted mandibular third molar is one of the most frequent causes of dental infection. Removal of the impacted tooth helps prevent facial space infection of the neck which can be potentially life-threatening.

When should people have them removed?

The decision to have wisdom teeth removed mainly depends on whether there are symptoms of pain, pathological conditions, or the presence of disease related to the wisdom teeth.

A more challenging management decision is how to treat an asymptomatic, disease-free wisdom tooth.

What does the procedure involve?

If your dentist recommends the removal of your wisdom teeth, an x-ray is first taken to determine its positioning and complexity. Before teeth removal, local anesthesia is applied to numb the surrounding areas. General anesthesia may also be an option for more complex procedures or increased comfort.

If the wisdom tooth is non-visible through the gum, a small incision is made into the gum. A small piece of the bone covering the tooth may also need to be removed. The tooth may possibly be cut into smaller parts to make it easier to remove through the opening.

Stitches may be used to seal the gum where incisions are made. Your dentist will inform you when to remove the stitches or how long it may take for dissolvable stitches to dissipate.

What are the risks of wisdom teeth removal?

Many individuals experience swelling in their mouth or cheeks after an operation or may not be able to fully open their mouth for the first few hours to days. Most individuals feel temporary pain after the procedure.

It is possible that nerves and blood vessels can be impacted or damaged during the procedure. This can cause bleeding and usually temporary numbness in the tongue or face. The risk varies with the extensiveness of the procedure.

It can take up to two weeks to recover from wisdom teeth removal. During the healing period, you should report any excess bleeding, severe pain, or any other unusual symptoms to your dentist immediately.

Compiled by the Oral and Maxillofacial Department of the Bangkok International Dental Hospital (BIDH).