Maxillofacial surgery

What Is a Wisdom Tooth?

The wisdom tooth is the last tooth in each row of teeth. It is called the “wisdom tooth” or “third molar” because it typically begins to emerge around the age of 16, coinciding with the onset of adulthood.

Wisdom teeth come in various shapes, crowns, roots, and positions. Some have a single root, while others may have up to four roots. Some wisdom teeth are fully erupted, while others remain impacted.

In some cases, the wisdom tooth may be closely associated or entangled with the main nerve in the lower jaw, making its extraction a challenging procedure that requires extreme caution and expertise.

Is It Always Necessary to Remove Wisdom Teeth? And Why?

In most cases, wisdom teeth need to be removed because there is insufficient space in the jaw to accommodate them. As a result, they may exert pressure on adjacent teeth while attempting to erupt through the gums, or they may remain impacted within the jawbone.

If the wisdom tooth emerges fully and in the correct position, the patient does not need to have it removed. However, if it emerges crooked or causes pressure on neighboring teeth, it should be extracted immediately.

Are There Risks of Not Removing an Impacted Wisdom Tooth?

An impacted wisdom tooth can cause erosion of the roots of adjacent teeth, leading to severe pain in the area and significant, irreversible damage. It may also lead to the formation of a cyst within the jawbone.

In cases of partially impacted wisdom teeth, they can cause inflammation of the overlying gums due to repeated biting on the area. Additionally, they create a deep environment where food gets trapped, promoting the growth of harmful bacteria in that region.

What Are the Problems Associated with Wisdom Teeth?

Problems with wisdom teeth typically begin to appear between the ages of 15 and 25, while individuals over 30 years old rarely experience issues that require wisdom tooth extraction.

Some of the most common problems associated with wisdom teeth include:

• Lack of Space: The wisdom tooth may only partially emerge from the gums due to insufficient space, leading to the growth of gum tissue around it and increasing the risk of gum inflammation.
• Improper Alignment: Sometimes, the wisdom tooth may grow in the wrong direction or at an improper angle.
• Small Jaw Size: Some people have a smaller jaw, which limits the space available for the wisdom tooth to emerge, causing it to become impacted and unable to break through the gums.
• Emerging at the Back of the Mouth: The wisdom tooth may emerge at the very back of the mouth, making it difficult to access and clean properly.
• Cyst Formation: Cysts may develop around the wisdom tooth, causing damage to the surrounding bones and roots.

What Are the Symptoms of Wisdom Tooth Problems?

You may notice the following symptoms if you have issues with your wisdom teeth:

• Severe pain or stiffness in the jaw around the area where the wisdom tooth is emerging.
• Irritation and pain due to the wisdom tooth growing in the wrong direction.
• Swelling and inflammation caused by gum tissue growing around the wisdom tooth.
• Crowding of teeth due to insufficient space for the wisdom tooth to emerge.
• Tooth decay and gum inflammation if the wisdom tooth emerges at the back of the mouth, making it difficult to clean.

Does It Require Surgical Extraction or a Difficult Extraction?

This decision depends on the degree of eruption of the wisdom tooth. If the tooth is fully grown, fully erupted, and in its natural position, extraction may be required for other reasons, such as decay, nerve inflammation, or gum infection. In such cases, the extraction is straightforward.

However, if the wisdom tooth is impacted or misaligned, the dentist may perform oral and maxillofacial surgery. This involves making a small incision in the gum to access and remove the tooth easily. In some cases, the tooth may need to be sectioned using a dental drill to divide it into smaller parts for easier removal.

What Problems Might Occur After Wisdom Tooth Extraction?

There are general surgical complications that may occur after any surgical procedure, such as:

• Pain: Moderate pain that lasts for about 24 hours and can be easily managed with painkillers.
• Bleeding: Bleeding that may continue for 2 to 3 hours after extraction.
• Bacterial Infection: An infection at the extraction site, which can be treated with antibiotics.

There are also specific complications related to wisdom tooth extraction, though these are rare. These include:

• Nerve Damage: Damage to the jaw nerve, which may cause numbness in the patient’s tongue or lips.

Does Everyone Have Wisdom Teeth?

More than 10% of the world’s population does not develop wisdom teeth, while the rest have at least one wisdom tooth.

How Many Wisdom Teeth Are There?

The wisdom tooth is the last tooth in each row of teeth, also known as the third molar. Normally, individuals have 4 wisdom teeth, one in each quadrant of the mouth, numbered 1, 16, 17, and 32 according to the U.S. numbering system.

However, more than 10% of people have fewer than four wisdom teeth.

What Are Canines?

The four canines are the sharpest teeth and are primarily used for tearing food. Primary canines appear between 16 and 20 months, with the upper canines emerging just before the lower canines. In permanent teeth, this order is reversed. The lower canines appear around 9 years of age, while the upper canines emerge around 11 to 12 years of age. Canines are located at the corners of the incisors and have the longest single root of any tooth, with a single cusp.

It is important to note that the gum tissue around the canines is prone to erosion due to their position in the mouth. It has been observed that the mandibular canines and lower incisors are the most common sites for gum recession. Canines also receive more pressure during brushing because they are said to protrude on either side of the incisors.

What Are Impacted Canines?

Canines, especially the upper jaw canines, play a crucial role in your mouth. They are essential for biting and tearing food, as well as guiding your jaw into proper alignment. Impacted canines are those that cannot grow properly. The upper jaw canine is the second most commonly impacted tooth after wisdom teeth.

When wisdom teeth (third molars) are impacted, the most common solution is extraction, which often improves oral health.

What Are the Causes of Impacted Canines?

There are several different reasons why your canines may become impacted:

Crowding:

When your front teeth are crowded, often due to misalignment, there may not be enough space for your canines to emerge.

Extra Teeth:

Any extra teeth can block your canines, preventing them from erupting.

Overgrown Gums:

Although rare, overgrown gums can prevent the canines from emerging.

What Is the Problem with an Impacted Canine?

The canine may fail to emerge into the mouth and remain embedded in the upper or lower jawbone. This can affect the appearance of the teeth and may lead to the formation of a cyst or damage to adjacent teeth.

What Is the Treatment for Impacted Canines?

The optimal treatment for impacted canines is orthodontic intervention. The orthodontist uses braces and wires to create space in the jaw for the canine to emerge. A small incision is made in the gum to expose the tooth, and then brackets are attached to guide it into place.

However, if the canine is impacted in a difficult position or at a challenging angle (such as horizontally) or if it is far from its original position or surrounded by a cyst or tumor, the treating doctor may opt for surgical extraction.

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