Definition

Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt; they usually come in when a person is in their late teens or early twenties.

Signs & Symptoms

Wisdom teeth that only partially emerge or come in crooked can cause pain and swelling in the surrounding tissues.

Cause

As wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted (below the gum line and not fully erupted). If teeth are impacted, swelling and tenderness may occur in the area of the third molar.

Diagnosis

As wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted (below the gum line and not fully erupted). If teeth are impacted, swelling and tenderness may occur in the area of the third molar.

Treatment

Wisdom teeth are often best removed before the age of twenty years as root formation may not yet be completed. If the wisdom teeth are erupted, the tooth (or teeth) will normally be removed with local anaesthetic. After surgery, you may be asked to bite down softly on a piece of gauze for 30 minutes after you leave the surgery, to limit any bleeding that may occur.

If the wisdom teeth are impacted and embedded in the bone, the oral surgeon will put an incision into the gums and remove the tooth or teeth in sections in order to minimise the amount of bone being removed. Some pain and swelling may occur, but it will normally go away after a few days; however, you should call your dentist or oral surgeon if you have prolonged or severe pain, swelling, bleeding or fever.

After surgery, swelling and tenderness in the face and neck are common, as is bruising. Ice packs and pain medications prescribed by the dentist or oral surgeon will help, but if you have any questions or are concerned about what you are experiencing, contact your practitioner.

Complications

Dry socket

After a tooth is extracted a blood clot forms in the tooth socket and seals the area so that it can heal. A dry socket occurs during the first five days after extraction, when the blood clot breaks down or is dislodged and it exposes the bone which becomes infected.

A dry socket is very painful! To ease the pain, a dentist will rinse out the empty socket, remove any debris and apply medicated dressings to protect the area and decrease the pain. Painkillers will help to reduce discomfort. With proper care and rest a dry socket should heal in 7 to 10 days.

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Related Conditions

Pericoronitis is a dental infection that occurs when there is not enough room in the mouth for a wisdom tooth to erupt. The wisdom tooth is partially erupted and the gum tissue covers a part of the top of the tooth. This allows food or plaque to become lodged under the gum tissue flap. If the area becomes infected, it is called pericoronitis and the gum tissue will become swollen and red.

Symptoms can include a bad smell or taste in the mouth, discharge of pus from the gum near the tooth, swollen lymph lodes under the chin, muscle spasm in the jaw and swelling on the affected side of the face. You can treat it by rinsing with warm salt water in the early stages. An antibiotic may be prescribed if the infection progresses and the wisdom tooth should be extracted.