The ‘wisdom teeth’ or third molars are the last teeth to come through during adulthood, right at the very back of the jaw. Although adults can have a maximum of 32 teeth, many people often only have room for 28 meaning that there may not always be enough space for wisdom teeth to come through properly.
If there is enough room for the wisdom teeth to come through there will not usually be a problem, although some temporary discomfort may be felt as they settle into place. An ‘impacted’ wisdom tooth is when there is not enough room for the tooth in the jaw. The wisdom tooth will get stuck against the tooth in front of it and come through at an angle in this instance.
When part of the wisdom tooth remains under the gum and becomes sore and swollen, this is known as pericoronitis. As the area may be sore and difficult to clean, food and bacteria can collect under the edge of the gum. In order to combat this, mouthwashes and careful cleaning methods should be used.
Mixing warm water with a teaspoon of salt and using as a mouthwash is a good way to reduce inflammation, and can be swilled around the mouth several times a day. Painkillers such as paracetamol can also help in the short term, but you should seek expert advice if pain continues or becomes severe. Although pericoronitis is only a temporary problem, if it occurs often you may have to have the tooth removed.
If your wisdom teeth are not causing you any problems they will not be removed. However, if removal is suggested it is likely to be for one of the following reasons:
There is not enough room for them to come through in a useful position
They are causing pain and discomfort
They have only partly come through and have decayed
Your dentist will usually use an x-ray to determine where the roots of the tooth are before advising you on how and where it should be removed. Upper wisdom teeth are usually easier to remove than lower wisdom teeth, as these are more likely to be impacted. Wisdom teeth can be removed either by your dentist or an oral surgeon at a hospital, with where you go depending on how easy the removal of the teeth is likely to be.
Either a local anaesthetic or a sedation will be recommended for the removal of the tooth, with a general anaesthetic available in hospital only.
The amount of pain and discomfort following the removal of a wisdom tooth will depend on how easy it was to do. Swelling is normal for a few days after the procedure, and mouthwashes are often advised to help with the healing process. Stitches may be required if there is a lot of bleeding, but these should be removed after about a week during a check up with your dentist if all is well.