Do Wisdom Teeth Have to be Removed?

You made a trip to the dentist and they gave you this lovely advice that you need to remove your wisdom teeth.  They don’t hurt… so why are they telling you that you should remove them? 

Overview

Wisdom teeth are the final set of molars in the back of the mouth that most people remove in their early twenties or late teens. Most individuals have a set of four wisdom teeth – two on top and two on bottom. Wisdom teeth removal is a standard practice in oral surgery and is almost like a rite of passage for young adults. Sometimes wisdom teeth can be helpful if they are healthy, properly aligned, and are able to be properly cleaned… but typically they are misaligned and need removal. 

Wisdom teeth typically don’t have room to grow properly which leads to problems for your other teeth. Your dentist can identify these problems through x-rays and scans of the jaw and mouth. Your dentists’ ability to predict problems early can mean you may not have pain when they recommend an extraction.

Potential Problems or Complications

Erupted wisdom teeth can grow in at various angles and sometimes come in horizontally. This can lead to other serious problems including:

• Jaw Damage

  • Wisdom teeth that stay completely hidden inside the jaw are considered impacted and can lead to tumors and cysts.
  • What happens is that the wisdom tooth will develop in a sac within the jawbone. This sac may fill with fluid which forms into a cyst that may lead to damaged teeth, nerves, and your jawbone. If kept untreated, they can damage your nerves and hollow out your jaw.
  • A tumor rarely occurs but if it does it is typically noncancerous (benign). Removal of bone and tissue may be required in this sort of complication. 

• Cavities

  • When your wisdom teeth are emerging through your gums, you have a higher risk of bacterial growth in that area. Your wisdom teeth have a higher chance of decay than your other teeth because food and bacteria get trapped between the partially erupted tooth and gums.  This can increase your chances of infection or gum disease. 
  • Since these teeth are harder to keep clean – they can also cause cavities that cannot be repaired.

• Alignment & Damage to Other Teeth

  • If there is not enough space in your mouth for the teeth to emerge, this can cause your teeth to become crowded. It may even damage your other teeth. 
  • Other straightening treatments may be necessary if this occurs.

• Sinus Issues

  • Some problems with your wisdom teeth can actually lead to sinus pain, congestion, and pressure.

Unfortunately, you cannot prevent impaction from occurring. Keeping up with your regular dental appointments every six months enables your dentist to monitor your wisdom teeth. 

Impacted Wisdom Teeth

 

Wisdom teeth are considered impacted when they do not have enough room to develop normally or emerge. Therefore, they can result in other dental problems including pain and damage to your other teeth. Your wisdom teeth may not cause any immediate or apparent problems, but they may be more vulnerable to gum disease and tooth decay since they are harder to clean. 

In addition, some oral surgeons and dentists recommend removing non-symptomatic wisdom teeth that are impacted to prevent future issues. 

Whether fully or partially impacted, your tooth might:

• Grow towards the next tooth angled at your second molar.
• Extend at an angle towards the back of your mouth.
• Grow at a right angle to your other teeth. In an x-ray this tooth looks like it’s almost laying down within the jawbone.
• Stay trapped in the jawbone but grow straight up or down like other teeth.

 

 

When Should I Have My Wisdom Teeth Removed?

It is typically recommended that patients remove their wisdom teeth in their later teenage years. Recovery is much easier if patients have surgery before the roots are fully formed at a younger age. Again, many individuals get these teeth removed without experiencing any negative side effects, the surgery is done as a preventative measure.

If you decide to postpone your wisdom tooth removal til later in life, you should contact your dentist if you begin to experience changes in your teeth or if you experience any of the following symptoms:

According to the American Dental Association, wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as:

• Pain
• Repeated infection of soft tissue behind the lower last tooth
• Cysts (fluid-filled sacs)
• Tumors
• Repetitive infection of soft tissue behind the lower last tooth
• Damage to other teeth
• Extensive tooth decay
• Gum disease

Discuss with your dentist about the health and position of your wisdom teeth so you can determine the best solution for you. 

Do you have other teeth that you are thinking about extracting? You can learn more about pulling your tooth or saving it by visiting our other blog post Should You Pull Your Tooth or Save It? .

Wisdom Tooth Extraction Care

Okay, so you did it! Finally, your wisdom teeth have been removed, now what? Here are some home care instructions to follow after extraction. 

• Avoid touching the wound area.
• Restrict your activities.
• Do not rinse your mouth vigorously.
• Apply ice or frozen peas to your cheeks on the outside of the surgery site.
• 30 minutes after your surgery you should remove the gauze surgical pad. 
• As soon as you feel discomfort, you should take your prescription pain medications.

Additional Symptoms

You may experience some additional discomfort and symptoms. We’ve have provided a list of some of them for you here to make your recovery time more comfortable.

• Bleeding

  • Some slight oozing, bleeding, or redness in your saliva is common. If you are experiencing excessive bleeding, you can place a gauze pad on the surgical area then bite down firmly for 30 minutes.
  • If you notice that the area is still bleeding, try biting on a moistened tea bag for an additional 30 minutes. This remedy works because of the tannic acid in the tea bag. It helps contract the bleeding vessels and helps form a clot.
  • You can minimize bleeding by sitting upright, staying calm, and avoiding exercise. 

• Pain

  • If the pain is moderate, take over-the-counter medications such as: Tylenol, Extra Strength Tylenol, Motrin, or Advil (ibuprofen). 
  • You should take your prescription medications as directed for severe pain. Sometimes pain medications can make you a little dizzy so just be careful standing up too quickly, make sure you stand up gradually.
  • If you develop a rash or other side effects, stop taking the medication and contact the dentist who did the procedure immediately.

• Nausea

  • If you experience vomiting and/nausea, it is suggested not take any medication for at least an hour after surgery. Try slowly sipping tea or ginger ale. You can start taking your prescription medication once the nausea has subsided.

• Discoloration or Swelling

  • Swelling around your cheeks, mouth, eyes, and sides of your face can happen. This is a normal reaction for your body to have after surgery. Sometimes swelling doesn’t appear until the day after surgery and will not reach the maximum amount of swelling until two or three days after the surgery. 
  • Applying ice can help with the swelling. Switch to moist heat 36 hours after the surgery. 
  • In some cases discoloration occurs because of the blood spreading beneath the tissue. Discoloration colors include black, green, blue, or yellow. This is normal and using moist heat can help. 

• Oral Hygiene

  • You may be wondering how you can brush your teeth after surgery. You may brush your teeth the night of surgery. Just make you rise gently and be very careful around the surgery site. You should begin rinsing at least five to six times per day on the first day after your wisdom teeth are removed. You especially rinse after you eat anything. During the process of healing, we suggest keeping your mouth as clean as possible with a toothbrush or salt water rinses. 

• Stitches 

  • Stitches in your wisdom teeth help limit bleeding and promote healing. Sometimes the stitches may fall out, if this happens just discard them… It’s no big deal. Typically about one week after surgery you can get your stitches removed. 

• Dry Socket

  • Dry socket is when the blood clot becomes dislodged early from the socket of where your wisdom tooth was located. You can experience pain at the surgical site or even ear pain if this happens and can last two to three days. You should call your dentist if this occurs

• Other Complications

  • Sometimes you may experience lip, tongue, or chin numbness but this is typically only temporary. Also, temperature elevation post surgery is not uncommon. If this happens you can take ibuprofen to help lower your fever. 
  • Sometimes your lips can get dry, chapped, or cracked during the healing process. Just try to keep your lips moistened.
  • Pain when swallowing or a sore throat can occur and typically goes away within two to three days. Jaw stiffness may cause difficulties opening your mouth. That’s normal and will get better with time. 

What To Eat

Your diet can take a huge part in your healing process. Follow these guidelines to help aid your recovery.

• • Drink lots of liquids. It is recommended to drink at least five to six glasses of water daily. 
  • Do NOT use straws! Sucking can cause the blood clot around the surgical site to dislodge. 
  • Try not to miss any meals – it’ll help you feel better, provide less discomfort, give you more strength, and can even make you heal faster. For instance, you should eat soft foods that are high in protein and calories such as:
    • Blended Soups
    • Greek Yogurt
    • Scrambled Eggs
    • Mashed potatoes
    • Applesauce
    • Banana Ice Cream
    • Mashed Bananas
    • Broths

Above all, it is important to contact your Dentist if you are experiencing any pain associated with your wisdom teeth.