Tuesday 17 December 2013

There is no Wisdom in having Wisdom Tooth…..

People say the day you get your wisdom tooth, you become wiser. But it is important for you to know it is wiser to get the wisdom teeth removed. 




What a wisdom tooth is?

A wisdom tooth is any of the usual four third molars, is the last teeth to erupt in your mouth. This usually appears between the ages of 16 and 24, a time of life that has been called the “Age of Wisdom.”
Most adults have four wisdom teeth, but it is possible to have fewer, or more. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray. 
A few people have space in their mouth or jaws for the wisdom tooth to erupt completely and visibly enter the mouth. And many of us are first alerted to the problem when our wisdom teeth don’t emerge into the mouth properly and partially enter the mouth , because there is no room or space for them to fit in the jaws. In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. These blocked teeth are called impacted teeth.  They may cause pain, but you may feel nothing at all for years.

Thus, there are three categories of wisdom teeth:

  Erupted: The wisdom teeth are fully erupted, aligned properly with your molars and do not indicate any need for removal.
 Partially Erupted: The term implies that the tooth is partly visible or in communication with the oral cavity. The wisdom teeth are positioned so that only a portion of the teeth is visible.
Unerupted (Impacted): The wisdom teeth are trapped in the jawbone and unable to erupt.  Tooth which is prevented from completely erupting into a normal functional position. This may be due to lack of space, obstruction by another tooth, or an abnormal eruption path.
What is an Impacted Tooth?
A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.
Wisdom Tooth Impaction types
Impacted wisdom teeth fall into one of several categories.
Mesioangular impaction is the most common form (44%), and means the tooth is angled forward, towards the front of the mouth.
Vertical impaction (38%) occurs when the formed tooth does not erupt fully through the gum line and is positioned vertical to the adjacent second molar tooth.
Distoangular impaction (6%) means the tooth is angled backward, towards the rear of the mouth. 
 Horizontal impaction (3%) is the least common form, which occurs when the tooth is angled fully ninety degrees forward, growing into the roots of the second molar.
Impacted wisdom teeth may also be categorized on whether they are still completely encased in the jawbone.
 If wisdom teeth are completely encased in the jawbone, it is a Bony impaction. If the wisdom teeth have erupted out of the jawbone but not through the gum line, it is called a Soft tissue impaction.

Typically distoangular impactions are the easiest to extract in the maxilla and most difficult to extract in the mandible, while mesioangular impactions are the most difficult to extract in the maxilla and easiest to extract in the mandible.

       Possible symptoms with impacted / erupting wisdom teeth


The common symptoms of an infection caused by a wisdom tooth include:

       Reddened, inflamed gum alongside the wisdom tooth
       Swelling
       Pain
       Pus coming from the gum line
       A bad odor or taste in the mouth
       The lymph glands under the jaw become enlarged and sore
       Difficulty in opening the mouth. It may become difficult to open the mouth and to swallow
       Fever
       Pain in the general area which may also run down the entire lower jaw or possibly the neck. 














Why do your wisdom teeth hurt!?  Because they hate you?  Because they are cursed?  For no discernible reason at all?  Sometimes it truly feels that way.  
But usually there is a reason for the pain

              


               Most common Reasons for getting wisdom tooth removal 

Pericoronitis and the pain it causes is the most common reason that people need their wisdom teeth taken out.

Sometimes the wisdom tooth fails to erupt completely through the gum bed and the gum at the back of the wisdom tooth extends over the biting surface, forming a soft tissue flap or lid around the tooth called an operculum







Teeth covered by an operculum can be difficult to clean with a toothbrush. However, debris (formed by food particles) and bacteria can easily accumulate under an operculum, which may cause mild irritation, a low-grade infection called pericoronitis and swelling.


If the operculum does not disappear, recommended treatment is extraction of the wisdom tooth. Untreated pericoronitis can progress to a much more severe infection.



Pericoronitis, a common infection problem in young adults with partial impactions that is often exacerbated by occlusion with opposing 3rd or 2nd molars.






Even if your wisdom teeth aren't causing any pain or other problems, they may cause problems at some point.

The most common problems are Decay/Cavity, Infection, and Crowding or Damage to other teeth. But more serious complications can occur, including the development of a Cyst that can cause permanent damage to bone, teeth and nerves. 

If your Wisdom Tooth has a Cavity! Or Decayed!
Decay of wisdom tooth and adjacent tooth 
 Wisdom teeth do get cavities!  When a wisdom tooth begins to erupt, it becomes exposed to the bacteria in the mouth.  These bacteria will cause the wisdom tooth to decay!  More often than not, your wisdom teeth are very hard to clean and so the bacteria flourish. The longer that these food by-products and bacteria remain on the tooth surfaces, the more likely they are to produce acid that helps the bacteria break through the surface structure of the tooth, resulting in a  Cavity.                                                                                                                                                                                                                                                   
Decay of wisdom tooth and adjacent tooth on x ray

While dental restorations such as crowns or fillings may repair damage caused by dental caries, these restorations do nothing to prevent the actual cause of the problem and due to such position of  wisdom tooth, decay proceed to adjacent second molar tooth.
  Infection!
There are two basic types of infections that may be associated with wisdom teeth.

 Soft tissue infection is called “Pericoronitis.” Pericoronitis    occurs after food and bacteria have been lodged next to a    wisdom tooth beyond the reach of toothbrush and floss. The      bacteria multiply in this warm, moist, dark, undisturbed  environment. The result is pain, swelling, and redness all around the wisdom tooth.
The second most common type of wisdom tooth infection is a Dental abscess. An abscess results from a cavity that spreads to the inside of a tooth and infects its pulp system. The infected tissue of an abscess extends through the roots of the tooth and into the surrounding bone. This infection of the tooth and the bone can spread further into the soft tissues of the face and neck if not treated promptly called cellulitis , characterized by pain, swelling, and redness.
With both types of infection, you may also have a fever or difficulty in opening your mouth.
Crowding or Damage to other teeth!



Adjacent teeth are pushed out of position by the     wisdom tooth.






Wisdom teeth can damage the adjacent teeth .It causes the               resorption of the roots of the adjacent 2nd molar tooth or                     also lead  to to the resorption cavity.








Root Resorption and resorption cavity of adjacent tooth!
Resorption occurs when a  wisdom tooth pushes against an adjacent tooth and causes erosion of the adjacent tooth  surface as it attempts to erupt into its final position. There is gradual disappearance of the root of the adjacent tooth owing to the pressure from the wisdom tooth and inflammation in the surrounding tissues in response to dental plaque.This can cause severe damage to an adjacent, previously healthy                                                tooth.
Cyst!
  More serious problems may occur if the sac surrounding the     impacted tooth becomes filled with fluid and enlarges to form     a cyst. 
 Cysts are more commonly seen with wisdom teeth than       with any other teeth. As the cyst grows it may hollow out the       jaw and permanently damage adjacent teeth, the surrounding     bone and nerves. Rarely, if a cyst is not treated, a tumor may     develop from its walls and a more serious surgical procedure     may be required to remove it. Cysts often can be removed        during routine wisdom tooth removal. Some larger cysts and    tumors, however, may require much more involved surgical         Impacted Tooth cyst on X-ray      procedures in a hospital setting.







PLEASE NOTE !!!!  Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.


Removal of any symptomatic wisdom tooth should be considered, especially where there have been one or more episodes of infection such as pericoronitis,cellulitis, abscess formation; or untreatable  pulpal/periapical pathology.

Removal should be considered where there is caries in the third molar and the tooth is unlikely to be usefully restored, or when there is caries in the adjacent second molar tooth which cannot satisfactorily be treated without the removal of the third molar.

Third molar removal should be considered in cases of external resorption of the third molar or of the second molar where this would appear to be caused by the third molar.

Third molar removal should be considered in cases of dentigerous cyst formation or other related oral pathology.

 Removal should be considered in cases of periodontal disease due to the position of the third molar and its association with the second molar tooth.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow our dentist to follow the progress of your wisdom teeth with X-rays.
When we can get our wisdom tooth removed ?
Wisdom teeth are easier to remove when the patient is younger, since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed (may involve the nerve), and the jawbone is denser.
The precise reasons why an individual’s wisdom teeth need to be extracted should be explained to them by their dentist, after an examination of their wisdom teeth which almost certainly will need to include x-rays.




A panoramic x-ray (“OPG”) is the best x-ray to view wisdom teeth and diagnose their problems.


 At  Smile N Care Dental Clinics, most wisdom tooth extractions are performed under local anesthesia by dental surgeon having proper training and experience in performing such extractions.
Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by our Dental Oral Surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

Act Now!

Consult our dentist about your impacted wisdom teeth and avoid any potential suffering now.

Your well-being is our priority.  

Contact us      

Smile N Care Dental Clinics ,New Delhi

  Karol Bagh    Clinic      09311760293

  Kamla Nagar  Clinic     09999891915

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