Wisdom Teeth Complications

Wisdom teeth (or the third molars) are the last set of teeth to grow or erupt.

They normally appear anywhere from 17 to 25 years. You can find them at the end of both the upper and lower gums, usually one on each side. Most people tend to have up to four wisdom teeth. It may be rare, but some individuals can have more than four.

Wisdom teeth are a part of the human mouth, so you should not be scared of them. However, the reality is that the mouth cannot handle 32 teeth, which include the wisdom teeth. If your wisdom teeth do erupt, they can lead to complications, such as crowding and swollen gums. Some people complain about ear pain and infections.

When your mouth does not have enough space for the growing wisdom teeth, the teeth do not fully erupt. They are now called impacted wisdom teeth, which can grow in the wrong direction, partially, or at an incorrect angle. 

Wisdom teeth about to be extracted in day surgery.

Signs and Symptoms of Impacted Wisdom Teeth

The following are symptoms of impacted wisdom tooth:

  • The tooth is slanted towards the front of the mouth, which is a condition known as mesioangular impaction. The wisdom tooth did not break through the gum line or did not erupt complete and is known as vertical impaction.
  • If the tooth slants towards the back of the mouth, it is called distoangular impaction.
  • If the tooth grew sideways at a full 90-degree angle, it could affect the roots of the molar nearby. This condition is called horizontal impaction.

The good news is that wisdom teeth can grow properly and settle down. In this case, they do not need to be extracted. However, you must practice good oral hygiene. The teeth should also be monitored regularly because they still have the potential to develop problems later on, especially as you grow older. 

The Australian Government’s Health Direct agency agrees that some patients may require having their wisdom teeth removed completely. A few interpretive signs to watch out for are:

  • Swelling
  • Pain
  • Discomfort
  • Pressure
  • Lack of space where the tooth is growing
  • Partially erupted tooth
  • Decayed tooth
  • Hard-to-reach area for cleaning the tooth

If any of the above signs are present, you may need to have the teeth removed. In some cases, even if you do not feel pain, yet the third molars can damage the surrounding teeth, they should be extracted. 

More often than not, removing impacted wisdom teeth is necessary to avoid the following problems:

  • Second molar damage: Your newly grown wisdom tooth can push the other teeth nearby, which damages the second molar. The area can be at risk of infection. Plus, the pressure from the wisdom tooth can cause teeth crowding. 
  • Pericoronitis: It is often difficult to clean wisdom teeth because they are located at the back of the mouth. The challenge is even more significant when the teeth only erupted partially. It can lead to pericoronitis, which is the inflammation of the gum surrounding the crown of the teeth. 
  • Gingivitis: Gum diseases can develop when the plaque irritates the gums due to the toxins it releases. A study by the Australian Dental Association showed that the number of people with gingivitis or periodontitis increases as they age. About 38.4% of individuals aged 55 and up had periodontal pockets. Only eight per cent had the same dental problem in the 15 to 35 age group.
    The formation of a cyst as the wisdom tooth pushes through.
  • Cysts: Wisdom teeth start in a sac found within the jawbone. This particular sac can quickly pile up with fluid, which will then form a cyst. This cyst can damage not only the teeth but also the nerves and the entire jawbone. In rare cases, a tumour may develop. Although it is benign or noncancerous, it may often need to be removed, along with a portion of tissue and bone.
  • Caries: Even if the impaction is only partial, the teeth can still be at a higher risk of caries or decay compared to other teeth. One in three Australians has dental decay. Because of the location and incomplete development, wisdom teeth are difficult to clean. Therefore, food and bacteria can get trapped between the gum and the impacted wisdom tooth.
  • Infection: With the wisdom teeth affecting the others in the mouth, it can start an infection. If left untreated, it may lead to other problems, including earaches, headaches, and bad breath or halitosis. A common symptom that you have an infection is if you can taste something strange in the mouth. Swollen, abnormally red, and bleeding gums are all signs of an infection. Sometimes, it can look like you have a swollen jaw.
  • Cellulitis: Impacted wisdom teeth can cause more serious infections, such as cellulitis. It happens in the throat or the cheek tongue. 

While some people may not agree, it is better to remove impacted wisdom teeth, even if they do not cause problems. The procedure is simply a preventative measure, which aids in reducing infection, tooth decay, and gum disease. Additionally, it is much easier to take out the tooth while the patient is still young.

How Can an Orthodontist Help?

An impacted wisdom tooth can affect the teeth close to it. Most of the time, the growth can cause pressure, which then moves the other teeth to the wrong direction. Teeth can shift, especially for older people. It is why it is necessary for those who used to wear braces to wear their retainer.

If your wisdom teeth are impacted, the process is simple when removing them in an outpatient surgical procedure. While people go to the dentist, you have to visit your orthodontist if you are currently wearing braces or Invisalign.

You should not worry about the wisdom teeth affecting your teeth or braces. They can be removed quickly. If the orthodontist sees that you have teeth crowding due to wisdom teeth, they may have to be extracted before you get your braces.

Some wisdom teeth appear in people as young as 15 years. Therefore, it helps to be prepared. Parents whose children need to have orthodontic treatment should already be aware of the risks of impacted wisdom teeth. 

It is recommended that children should visit orthodontists by the time they are seven years old. Around this age, they will typically have both baby and adult teeth. It becomes easier for orthodontists to diagnose problems, as well as provide solutions for them. Correcting tooth and jaw issues early can help avoid the need for surgical treatments.

Orthodontists are well aware that patients have unique requirements when it comes to orthodontic care. It is why a thorough evaluation should be carried out first to determine what the patient truly needs.

Individual wisdom teeth x-rays.

Private Health Cover for Wisdom Teeth Extraction

Whether it is due to a recurring infection or teeth crowding, several Australians seek to have their wisdom teeth removed at some point. Some would have the procedure during their late teens or early twenties. No matter when you have it, a common concern involves the cost of the extraction.

For many Australians, wisdom teeth removal is a minor and straightforward procedure. The process uses a straightforward extraction method of one or two teeth.

There are cases, however, when at least one tooth is impacted. Others require the removal of more than two teeth. Therefore, these situations may call for a more invasive procedure.

As with numerous other dental procedures, wisdom tooth extraction is not covered by Medicare. It is possible though to have other options under the public system.

Straightforward extractions can cost up to $400 for each tooth. This amount already includes X-rays and consultation fees. On the other hand, if you require a more invasive procedure, it means you need to see a specialist. Often, it will be performed in a hospital while you are under general anaesthetic or sedation. In such a circumstance, the fees will include different costs, including hospital, medical, and dental.

Tooth extraction can be around $1,580 or more which already includes hospital and medical expenses. It is not an affordable procedure, but your health insurance may cover at least some of the payments.

Before getting your wisdom teeth out, you should check with the health insurer, doctor, and dentist to determine which out-of-pocket expenses you will pay.

Private health insurance lets you choose your oral surgeon, especially if you need to undergo a more complex procedure. Depending on your coverage and type of insurance, it is possible to have 40% off of the total cost of extractions.

Dental Surgery and Sedation 

A dental surgeon operating on a sedated patient.

You will first have to consult your dentist before you get your wisdom teeth removed, which can include the following steps:

  • Reviewing of your dental history
  • Taking X-rays
  • Assessing the wisdom teeth and their condition
  • Examining the overall health of your mouth

During the consultation, you will know if your teeth can cause problems. If they are likely to be problematic, you may have to undergo surgical extraction.

Typically, the dental professional will utilise sedationgeneral anaesthesia, or local anaesthesia. This step is important because your mouth should be numb during the procedure. You may also be unconscious during the surgery.

If your tooth will be removed, an incision will be created, which will result in the exposure of the tooth itself and the bone. There are times when the bone blocks access to the root. The oral surgeon may decide to remove that bone.

Some wisdom teeth are difficult to extract. It happens to many patients, which requires division of the teeth into several pieces before the removal. Once the extraction is completed, cleaning the site thoroughly is essential. All remaining debris will also be removed.

The site may be stitched up so that it can heal properly. Then, gauze will be placed on the site to stop or control any bleeding. It will also help form a blood clot quicker.

Myths about Wisdom Teeth and Extraction

Wisdom teeth and their removal can be a straightforward process. However, there are a lot of old wives’ tales out there.

It is time to debunk these myths, so you understand wisdom teeth better:

Wisdom Teeth Affect the Outcome of Orthodontic Treatments, Such as Braces

This myth is quite popular. Your wisdom teeth will not affect the process of straightening your teeth through braces. Therefore, it is perfectly fine to wear orthodontic treatments when you have wisdom teeth developing.  

Additionally, braces only affect the teeth visible when you smile, which are typically just the 10 to 12 teeth at the front.

Wisdom Teeth Can Make Your Teeth Crooked Once You Have Completed Your Orthodontic Treatment

Many brace-wearers believe that their wisdom teeth can impact their teeth after they are done with their braces. It is not true. The growth of wisdom teeth will not cause any misalignment. However, it is real that there is some push from the developing wisdom teeth. It should not worry you because the force is too insignificant.

Still, you should always visit your orthodontist and ensure that you heed the advice. Orthodontists will often recommend wearing retainers after braces.

Only a Specialist Can Remove Wisdom Teeth

A general dentist can perform the procedure. This way, you do not have to go to an oral or maxillofacial surgeon. However, if your case is complex, you may be referred to an oral surgeon.

Cone bean images of wisdom teeth causing problems.

FAQs about Wisdom Teeth

Whether or not you will have your wisdom teeth removed, you surely have some questions that you would like answered.

We have compiled the most common questions and answers so you can get the information you need in one place:

1. Why Do Wisdom Teeth Develop?

Not everyone has wisdom teeth. However, anthropologists think that the third molars originally erupted to help ancestors eat properly. Back in the day, their diets involved hard and coarse food, including nuts and meats. They needed bigger and more powerful jaws so that they could chew the food. 

Over time, modern humans have evolved with smaller jaws compared with the Neanderthals. Therefore, the extra teeth do not truly fit in the mouth. Our diets have also changed, which now included soft and cooked foods. We no longer require wisdom teeth as much for survival. Evolutionary biologists claim that these teeth are vestigial organs, meaning they are functionless as we have evolved with time.

2. Do All Wisdom Teeth Need to Be Extracted?

Decades ago, wisdom teeth were automatically removed, even if they do not cause any issues. However, it has become less frequent over the years. In 2008/09, there were about 527 in 100,000 Australians who had their impacted wisdom teeth removed. 

While it is true that you can simply leave the teeth alone, Australian experts believe it is better to extract them now rather than later. This way, you can avoid the negative impacts of having these teeth, such as recurrent infections and potentially damaging the nearby healthy molars.

3. Is the Wisdom Tooth Removal Painful?

You will be sedated or under local or general anaesthesia, which means you may not sense anything during the procedure. However, you may feel the discomfort after the extraction.

Patients must understand that the removal of wisdom teeth is a standard procedure. About 10 million people in Australia have their molars removed every year, and a considerable percentage of this number involves those who have their third molars extracted. 

Also, you have to be prepared before the procedure. You can talk to your dentist or oral surgeon about your worries, including the duration of the process and if there are other necessary dental treatments after.

Since extraction is an outpatient procedure, you can go home on the same day. The entire removal can take anywhere from a few minutes to 20 minutes.

4. What Are the Risks of the Procedure? Are There Alternatives?

After the surgery, you may find some swelling, pain, and discolouration. Bleeding is also common, as well as dry socket, which means blood clotting has failed. Other complications include a fistula between the sinus and the mouth. However, these problems are not severe, and you will feel better in a couple of days or so.

Practice good hygiene and always talk to your dentist to minimise dental problems.

In some cases, removal of the wisdom teeth is not required. You can use painkillers, such as paracetamol, to help alleviate the pain. Antibiotics can also help, as well as chlorhexidine mouthwash or simply rinsing with warm salty water. 

Operculectomy or removal of the gum over the tooth can be performed for patients whose wisdom teeth remained partially erupted. 

Coronectomy is another alternative where the crown of the tooth is removed. It is useful if the root of the wisdom tooth lies near the lower lip nerve.

5. What Should You Do After Wisdom Teeth Extraction?

If you were sedated or given general anaesthesia, you would need to recover for a few hours before leaving. Make sure you have someone with you to help drive you home. You may also be prescribed with medication to help you manage the pain once the anaesthesia wears off.

Most of the time, you may need to rest for a week after the procedure. You will also have to eat soft food for up to seven days. 

When in doubt, ask your orthodontist and dentist. All necessary information will be provided for the after-care. If you experience any complications, call the dental office right away.

Upper wisdom teeth shots.