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(SW: Hello and welcome to Ask Your Dentist TV with me Sarah Wylie and our dentist Dr. Jacob Krikor. On the show we will be discussing hot dentistry topics, while trying to shed light on the areas that matter the most to help you keep your mouth, teeth and gums healthy and looking good. If you don’t want to miss any future episodes subscribe to our channel now so you get notified when the next episode lands.
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In today’s episode we will be discussing wisdom teeth and the issues associated with those teeth.
It is not unusual to hear that a friend or a relative has had some sort of problem with a wisdom tooth and has even had one or more removed. There are probably many reasons to having a wisdom tooth removed but I will start by asking Jacob what are wisdom teeth?
JK: Hi Sarah, hello everyone and welcome to Ask Your Dentist TV
The wisdom tooth is the last molar situated at the back of our jaw. We usually have four wisdom teeth, two at the top and two at the bottom. So one in each quadrant. It is the number 8 tooth counting from the middle line if you have all your other teeth.
It is not uncommon to find that some people will have more than four wisdom teeth and others have fewer or none.
Sometimes the wisdom tooth does not erupt through the gum but stays impacted under the gum or completely encapsulated in the jaw bone. So if you don’t have the third molar in one quadrant that could mean that your wisdom tooth is still under the gum or is completely missing.
SW: I see. So how do I know if I have a wisdom tooth under the gum and when do we usually get them?
JK: Usually you can see the un-erupted wisdom tooth in an X-ray.
The X-ray can be intra-oral which means the film is placed inside the mouth during a routine examination carried out by your dentist or extra-oral, when the film is placed outside the mouth. The timing of the wisdom tooth to erupt into the mouth is from around the age of 17-18 to mid-20s.
There are of course variations as well where you can see fully erupted wisdom teeth in younger teenagers or delayed much later into adulthood.
SW: What Symptoms are associated with wisdom teeth?
JK: Firstly: Pain: Unfortunately it is not uncommon to have some kind of discomfort caused by erupting wisdom teeth. Often it is the lack of space at the back of the jaw that prohibits the smooth eruption in place and in line with the other teeth. The pain my patients describe is a dull, diffused pain from the molar area. The pain is intermittent, so lasting for an hour or more and then goes away. It can last for a day or two.
Of course the pain can become intense at times.
Secondly we have swelling: If the tooth is partially erupted, which means that you can see part of the tooth emerging through the gum at the back, you can get bacteria or small food particles stuck underneath the gum around the wisdom tooth causing irritation and infections which leads to swelling. This condition is called Pericoronitis.
The gum covering the wisdom tooth at the back is called operculum. Sometimes this gum is traumatised when the opposing tooth is chewing on the gum part and that can also cause swelling and pain.
SW: I assume it is more difficult to get all the way to the back of the teeth and clean properly. Do you have any tips on how to clean around them?
JK: Yes Sarah absolutely. Because of the awkward position and especially if the wisdom tooth is partially erupted or positioned in an angle with the tooth in front. It is more difficult to clean. So to get to the area with a brush you might need to consider getting one of these brushes that has a small pointy head, like this one.
I also recommend using a fluoride mouthwash. The mouthwash will reach the areas that the brush might not reach and by doing so you prevent tooth decay from developing in the tooth. Due to limited space at the back and the awkward positioning of the wisdom tooth it is not always possible for your dentist to get to the decay and clean it out properly and we resort to extracting the whole tooth instead. So in this case proper cleaning of the area is the best way of preventing tooth decay and gum inflammation.
SW: So you mentioned that a decayed wisdom tooth might need to come out, is there any other reason for removing the wisdom tooth?
JK: Yes indeed. If you as a patient get repeated episodes of inflammation and swelling of the gums around the wisdom tooth, what we call Pericoronitis, we usually recommend the removal of the wisdom tooth. Another very important indication for taking the wisdom tooth out is the risk of decaying the tooth in front of the wisdom tooth. It is not unusual to see that both the wisdom tooth and the tooth in front of it get decayed. This happens if the wisdom tooth is positioned in an awkward way making it very difficult to clean and leading to decay on the tooth in the front. Removing the wisdom tooth creates the necessary space to brush and clean properly at the back. Also it makes it easier for the dentist to clean the decay and repair the tooth situated in front of the wisdom tooth.
SW: How do I know if I have decay either in the wisdom tooth or the tooth in front?
JK: By visiting your dentist regularly you know that you are in good hands. Your dentist will inspect the teeth and take the necessary X-rays to make sure that no decay or other abnormalities are taking place. Your dentist and hygienist will also give you the necessary advice and oral hygiene instructions to prevent any decay or gum problems around the area.
SW: How easy is it to remove wisdom teeth? I assume the ones that are still under the gum are the ones that are more difficult to remove.
JK: Absolutely. The upper wisdom teeth are much easier to remove. The lower wisdom teeth are trickier and more risky to remove. The bone around these teeth is more compact so they are sitting more firm and sometimes it is necessary to remove a bit of that bone to get the tooth out. The risky element here is the inferior alveolar nerve. It is the nerve that innervates half of the lower jaw.
The closer the wisdom tooth or its roots are to the nerve the riskier it is to perform the surgery.
SW: That is good to know if you are a patient who has some issues with your wisdom tooth whether the upper or the lower one.
Well thank you Jacob for this informative session and for shedding some light on this important topic that I am sure many of our viewers will learn from.
And if you have enjoyed our topic for today please give it a like below and subscribe for future episodes. Also if you are curious about more dental topics go to Askyourdentist.com for more useful reading. Thank you and good bye till next time.
JK: Thank you and good bye)