Humans have four wisdom teeth. These are the back molars that emerge later in life, often between the ages of 18 and 24. Not everyone has all four wisdom teeth erupting. Some only have three or two pieces. And in a small part of the population, wisdom teeth never come in at all. The jaw has become narrower, which often makes it more difficult or impossible for these molars to emerge. When they do come through, it may only be half or crooked. This can cause problems such as a cyst, inflammation or caries. In this case it is better that the tooth is removed. The oral surgeon can pull or cut out the wisdom tooth. This depends on the extent to which the molar has emerged.
What are the wisdom teeth?
These are the back molars in the teeth. There are four wisdom teeth in total: two in the upper jaw and two in the lower jaw. They break through last, often around the age of 18. They don’t break through for everyone. More than four percent of people never have their wisdom teeth erupt. In more than 25 percent of people, only 2 to 3 wisdom teeth emerge. Remarkable, because a long time ago everyone’s wisdom teeth came through. This means that wisdom teeth have lost their function and therefore erupt less and less often. It is expected that one day the wisdom teeth will no longer erupt at all. This is partly due to the shrinking size of our jaw. Our food habits have changed considerably since prehistoric times.
The name wisdom tooth comes from the fact that it erupts so late, at the age when reason or wisdom also arrives. That is why they are also called wisdom teeth. The name has nothing to do with the distance of the molars.
They often cause complaints
If the wisdom teeth erupt nicely and are straight, there is nothing to worry about. Sometimes they cause problems with brushing because they are so far back in the mouth. Not everyone can do that equally well. Regular check-ups with the dental hygienist or dentist are always recommended.
Sometimes the wisdom teeth erupt but are crooked. This is often caused by a jaw that is too narrow. Our jaw is simply no longer built for the presence of wisdom teeth. Because they are crooked, the jaw may no longer close properly. This causes problems with chewing. In addition, the neighboring tooth can be oppressed by the wisdom tooth. Keeping the wisdom tooth and its neighbor clean is also more difficult when it is crooked.
If the wisdom tooth does not erupt properly, an edge of the gum remains over it. This can cause pain, but also inflammation. After all, it is easier for food particles to get stuck under the piece of gum. Bacteria will settle here. The disadvantage of this inflammation is that the bacteria can expand quickly. The inflammation then becomes deeper. This causes a lot of pain and often also fever.
Sometimes a cyst develops around the wisdom tooth. This is a cavity filled with fluid and is often caused by an infection. A tumor can also develop around the wisdom tooth. A tumor can also cause a cyst.
Wisdom tooth extraction, why?
It is a wrong idea that everyone should have their wisdom teeth extracted. For many people, the wisdom teeth can remain in place. Especially when there is sufficient space in the jaw, these molars rarely cause complaints. It is important that the back molars are not forgotten when cleaning the teeth.
In case of inflammation, the wisdom tooth will be extracted, especially if it has not fully erupted. The chance of recurrence is then very high. The wisdom tooth is also removed if it pushes the other molars aside, causes pain due to failure to erupt properly, causes inflammation, a cyst, a tumor or caries or causes a nuisance in some other way. There are known cases where the wisdom tooth is removed for prevention. However, this is not necessary if there is no reason to do so. In this case, it must be carefully considered whether preventive removal of the wisdom tooth outweighs the burden that removal entails.
Pulling or cutting?
There are two ways to remove a wisdom tooth: pulling or cutting. Which method is chosen depends on the extent to which the molar has emerged. If it is still completely or partially under the gums, it is often necessary to cut it away. After all, the dentist or dental surgeon has no grip with his pliers if the tooth is not yet (completely) there. In all other cases, the tooth will be extracted. In some cases this happens quite quickly, in other cases the doctor has more difficulty and it can sometimes take up to half an hour before the tooth is removed! In most cases, the removal of the wisdom tooth will be done by a dental surgeon.
Pain and numbness
The tooth is removed under local anesthesia. Fortunately, because pulling or cutting out the wisdom tooth can be painful. You will not feel much of the anesthesia: the injections can be sensitive but are rarely experienced as (very) painful. The anesthetic fluid can enter the mouth: this gives a bitter taste. The tooth extraction is painless thanks to the anesthesia, but it can cause an unpleasant feeling. After all, you feel the pressure of pulling. Cutting can also cause pressure. In addition, the bone is drilled. This will result in swelling later.
Post-pain and bleeding
The cavity where the tooth was located will bleed. This is a completely normal phenomenon. The doctor will often provide a piece of gauze that can be bitten. This stops the bleeding and collects the blood. After-pain is a phenomenon that can also occur. It is impossible to predict in advance how much pain you will experience. One person hardly experiences any pain while the other suffers from it a lot. Your own pain threshold also plays a role in this.
Cutting out a tooth is a more drastic event than extracting it. The wound takes a longer time to heal. Most people do not feel well during the first three days and suffer from (a lot of) after-pain and bleeding. This can be combated with painkillers. It is best to take the first painkiller 1 hour after the treatment. The anesthetic itself wears off after two to four hours. The maximum prescribed dose may be taken during the first two days.
Caring for the wound is important: it prevents inflammation. Sometimes the oral surgeon has prescribed a mouthwash. It may also be that an injection has been given into which a solution can be added. This allows the wound to be rinsed. It is important not to suck too hard on the wound during the first two days. This increases the risk of subsequent bleeding. The teeth can be brushed with a toothbrush. Not smoking is important: this will heal everything faster.
Age
The wisdom tooth or wisdom teeth are preferably removed before the age of 25. This is to allow the jaw bone to recover properly. If the tooth is removed later in life, the jawbone will not simply recover. This can cause problems for the other molars. In addition, wounds heal faster in young people. If problems occur with the wisdom teeth, or if it appears that this will occur in the future, it is better to have them removed (preventively) at a young age.
