Wisdom teeth are often a topic of concern in the field of oral health. Many people will feel pain and discomfort when they grow wisdom teeth, and then they will face a problem: Do wisdom teeth need to be removed? If it is to be removed, is the wisdom teeth simply removed? To answer these questions, we need to have a deep understanding of wisdom teeth.
Understanding wisdom teeth
Wisdom teeth, also known as third molars, usually start to erupt around the age of 18-25. During this period, people’s minds are close to maturity, so it is called “wisdom teeth”. From the anatomical point of view, wisdom teeth are located in the innermost part of the mouth, up and down, left and right, a total of four. However, not all people grow all four wisdom teeth, and some may grow only one or two, or none at all.
The eruption of wisdom teeth is not always smooth. Over the course of human evolution, jaw bones have gradually become smaller, but the size and number of teeth have changed relatively little, resulting in insufficient room for wisdom teeth to grow. This makes wisdom teeth prone to various problems when erupting, and is also an important reason for many people to consider removing wisdom teeth.
Common causes of wisdom tooth removal
Recurrent inflammation and pain
When wisdom teeth do not fully erupt, a narrow blind pocket will form around the crown, which is easy to impinge food debris and difficult to clean. Bacteria thrive in this warm and humid environment, causing pericoronitis of wisdom teeth. Patients will feel red, swollen and painful gums around the wisdom teeth, and in severe cases, there may be limited mouth opening, difficulty swallowing, and even facial swelling, fever and other systemic symptoms. This repeated inflammation not only brings pain to patients, but also may affect normal life and work, usually doctors will recommend the removal of wisdom teeth.
It causes dental diseases in neighboring teeth
Due to the lack of space, wisdom teeth may grow towards neighboring teeth and squeeze them, causing problems such as root absorption and decay of neighboring teeth. Once the adjacent teeth are damaged, the treatment is often more difficult and expensive than the removal of wisdom teeth, and the health of the adjacent teeth is crucial to the overall function and beauty of the mouth. In order to protect the adjacent teeth, timely removal of the problematic wisdom teeth is a necessary measure.
Affect the occlusal relationship
A normal occlusal relationship is critical for masticatory function and TMJ health. If the wisdom teeth grow improperly, such as tilted growth or horizontal impaction, it may interfere with normal occlusion, lead to tooth arrangement disorder, affect chewing efficiency, and may cause temporomandibular joint disease in the long term, with symptoms such as joint bounce, pain, and restricted mouth opening. In this case, the removal of wisdom teeth can help restore normal occlusal relations.
Influencing factors of wisdom tooth extraction difficulty
The location of wisdom teeth
Vertical impaction: This is a condition that is relatively easy to remove. When wisdom teeth grow vertically, the crown is mostly exposed in the mouth, and the root shape is normal, the doctor can operate relatively easily during the extraction process. Using instruments such as braces and forceps, wisdom teeth can generally be removed more smoothly. However, if the tooth root is closely related to the mandibular nerve tube, special care needs to be taken during removal to avoid damage to the nerve.
Mesio-impacted: The wisdom tooth tilts toward the direction of the neighboring tooth, and the crown is partially blocked by the neighboring tooth, which will increase the difficulty of removal. When removing such wisdom teeth, it is often necessary to first divide the wisdom tooth into several parts and then remove them separately. This not only tests the skill level of the doctor, but also requires more delicate manipulation to reduce damage to the adjacent teeth and surrounding tissues.
Horizontal impacted: Wisdom teeth grow horizontally and are completely embedded in the alveolar bone, making removal the most difficult. Doctors need to cut through the gum, remove part of the alveolar bone, fully expose the wisdom tooth, and then cut it out. In this process, the trauma to the surrounding tissue is greater, and the possibility of complications such as swelling, pain, and bleeding after surgery is also higher.
Root morphology
The number and shape of the roots of wisdom teeth vary. Some wisdom teeth are short, single roots, and the shape is more regular, and it is relatively easy to remove. Some wisdom teeth have many roots and are curved, or even forked, and need to be more careful to remove the root completely to avoid root residue. Residual tooth roots may cause postoperative infection, pain and other problems, need to be removed again, increase the pain of patients and treatment costs.
Patient’s own situation
Age: Young patients have relatively loose bones, wisdom teeth removal is relatively easy, and postoperative recovery is faster. With age, the bone gradually stiffens, the difficulty of removing wisdom teeth will increase, and the recovery time after surgery will be longer.
General health: Patients with systemic diseases such as high blood pressure, heart disease, and diabetes need to be evaluated and controlled before wisdom teeth are removed. For example, extraction of teeth in hypertensive patients with unstable blood pressure control may lead to excessive intraoperative bleeding; Patients with diabetes have low resistance, are prone to infection after surgery, and wound healing will also be affected. Therefore, such patients need to be more careful when removing wisdom teeth, and if necessary, they need to consult with doctors in relevant departments to ensure the safety of tooth extraction.
The process of wisdom tooth extraction
Preoperative preparation
Before deciding to remove wisdom teeth, patients need to have a detailed oral examination and imaging tests, such as a panoramic oral film or cone beam CT (CBCT). These examinations can help doctors understand the growth location of wisdom teeth, root morphology, and the relationship with surrounding tissues, and make appropriate tooth extraction plans. At the same time, the doctor will also ask the patient’s medical history, including allergy history, history of systemic diseases, etc., to assess whether the patient’s physical condition is suitable for tooth extraction.
narcotize
At present, wisdom teeth are generally removed by local anesthesia. Commonly used narcotic drugs such as lidocaine. The doctor will inject anesthetic drugs into the gum and alveolar bone around the wisdom tooth to make the surgical area lose pain. There may be slight pain during the injection of anesthesia, but this pain is generally tolerable. The effects of anesthesia usually begin to show within a few minutes of injection, and patients generally feel no pain during the procedure.
Tooth extraction
Depending on the specific condition of the wisdom tooth, the doctor will use different extraction methods. For wisdom teeth that are easier to remove, the doctor will use a denture to loosen the tooth and then pull it out with a dental clamp. For impacted wisdom teeth, such as mesio-impacted or horizontally impacted wisdom teeth, it is often necessary to cut the gum, remove the bone, and separate the teeth. After the gum is cut, part of the alveolar bone is removed to fully expose the wisdom teeth, and then the wisdom teeth are divided into small pieces and removed separately. Throughout the extraction process, the doctor will try to minimize damage to the surrounding tissue.
Postoperative management
After the wisdom tooth is removed, the doctor will place a cotton ball or gauze on the extracted wound and let the patient bite tightly to prevent bleeding. Generally, the cotton ball can be spit out after 30-40 minutes of biting. Postoperative patients need to pay attention to rest, avoid strenuous exercise, and prevent bleeding. In terms of diet, avoid eating within 2 hours after surgery, 2 hours later can enter warm, soft food, avoid spicy, irritating food and overheated food. Do not brush or gargle within 24 hours after surgery to avoid destroying the blood clot formed at the tooth extraction wound, leading to bleeding or infection. If pain, swelling and other symptoms occur after surgery, you can take analgesic and detumescent drugs under the guidance of a doctor.
Simple removal of wisdom teeth
When the wisdom tooth is completely erupted, the growth position is normal, the root shape is simple, and the patient is in good physical condition, the removal of the wisdom tooth is relatively simple. This kind of wisdom tooth in the extraction process, the doctor is convenient to operate, the operation time is short, the damage to the surrounding tissue is small, and the postoperative recovery is faster. The patient may have only slight pain and swelling after surgery, and the symptoms will be significantly relieved in 3-5 days, and the wound will basically heal in about a week.
Complicated removal of wisdom teeth
As mentioned above, impacted wisdom teeth, especially horizontally impacted wisdom teeth, as well as wisdom teeth with complex root morphology and close relationship with important surrounding structures, are difficult to remove. The surgical process may need to cut the gum, bone, tooth separation and other complex operations, the operation time is long, the doctor’s technical requirements are high. Patients are at increased risk of complications such as pain, swelling, bleeding, infection, and longer recovery times after surgery. In some patients, swelling may last a week or more after surgery, and the pain is more obvious, requiring a longer period of recovery and care.
Risks and complications of wisdom tooth removal
Although wisdom tooth removal is a common oral surgery procedure, there are still certain risks and complications. In addition to the pain, swelling, bleeding, infection and other problems mentioned earlier, there may also be damage to the mandibular nerve tube, resulting in numbness of the lower lip; When maxillary wisdom teeth are removed, if the operation is improper, it may penetrate the maxillary sinus and cause maxillary sinusitis. However, the incidence of these serious complications is relatively low, as long as you choose regular oral medical institutions and experienced doctors, do a detailed examination and assessment before surgery, standard operation during surgery, and good care after surgery, most of the risks and complications can be effectively avoided.
Conclusion
Whether wisdom teeth are simply removed cannot simply give a yes or no answer. It is affected by many factors such as the location of wisdom teeth, root morphology and patients’ own conditions. For normal growth of wisdom teeth without obvious symptoms, you can choose to observe; For wisdom teeth that have indications of removal such as repeated inflammation, causing dental changes in the adjacent teeth, and affecting the occlusal relationship, timely medical treatment should be conducted to evaluate the necessity and difficulty of removal by a professional doctor. When deciding to remove wisdom teeth, patients should not worry too much about the complexity and risk of the operation, believe in the professional judgment and technical level of the doctor, actively cooperate with the treatment, do a good job of postoperative care, in order to promote the smooth healing of the wound and maintain oral health.
Related topics:
Can I Eat a Honey Bun After Wisdom Teeth Removal?
Can You Eat Clam Chowder After Wisdom Teeth Removal?
12 Lunch Tips After Wisdom Teeth Removal
