In the field of oral health, extracting wisdom teeth is a topic that is often mentioned and feared by people. When many people hear the words “wisdom tooth extraction”, the first thing that immediately comes to mind is a strong sense of pain. Some even describe wisdom tooth extraction as “one of the most painful experiences in life”. So, why is extracting wisdom teeth so painful? This involves multiple factors such as the special physiological structure of wisdom teeth, the complexity of the tooth extraction process, and the physiological responses of the human body.
The special physiological structure of wisdom teeth: The underlying basis of pain
Wisdom teeth, scientifically known as the third molars, are the last teeth to emerge in the human mouth, usually starting to grow around the age of 16 to 25. From an evolutionary perspective, the human jawbone is gradually getting smaller, while the size and shape of wisdom teeth have not changed significantly. This results in the fact that the oral space of most people cannot accommodate the normal eruption of wisdom teeth.
The growth positions and directions of wisdom teeth are diverse, which is one of the important reasons why they cause pain. Common impacted wisdom teeth include horizontal impacted teeth, vertical impacted teeth, proximal impacted teeth, and distal impacted teeth, etc. Horizontal impacted wisdom teeth refer to teeth that grow horizontally and are completely or partially embedded in the alveolar bone. Such wisdom teeth often press against adjacent teeth, not only exerting pressure on the adjacent teeth, leading to tooth decay and root resorption, but also requiring the incision of the gum and the removal of a large amount of alveolar bone during extraction, resulting in significant surgical trauma and naturally more severe pain. Although vertical impacted wisdom teeth grow vertically, if they are covered by the gums, forming blind pockets, food debris can easily accumulate in them and be difficult to clean, which can breed bacteria and cause pericoronitis. When the inflammation occurs, the pain is unbearable. When extracting such wisdom teeth, the gums also need to be cut open to deal with the surrounding inflamed tissues, and the postoperative pain is also quite obvious.
The tissue structure around wisdom teeth is complex, increasing the risk of pain. The roots of wisdom teeth are relatively close to important structures such as the inferior alveolar nerve and the maxillary sinus. During the extraction of mandibular wisdom teeth, if the root of the wisdom tooth is closely connected to the inferior alveolar nerve, the extraction operation may damage the nerve, leading to discomfort symptoms such as numbness and pain in the lower lip after the operation. Moreover, the recovery process of the pain caused by this nerve damage is slow and may last for a relatively long time. When extracting wisdom teeth in the upper jaw, if the tooth root is close to the maxillary sinus, once the tooth root enters the maxillary sinus, not only additional treatment is required, but also the risk of infection increases, leading to intensified pain.
The complexity of the tooth extraction process: A direct cause of pain
The surgical process of extracting wisdom teeth is more complicated than that of extracting ordinary teeth, which directly leads to pain during and after the tooth extraction. Before tooth extraction, although local anesthesia is administered, the anesthetic effect is not completely painless for everyone. Some people, due to individual differences, have a lower sensitivity to anesthetic drugs and may experience a certain degree of pain during the operation. Moreover, wisdom teeth are located at the back, and the space for oral operation is limited. The injection of anesthetic drugs is relatively difficult, and there may be insufficient anesthesia, which increases the chance of pain during the operation.
The surgical operation itself can cause traumatic pain. For impacted wisdom teeth, the first step is to cut open the gum to expose the wisdom tooth. The gums are rich in nerve endings. The moment the gums are cut open, the nerves are stimulated, causing sharp pain. Then, as wisdom teeth are surrounded by alveolar bone, it is often necessary to use a dental drill to remove part of the alveolar bone. The vibration and pressure generated during the bone grinding process can stimulate the surrounding periodontal ligament and nerves, causing pain. The periodontal ligament is an important tissue that connects teeth and alveolar bone. It is rich in nerves and blood vessels and is highly sensitive to pain. During the process of separating teeth from the periodontal ligament and protruding teeth, the periodontal ligament is pulled and torn, and the pain will further intensify. If the root shape of wisdom teeth is complex, such as multiple roots or curved roots, more time and effort will be needed for extraction. Repeated operations will constantly stimulate the surrounding tissues, leading to prolonged pain.
Bleeding during the tooth extraction process is also one of the factors causing pain. After tooth extraction, the wound will bleed and form a blood clot, which plays a role in protecting the wound and promoting healing. However, if there is a significant amount of bleeding and a large hematoma forms, it will compress the surrounding nerves and tissues, causing a feeling of distension and pain. Moreover, if the blood clot falls off, it will expose the bone surface and nerve endings beneath the wound, causing dry socket syndrome. Dry socket syndrome is a common complication after wisdom tooth extraction, characterized by severe pain at the extraction site that radiates to the temporal region of the ear, the lower jaw area or the top of the head. The pain can last for several days or even weeks, causing great suffering to the patient.
The physiological response of the human body: the amplification effect of pain
The physiological response of the human body when facing the trauma of tooth extraction further amplifies the sensation of pain. Tooth extraction can trigger an inflammatory response in the human body. When the wound tissue is damaged, the body will activate its self-repair mechanism, and immune cells will gather at the wound site, releasing inflammatory mediators such as prostaglandins and interleukins. These inflammatory mediators can cause local blood vessels to dilate, increase vascular permeability, lead to tissue swelling, and also enhance the sensitivity of nerve endings to pain, amplifying the original pain sensation.
Pain can also trigger the body’s stress response. When the human body feels pain, it secretes stress hormones such as adrenaline and cortisol. Adrenaline can accelerate the heart rate and raise blood pressure, while cortisol regulates the body’s metabolism and immune function. The secretion of these stress hormones can put people in a state of tension and anxiety, and emotional factors, in turn, affect the perception of pain. Studies show that anxiety and tension can lower the pain threshold of the human body, making people more sensitive to pain and thus finding it more unbearable.
The pain during the postoperative recovery process should not be ignored either. The wound after tooth extraction takes some time to heal. During the healing period, the wound will go through stages such as inflammation subsiding and tissue repair. In the first few days after the operation, the pain at the wound site is quite obvious, especially during oral activities such as swallowing, speaking and chewing, which can pull on the tissues around the wound site, stimulate the nerves and aggravate the pain. Moreover, during the wound healing process, scar tissue is formed, and the contraction of the scar tissue may also cause pain and discomfort. If the wound gets infected, the pain will be more severe and may also be accompanied by systemic symptoms such as fever and swelling.
Individual difference factors influencing the degree of pain
In addition to the above common factors, there are significant differences in the pain perception of wisdom teeth extraction among different individuals. Age is an important factor. Young people have relatively stronger physical recovery abilities and may also have better tolerance for pain. However, due to the decline in physical functions and weakened tissue repair capabilities of the elderly, they may also have multiple underlying diseases such as hypertension and diabetes. These diseases can affect wound healing, leading to longer and more severe pain.
An individual’s pain threshold and psychological state can also have a significant impact on pain perception. The pain threshold refers to the lowest intensity of pain that the human body can sense. The pain threshold varies from person to person. Some people are born with a higher pain threshold and a stronger tolerance to pain, so they may feel relatively less pain when having their wisdom teeth extracted. People with a lower pain threshold, however, will find the pain unbearable. In terms of psychological state, patients who are overly tense and fearful before the operation often experience more intense pain during the tooth extraction process and after the operation. On the contrary, people who maintain a relaxed and positive mindset can better cope with pain, and their pain perception will be relatively alleviated.
The local health condition of the oral cavity is also related to the degree of pain. If a patient has poor oral hygiene before tooth extraction and has inflammation such as gingivitis and periodontitis, the inflamed tissues are more likely to be stimulated during tooth extraction, and the risk of postoperative infection is also higher, thereby aggravating the pain. In addition, for patients who smoke, the harmful substances in the smoke can affect the blood circulation and tissue repair of the wound, which may also lead to increased pain and delayed healing.
Conclusion
The pain caused by wisdom tooth extraction is the result of the combined effect of multiple factors. The special physiological structure of wisdom teeth, the complex extraction process, the physiological responses of the human body, and individual differences all make wisdom tooth extraction an oral surgery with a relatively high risk of pain. Understanding the causes of these pains can help us make full psychological preparations before extracting wisdom teeth, choose an experienced dentist to perform the operation, and follow the doctor’s advice after the operation, do a good job in nursing, try to relieve the pain and promote the smooth healing of the wound. Although the process of extracting wisdom teeth may cause some pain, for the sake of oral health, it is very necessary to deal with problems with wisdom teeth in a timely and correct manner when they occur.
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