Exodontia.Info
'Wisdom Teeth' / 3rd Molars
Why do we have Wisdom Teeth?

Adults can have a maximum of 32 teeth.  The wisdom teeth
are the last to come through, right at the back.  They
usually appear between the ages of 17 and 25, although
sometimes they appear many years later.  Nowadays,
people often have jaws that are too small for all 32 teeth;
28 is often the most we have room for.  So, if all the teeth
are present and healthy, there may not be enough space
for the
wisdom teeth to come through properly.


Do they always cause problems?

No.  If there is enough room they will usually come through
into useful positions and cause no more problems than any
other tooth.  Often there will be some slight discomfort as
they come through, but this is only temporary and will
disappear once the tooth is fully in position.


What is an impacted Wisdom Tooth?

If there is not enough room, the wisdom tooth may try to
come through, but will get stuck against the tooth in front of
it (“
impacted”).  The impacted wisdom tooth can be angled
in a number of different ways and this can indicate how
difficult the tooth may be to remove.


What problems should I be prepared for?

If part of the wisdom tooth has appeared through the gum
and part of it is still covered, the gum may become sore
and perhaps swollen.  Food particles and bacteria can
collect under the gum edge and it will be difficult to clean
effectively.  You will be advised whether this is a
temporary problem that can be dealt with by using
mouthwashes and special cleaning methods (and possibly
antibiotics) or whether it is better to have the tooth
removed.


What can I do to help myself?

A hot saltwater mouthwash or an antiseptic mouthwash
such as
Corsodyl will help to reduce gum soreness and
inflammation, getting into areas your toothbrush cannot
reach.  Painkillers, such as
Paracetamol or Ibuprofen can
also be useful in the short term.


What if these don't help?

If the pain doesn't go or if you find it difficult to open your
mouth or get repeated infections around the crown of the
tooth, then it is likely that you will need medication or
extraction.
Last Updated 22nd January 2016
Are X-rays needed?

The tooth will need to be X-rayed to see the position of the tooth, its angulation /
impaction and whether there is any disease process present that compromises the
wisdom tooth or its adjacent teeth.


What are the main reasons for taking Wisdom Teeth out?

  • When there are repeated infections associated with the wisdom tooth




  • If the wisdom tooth is in the line of surgery.

The indications for
Wisdom Tooth / Teeth removal, in the UK (outside Scotland -
Scotland uses the
SIGN Guidelines) and in the NHS, is governed by the NICE
Guidelines.


Are Wisdom Teeth difficult to take out?

It all depends on the position and shape of the roots.

You will be told how easy or difficult to remove each tooth is likely to be after
having an X-ray.

Upper wisdom teeth are often more straightforward to remove than the lower
ones, which are more likely to be impacted.

Very occasionally, there is a possibility of some
numbness of the lip ± tongue after
the removal of a lower tooth (this can be a permanent or temporary numbness).  
You will be told if this is likely in your case.

A more comprehensive list of warnings can be found
here.


Will it make any difference to my face or my mouth?

Removing wisdom teeth may produce some swelling for a few days but as soon as
the area is healed, there will be no difference to your face or appearance.

Your mouth will feel more comfortable and less crowded, especially if the teeth
were impacted.


What should I expect after a Wisdom Tooth is extracted?

The amount of discomfort will depend on how easy the removal of the tooth was.

There is usually some swelling and discomfort for a few days afterwards and it is
important to follow any advice you will be given about mouthwashes etc, to help
with the healing.

Painkillers, such as Paracetamol or Ibuprofen will usually deal with any pain.

It is best to stay fairly quiet and relaxed for 24-hours afterwards to make sure
there are no problems with bleeding.

There may be some stitches to help the gum heal over; these are dissolvable.


Useful Websites:

National Institute of Clinical Excellence Guidance on the Removal of Wisdom Teeth

Scottish Intercollegiate Guidelines Network Management of Unerupted and
Impacted Third Molar Teeth


Useful Articles:

NHS Direct Best Treatments 2006 - Removing Wisdom Teeth

BAOMS Advice Regarding Wisdom Teeth

BMJ Clinical Evidence 2010 Impacted Wisdom Teeth

BJOMS 2011.  Technical Note.  A method for extraction of impacted upper 3rd
molars

BDJ 2012.  The Effects of NICE Guidelines on the Management of 3rd Molar Teeth

Get Well Soon (RCS England) - Wisdom Teeth Extraction (2012)

Cochrane Review 2014.  Review.  Surgical techniques for the removal of
mandibular wisdom teeth


American Association of Oral & Maxillofacial Surgeons.  Wisdom Teeth

Intech.  New Concepts in Impacted 3rd Molar Surgery