Wisdom teeth may sound like a positive term—after all, children are often told that only “wise adults” have wisdom teeth! However, when they do emerge, they can quickly turn into a painful story. While some people experience no discomfort as their wisdom teeth grow in, others may suffer from severe toothaches. In more serious cases, the pain can become so intense that it disrupts sleep, makes eating difficult, and causes facial swelling.
So, how should you deal with this troublesome issue? What treatment options are available? Do wisdom teeth always need to be removed? And is the cost of removal expensive? This article will explore these questions one by one.
What Are Wisdom Teeth?
Wisdom teeth are the third molars located on both sides of the upper and lower jaws and are the last teeth to emerge. A person typically has four wisdom teeth, originally intended to fill in gaps left by missing molars. However, with modern dental hygiene practices reducing the likelihood of molar loss, wisdom teeth often lack sufficient space to grow.
Wisdom teeth usually begin to emerge between the ages of 18 and 25. However, not everyone develops all four wisdom teeth. Statistics show that approximately 75% of people have all four wisdom teeth, while around 25% are missing one or more.
Wisdom teeth can be categorized into two types: erupted and impacted. Erupted wisdom teeth grow normally, aligning with the other teeth. Impacted wisdom teeth, on the other hand, occur due to modern humans having smaller jawbones than our ancestors, leaving insufficient space for the wisdom teeth to emerge. As a result, wisdom teeth may grow at an angle, either sideways, backward, or lower than the other teeth, and in some cases, they may remain entirely embedded within the jawbone.
Common issues with wisdom teeth include:
- Tooth Decay: Partially erupted wisdom teeth may be partially covered by gum tissue, making them difficult to clean. This can trap food particles, increasing the risk of tooth decay.
- Bad Breath: Due to the hidden position of wisdom teeth, they are difficult to clean, making it easy for food particles to become trapped, which can lead to bad breath.
- Pericoronitis: When there is not enough space for wisdom teeth to fully emerge, food debris can easily accumulate around them, leading to gum inflammation, swelling, and even bone loss in the jaw.
- Tooth Shifting: The growth of wisdom teeth may exert pressure on surrounding teeth, potentially causing them to shift out of alignment.
- Root Resorption: The growth of wisdom teeth may exert pressure on the roots of neighboring teeth, potentially causing the roots to shrink or resorb, which can weaken the affected teeth and lead to long-term dental issues.
- Periodontal Disease: Food debris can easily accumulate around wisdom teeth, increasing the risk of gum infections and periodontal disease, which may lead to gum recession, bone loss, and tooth instability over time.
The emergence of wisdom teeth can sometimes lead to serious issues such as pathological changes, cyst formation, or even jawbone fractures due to the pressure or weakening of the bone structure. Therefore, even if wisdom teeth do not cause noticeable pain, their presence should not be ignored. Timely evaluation and management are essential to prevent such severe complications.
When Should Wisdom Teeth Be Removed? What to Do About Impacted, Partially Erupted, or Inflamed Wisdom Teeth?
Wisdom teeth should be considered for removal if they cause cavities, infections, gum inflammation, cysts, or lead to the resorption of neighboring teeth. In many cases, wisdom teeth are removed as a preventive measure. Unless an individual is naturally missing wisdom teeth, most people will develop them, which can lead to various issues such as impaction or misalignment. Therefore, dentists must be well-prepared and possess the necessary skills to minimize the impact of wisdom tooth extraction on patients and to prevent potential complications.
Wisdom teeth are located at the very back of the mouth, making them difficult to clean properly during brushing. Due to this, they are prone to cavities, bacterial buildup, and gum inflammation. In some cases, issues with wisdom teeth are only discovered incidentally during an X-ray examination. Therefore, relying solely on symptoms such as pain or gum inflammation is not an accurate way to determine whether the teeth are in good health.
It is recommended to visit a dentist for an oral examination and X-ray between the ages of 17 and 19 to assess the growth of wisdom teeth and determine whether extraction is necessary. This preventive approach helps avoid potential dental issues in the future. At this age, young individuals generally have stronger immune systems, faster wound healing, and less pain after surgery. Additionally, since wisdom teeth are still in the early stages of growth, they are less likely to have cavities or inflammation, making extraction relatively easier. If you have any concerns, consult your dentist for an oral check-up and X-ray examination to evaluate the condition of your wisdom teeth and decide whether removal is required.
- Therapeutic
The wisdom tooth has decayed, causing gum inflammation and even pus formation. Additionally, cysts may develop, or the roots of the adjacent teeth may be resorbed.
- Preventive
Wisdom teeth often trap food and are difficult to clean, which may lead to more serious problems in the future. In such cases, extraction can be considered. Generally, partially erupted impacted wisdom teeth are more likely to cause issues, as plaque tends to accumulate around the impacted area, leading to cavities, periodontal disease, or pericoronitis.
Wisdom Tooth Extraction Process
Since wisdom tooth extraction is a minor surgical procedure, there are several important considerations before the surgery:
1) Inform your doctor of your medical history
You need to inform your doctor about your recent medical history, the medications you are currently taking, and any drug allergies you may have.
2) Oral Hygiene
Please ensure that your mouth and teeth are kept clean.
3) Wear Comfortable Clothing
It is also a good idea to wear comfortable and loose-fitting clothing before undergoing surgery.
4) X-Ray Examination
The doctor will conduct a detailed examination of your oral condition using a full-mouth X-ray to determine whether surgery is necessary for wisdom tooth extraction. In some cases, wisdom teeth are deeply embedded in the jawbone and located near facial nerves. If these nerves are affected during the procedure, it may result in numbness or loss of sensation in the mouth. Therefore, taking an X-ray is crucial for the safe removal of wisdom teeth.
Anesthesia
If surgical removal of an impacted wisdom tooth is necessary, the procedure is usually performed under local anesthesia.
6) Undergoing Surgery
Since impacted wisdom teeth are usually covered by gum tissue, the dentist will first make an incision in the gum and lift it to expose the tooth. Then, the surrounding alveolar bone covering the wisdom tooth will be removed. To minimize the size of the wound, the wisdom tooth may be sectioned into smaller pieces before extraction. After the tooth is removed, the dentist will clean the socket and suture the wound to complete the procedure.
Wisdom Tooth Surgery Risks and Post-Operative Care, Precautions? How to Take Care of the Wound?
Wisdom tooth extraction is a surgical procedure, and the most common side effects include facial swelling and pain. Other common risks include bleeding, wound infection, and tooth root fracture. A rarer complication is potential nerve damage when extracting lower wisdom teeth.
On the Day of Surgery
On the day of the surgery, special attention should be given to pain management and bleeding control.
Wisdom tooth surgery is usually performed under local anesthesia, which typically lasts for 3-4 hours. The doctor will prescribe painkillers to help manage the pain. Stitches can be removed after 7 days, but the wound will still take about one week to one month to fully heal.
For bleeding control, bite down gently on a gauze pad for about 30 minutes after the surgery. Additionally, avoid brushing your teeth, rinsing your mouth, or using mouthwash within the first 24 hours to prevent further bleeding. If bleeding persists, bite on a piece of gauze for about 30 to 40 minutes to help stop it. On the following day, you can rinse your mouth with salt water or warm boiled water to flush out any food residues from the wound, keeping your mouth clean and preventing infection.
During the first week after surgery, please pay attention to the following:
- You can apply an ice pack to your face on the day of the surgery to reduce swelling.
- Choose softer foods to eat and chew using the other side of your teeth.
- Choose softer foods to eat and chew using the other side of your teeth.
- Avoid smoking and drinking alcohol.
- Maintain oral hygiene to prevent wound infection.
- If bruising appears on the face a few days after surgery, apply a warm compress.
- Take pain medication as prescribed by your doctor when needed.
- If swelling persists or worsens within a week after surgery, or if you develop a fever, contact your doctor immediately for a follow-up examination.
These discomforts usually subside gradually within a week after surgery. However, if symptoms persist or worsen, seek medical attention promptly for follow-up.
Does removing wisdom teeth hurt?
The level of pain from wisdom tooth extraction varies depending on individual circumstances. After the procedure, you might experience swollen and sore gums, which is why many people feel apprehensive about having their wisdom teeth removed. In reality, the level of pain largely depends on the size of the wound and whether there is inflammation at the site.
If the wisdom tooth grows vertically and has already erupted, the dentist can simply use forceps to extract it. In such cases, the wound is usually small, and the pain and swelling are minimal. However, if the wisdom tooth issue has been left unaddressed for a longer time, and the surrounding tissue is severely inflamed, the wound may become more prone to swelling and pain.
That said, as long as you follow your dentist’s instructions, take painkillers and antibiotics as prescribed, the discomfort is unlikely to significantly impact your daily life.
Additionally, a minimally invasive surgical approach can be used for wisdom tooth extraction. This method results in a smaller wound, reduces pain, and speeds up the recovery process.
Cost of Wisdom Tooth Extraction
Regarding the cost of wisdom tooth extraction, if the tooth has grown in normally without any obstruction, surgery is usually not required, making the procedure relatively inexpensive.
However, if the wisdom tooth is impacted or grows sideways, the procedure becomes more complex. The dentist will need to prepare thoroughly and apply advanced techniques to minimize the impact on the patient and avoid potential complications. As a result, the cost of wisdom tooth extraction surgery is generally higher.
In general, the cost of extracting a wisdom tooth ranges from HKD 2,000 to 3,000. For surgical extractions, the price per tooth is typically between HKD 5,000 and 8,000. Specialist dentists may charge even more, with fees exceeding HKD 10,000. If the wisdom tooth’s position is particularly complicated and additional examinations are required, the cost may increase further.
The removal of wisdom teeth may lead to the following five potential complications:
- Anesthesia Risks: If the patient is allergic to anesthetics, thorough evaluation must be conducted before the procedure.
- Post-Surgery Infection: If the wound is not properly cared for or antibiotics are not taken on time after the procedure, bacteria may cause wound infection.
- Excessive Bleeding: Poor wound closure or abnormal platelet function in the patient may lead to uncontrolled bleeding.
- Impact on Adjacent Teeth: Improper handling during the procedure may damage surrounding teeth. Follow-up appointments are necessary to monitor the condition after surgery.
- Nerve Damage: As the roots of lower wisdom teeth are close to the nerve lines, there is a chance that these nerves may be affected during the removal process, potentially causing temporary numbness in the lower lip and tongue.
However, as long as you follow the doctor’s instructions, take medication on time, and carefully care for the wound, removing wisdom teeth generally does not result in serious complications. If any abnormal symptoms occur after the procedure, it is important to return for a follow-up as soon as possible to prevent the condition from worsening.
Q&A
Does everyone have wisdom teeth?
Apart from a small number of people who are born without wisdom teeth, the majority will eventually develop them. Approximately 75% of people have all four wisdom teeth, while about 25% are missing at least one.
No Pain, No Need to Worry? Do Wisdom Teeth Always Need to Be Removed?
It is common for patients to discover issues with impacted wisdom teeth only during X-ray examinations. Therefore, relying solely on symptoms like pain or gum inflammation is not an accurate way to assess dental health. Even if the growth of wisdom teeth seems less than ideal and there is no immediate pain, they can still cause other problems, such as pushing teeth out of their original positions, eroding surrounding teeth and bone, or even leading to severe complications like jaw fractures.
In addition, impacted wisdom teeth are often partially covered by gum tissue, creating gaps where food can become trapped and difficult to clean, potentially leading to cavities. Bacteria can also accumulate in these gaps, causing issues such as pericoronitis. Therefore, it is crucial to examine and address impacted wisdom teeth early to prevent these potential problems from causing greater harm to oral health.
Does Removing Wisdom Teeth Cause Facial Paralysis?
No, it won’t. The lower wisdom teeth are usually located near the inferior alveolar nerve, which is responsible for the sensation in the lower lip and tongue. Additionally, the lingual nerve is located near the gum tissue close to the tongue. In some cases, wisdom teeth may be positioned close to these nerves, and during the extraction process, there is a possibility of affecting these nerves, leading to temporary numbness in the lower lip or tongue. In severe cases, this could result in permanent damage, but it will not cause facial paralysis as rumored. This is because the affected nerves are sensory nerves, not motor nerves, so they do not control facial movement.
It’s also worth noting that in recent years, doctors have started using 3D computer scanning technology to assess the distance between wisdom teeth and the nerves, which helps minimize the risk of nerve damage during surgery.
