Wisdom Teeth


As often as we hear about “wisdom teeth”, usually stories of their extraction and afterwards eating as much ice cream as we wish, ever wonder where that connection with wisdom comes from? Humans gain their first set of molars at around age 6, their second set around puberty at age 12, and their third set when they grow even wiser, between the ages of 17 and 25!  Also known as Third Molars, they are the last teeth to erupt. Generally, there are four wisdom teeth, one in each corner of the dental arch. However it is not uncommon for one or more to be missing, and some people even have five!

We may wish for more wisdom, but having more teeth erupt into restricted space can be painful and problematic. In some patients, wisdom teeth erupt normally into the arch and cause no problems whatsoever, but in the majority of cases, these teeth only erupt partially or remain under the gum—we refer to them as“impacted”.

Wisdom teeth xray

Impacted teeth can grow in different directions and cause a variety of complications. Gums can become infected due to debris and bacteria sneaking in under the flap of gum that covers a partially erupted tooth. If the tooth is growing in asymmetrically, the pressure applied to an adjacent tooth can cause structural damage such as resorption, decay or change in another good tooth’s position. The wise ol’ wisdom teeth can get cavities from the difficulty one faces in brushing them well. And about 10% of unerupted wisdom teeth result in cyst formation later in life. If this cyst goes unnoticed by infrequent visits to the dentist, considerable damage can be caused to the jaw bone when the teeth are finally removed. Quite unwise to wind up losing part of your jaw due to these pesky wisdom teeth causing trouble long after they appeared in one’s teens.

The smart thing to do is to get an assessment in your teens or early twenties. This will begin with a clinical and a radiographic exam. A panoramic x-ray will provide an overall view of both jaws, the position of the teeth within the bone and their relationship to other important anatomical features, such as nerves and blood vessels, as well as the shape of the roots. Depending on the extent of the extraction, the removal can be done in a dentist’s office with local anesthetic, or will be referred to an oral surgeon where the procedure would likely be done under sedation.  Depending on the type of extraction, post operative pain and swelling can be expected. This will vary depending on the ease or difficulty in removing the teeth. Swelling, if it occurs, will generally peak at 72 hours, and bruising may appear as the swelling subsides.

“Arnica” is a natural product that if taken beforehand reportedly reduce the amount of post operative inflammation and swelling. You can discuss this with your pharmacist or naturopath for more information.
And Now for the Fine Print:

Removal of wisdom teeth is a surgical procedure, and like all surgeries, does involve some risk. The procedure can result in a variable amount of pain, bleeding, swelling and bruising, which will be controlled with medication, pressure and icepacks.  Wisdom teeth are close to nerves, fossae and sinuses. Unintentional damage may occur to regional nerves, or in the case of the upper wisdom teeth, sinuses can become exposed. These complications cannot always be predicted, and may become evident at the time of surgery or even afterwards during recovery. Damage to local nerves will present as a residual numbness long after the local anesthetic has worn off. Sensation will generally return over time, and this period will depend on the extent of the initial damage to the nerve.  Post operative healing is generally uneventful, but occasionally a socket may become infected and healing can be delayed. This can be painful, but controlled with socket dressings and medication

Earlier in our evolution, we needed our wisdom teeth to chew the heavy fibrous foods that sustained us, like leaves, stalks, etc. Fortunately, we now find our fiber in muffins, bran flakes, and apples, so we no longer need these teeth to eat the foods we buy at our grocery stores. They are what scientists call “vestgial” . . . we got ’em, but many of us would be better off without ’em. Use your head: have a clinical exam and x-rays to discover how easy or difficult your wisdom teeth might be, and have them removed, if necessary, sooner than later!

You will be much the wiser for it!