Wisdom Teeth

They are in the latest que of the teeth row and they grow at the latest. These teeth generally appear in the mouth between the ages of 17-22.  A decision should be made if they would be extracted or stay in the mouth according to their locations, the tissues that they are on, and whether they damage the adjacent teeth or not. The availability of enough space on the jaw, a convenient proportion between the sizes of teeth and jaw, and the stocking eruption positions of these teeth should be considered. It is useful to extract the ones that are impacted to the gingiva (totally or partially) or the bone.

If there are missing first and second molar teeth inside the mouth due to lack of treatment in the youth, the treatment to protect the wisdom teeth is necessary. In case a dental bridge prosthesis would be required in the future, the necessary treatment of the wisdom teeth can be done.. Otherwise, the need to apply removable teeth prosthesis may arise since there will be no chance to make dental bridge prosthesis.

The classification of the wisdom teeth according to their impacting levels;

Fully impacted wisdom teeth inside the bone,

Wisdom teeth that are not inside the bone but gingiva,

Wisdom teeth that are half grown, half inside the gingiva,

Normally grown wisdom teeth.

This classification is made from the hardest to extract to the easiest one, in terms of the extraction operation

The classification of the wisdom teeth according to the eruption inside the bone

The teeth that are in the same position with the other ones in the front, whose chewing surfaces are at the same level,

The teeth that tend to have different angles according to the teeth in front of the chewing surface,

The teeth of which the chewing surfaces are totally (with 90 degrees) in contact with the lateral side of the adjacent teeth. Here, there is a classification from the easiest to the hardest in terms of extraction.

The problems that the wisdom teeth can cause are;

Formation of cysts or tumors in the vicinity or root of the teeth,

Pain in the jaw, difficulties in opening and closing due to inflammation, gingivitis,

Crowding due to pressure to the frontal teeth,

Dental abscess in case they are ignored too much,

Swellings inside the mouth and on the face,

Bad breath due to decays and bacteria accumulation.

The bad positioning of the wisdom teeth makes them harder to reach with toothbrush or dental floss. For this reason, they can decay in a short time. Even if the dental care of the individual is enough, it would not possible to reach and clean these teeth. In such a case, there could be no decays in the early erupted teeth, but they can occur in the wisdom teeth. This is totally about the position of the teeth. Besides, the decay of the wisdom teeth also causes the decay of the second molar by making it to contact with the bacteria continuously, which is a decay factor.

When the wisdom teeth should be extracted?

The teeth that have not arrived at the right position even the development of the jaw is complete, have to be extracted as soon as they are detected. They should not be waited to cause pain or problems. It will be more challenging to extract a tooth which started to decay, has lost its pieces or is broken. It will not be possible to extract or respond to an abscessed or infected tooth and the use of antibiotics will become an obligation. The dentist can only perform the extraction after the infection is suppressed. Healing will be easier at the young ages, but the recovery difficulties will be more likely as getting older . Besides, the extraction could be very hard and recovery difficulties may arise due to heart, diabetes, and other systemic diseases; it may also be impossible to extract the tooth in some serious diseases.

The situations that the extraction of the wisdom teeth is essential;

In case the dental care cannot be done due to the position and location of the tooth, it has to be extracted due to the risk of progression and spread of the decay.

If orthodontics treatment is deemed necessary because of the wisdom teeth affect the arrangement of the teeth and causing crowding, then the wisdom teeth have to be extracted.

The fully impacted wisdom teeth start to erupt when the other teeth are extracted to apply palate prosthesis. The existence of these teeth in the mouth cannot be determined unless the necessary radiological assessment is done. The wisdom teeth erupt and grow through the mouth and after the prosthesis is fixed, and they cause pain due to prosthesis pressure on them. The compatibility of the prosthesis is affected. The prosthesis cannot be fully matched even after the wisdom teeth are extracted.

Formation of cysts around the wisdom teeth can often be observed. It may grow excessively when ignored and may cause large bone losses. Breaking in the jawbone can be seen although it’s very rare. Besides, tumor formations may occur around the tooth.

Too many food residues may build-up in the areas where there are impacted wisdom teeth in the gingiva. The build-up of bacteria will be excessive there. For this reason; gingivitis, bad breath, and bleedings may occur while brushing or without any external effect.

The procedure of wisdom tooth extraction;

Firstly, the extraction is done in the clinical environment, but under more sterile conditions.

Anesthesia is applied for a painless extraction and the operational area is anesthetised. The tooth is extracted.

The necessary stitches are put after the extraction and a quicker recovery for the area is ensured.

Antibiotics are advised, if necessary. Besided, painkillers are given.

The stitches are removed after a week, if there are any.

Care after the wisdom tooth extraction and things to be observed:

The buffer that is put on the area where the tooth is extracted should be kept for 30 minutes. This bleeding control will enable the formation of a clot.

If bleeding continues after the removal of the buffer, put a new, clean one and consult your dentist if the bleeding is excessive.

Do not eat or drink before the anesthesia loses its effect (2 hours on average).

Make sure to use the other side of the mouth for chewing during the first day.

Do not temperthe extraction area, avoid picking apart your cheek and lip to show or look at the stitches, and do not force yourself to open your mouth excessively. Such movements may cause toothache, bleeding, break off in stitches, and tear in gingiva.

Do not smoke and drink alcohol during the day.

Do not gargle and shake too much. This will cause the removal of the clot.

Depending on the difficulty of operation, there could be swellings on your face. During the first 24 hours, apply cold to the extraction area externally, with short intervals.

Use the prescribed medication properly and regularly. Consult to your dentist about the discomfort that may occur due to the medication.