Wisdom Teeth

What are wisdom teeth?

Wisdom teeth are third molars that usually appear in the late teens and early 20s. It is also also possible they will not come in. Your wisdom teeth are the last adult teeth to come through. There are four of them, right at the back of your mouth.

What is surgery to remove wisdom teeth?

An operation to remove your wisdom teeth involves making a small cut in your gum, separating the tooth from your jawbone and taking it out of your mouth. The teeth might be taken out whole or in small pieces. Sometimes, wisdom teeth don’t come through the gum properly. This usually happens when there isn’t enough space, or when the teeth are growing in the wrong direction. If they don’t come through properly, they’re called impacted wisdom teeth.

Who should have this operation?

Taking out wisdom teeth is one of the most common operations developed countries. But most people don’t need their wisdom teeth removed, even if the teeth are impacted. Guidelines from the National Institute for Health and Clinical Excellence (NICE), say that an impacted wisdom tooth should only be taken out if it’s causing you problems.

Problems include:
• An infection around the tooth
• Damage to a neighbouring tooth
• Decay (a cavity) in the tooth that your dentist can't treat
• A cyst (a sac filled with fluid) in your jaw.

If you do have one of these problems, you might get:
• Pain or tenderness in your gums or jawbone
• Bad breath
• Redness or swelling in your gums
• An unpleasant taste in your mouth
• Headaches or jaw ache.

If your impacted wisdom teeth aren ’t causing you problems, it’s best to keep them and avoid the risks of surgery. Sometimes, as your wisdom teeth come through, your gums may feel sore or tender for a while. This is normal, and isn’t usually a reason for having them removed. If you do need to have one or two of your wisdom teeth removed, it doesn’t mean that you need to have them all taken out.

What will happen if I don’t have surgery?

If your impacted wisdom teeth are causing you problems, it’s hard to know what will happen if you keep them. There isn’t much research, but most experts agree that it’s best to take them out. If you keep them, you could get mild infections that come and go. You might need to take antibiotics for these. Serious infections are rare, but can be dangerous. You could get a high temperature and swelling in your mouth bad enough to block your airways. An impacted tooth may damage your other teeth. You may also get a cyst (a sac filled with fluid) around the root of the impacted wisdom tooth, and the bone in your jaw may get damaged.

If your wisdom teeth are impacted but aren’t causing problems, taking them out may do more harm than good. But the research on wisdom teeth isn’t very good, so it’s hard to say for certain what will happen.
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• You may never get any symptoms at all. Many impacted wisdom teeth never cause problems.
• Your impacted wisdom teeth may eventually emerge normally.
• On the other hand, you may get a problem in the future, such as an infection, a cavity or gum disease.

Sometimes impacted wisdom teeth can damage nearby teeth and bone.

References
1. Removing Wisdom Teeth. Clinical Evidence, the British Medical Journal.