Wisdom Teeth Problems

Why do we have wisdom teeth?

In prehistoric times, humans had huge (and strong) jaws and these teeth helped in chewing hard foods such as raw meat and plants. So the third molars were needed and had plenty of room to erupt. Experts in evolutionary biology believe that wisdom teeth no longer have a function in the human body and that they will disappear over generations as a result of the natural evolution of the species. Although they do not currently have a specific function, wisdom teeth can provide some support in grinding and chewing (provided they are correctly developed), just like the molar teeth.

Wisdom tooth problems

Problems can occur with the wisdom tooth, mainly associated with its partial or incomplete eruption, namely a strong inflammation of the surrounding soft tissues, called pericoronaritis.

In these situations where problems occur in the eruption of the wisdom tooth, symptoms such as severe pain, inflamed gums or “swollen gums” due to edema or abscess, as well as limitation when opening the mouth (trismus) and bad breath (halitosis) occur in a common way. In other words, there is a situation where the soft tissues around the wisdom tooth become inflamed due to the eruption of the tooth.

No caso de impactação dentária, o dente do siso pode causar dor de cabeça ou enxaquecas, dores nos maxilares e, por vezes, provocar também dor de ouvido.

In certain circumstances, the wisdom tooth can be seen to bend the other teeth, namely the front teeth, due to the pressure it exerts during its eruption, which is reflected up to the anterior region.

Impacted wisdom teeth

Sometimes the wisdom tooth is left as an impacted or semi-included tooth. This occurs when the wisdom tooth does not erupt naturally, leaving the tooth impacted and crooked, or even retained within the jawbone.

This situation normally happens when there is not enough space for its proper positioning in the dental arch, or when it is in a “horizontal” or “lying” position inside the maxillary bone, thus not allowing it to erupt.

Surgery for wisdom tooth extraction

Wisdom tooth extraction surgery, “taking out or pulling the wisdom tooth” should be considered when there is a lack of space for its complete eruption or when the tooth remains impacted and can cause symptomatology or root resorption of adjacent teeth. Wisdom tooth extraction may also be considered when it causes severe pain upon its eruption in a prolonged manner.

In which cases should a wisdom tooth be extracted?

If the tooth is badly damaged or causing pain it should be extracted.

If they are turned towards the cheek, i.e. positioned incorrectly, they can cause permanent maceration and pain.

If the wisdom tooth is not causing pain but is causing decay in the adjacent tooth, it should be extracted.

When there are cysts or tumours associated with the wisdom tooth, the best diagnosis is to extract it.

In orthodontic treatments, the extraction of a wisdom tooth is sometimes the ideal solution to create space in the arch and facilitate the movement of other teeth in order to correct their position.

Is it contraindicated to extract wisdom teeth?

When there are infections or abscesses, these should be treated first.

Sometimes the wisdom tooth is positioned close to the lower dental nerve and its extraction can damage the adjacent structure with associated consequences, namely the appearance of paresthesia. This is reversible, however, it can last days, weeks or months, depending on the degree of injury to the dental nerve. In the event of a complete cut or section of this nerve, then we are faced with a more serious situation corresponding to paralysis of the affected area.

In this case, the ideal option is to opt for surveillance and only in the last resort to extract it.

What are the prices of an extraction?

In wisdom tooth extraction surgery, the price or value varies according to the complexity involved, being more expensive in cases where the wisdom tooth is still included. Only the specialist in maxillofacial surgery can determine how much the treatment costs, after diagnosis and evaluation in consultation.

How to relieve the pain of wisdom teeth?

When the pain is a reflection of the wisdom tooth eruption, appropriate medication is usually prescribed for its regression, often with a view to its subsequent extraction.

Medication for toothache, such as painkillers and anti-inflammatory drugs can reduce or relieve pain in these cases. Topical or local anaesthetics are also available, usually in directly applied spay.

It may also be necessary to prescribe an antibiotic when there is already an infection of the soft tissue adjacent to the wisdom tooth site.

It is also useful to apply an ice pack to the area of the face involved for about 15 minutes and more than once a day, which will reduce the inflammation.