Wisdom tooth removal is a surgical procedure to extract one or more of the four wisdom teeth (third molars) located at the back corners of your mouth, and usually erupt after the age of 16 years.
The fact that the wisdom teeth are the last ones to come out, and that there are no placeholders in the form of primary teeth, usually means that there is likely to be insufficient room in the mouth for them to grow into, causing them to develop abnormally.
When this happens, the teeth are said to be “impacted”. The teeth can be impacted forwards into the tooth in front or backwards into the jaw bone, leading to pain, swelling, and even an infection.
Impacted wisdom teeth can cause a variety of problems, including:
- Food packing – Food and bacteria get trapped around the edge, causing plaque to build up. This eventually leads to a variety of dental problems, including gum disease, tooth decay, abscesses in gums, and recurring mouth infections.
- Repeated attacks of infection in the gum surrounding the tooth, resulting in pain and swelling
- Round swellings or cysts that form around the wisdom tooth when fluid fills the sack that usually surrounds a developing wisdom tooth.
Wisdom teeth problems usually affect individuals in their late teens or early twenties, but they don’t have to be extracted if they are not causing any problems, as this can also result in certain side effects that have long-term implications.
Disadvantages of removing wisdom teeth
Although there are various complications and side effects that may arise from wisdom teeth removal, it’s important to note that not all patients will experience these complications, and many factors can influence the likelihood of complications, including the position of the teeth, the patient’s age, and the skill of the dentist or oral surgeon performing the extraction.
Ultimately, the decision to extract wisdom teeth should be made on a case-by-case basis, taking into account the potential risks and benefits for each individual patient.
Here are some disadvantages that may have long-term effects:
Pain and discomfort
The recovery period after wisdom tooth extraction can be uncomfortable and painful. Some patients experience swelling, bruising, and difficulty opening their mouth for several days following the procedure, but sometimes, the pain may persist for longer due to various complications.
Numbness or tingling
During wisdom tooth removal, there are two nerves located very close to the roots of the lower wisdom teeth. One of these nerves is responsible for providing sensation to the lower lip, chin, and lower teeth, while the other is responsible for providing sensation to the tongue and assisting with taste.
Sometimes these nerves can become injured during the extraction process, which can result in tingling or numbness in the lip, chin, or tongue, and sometimes a change in taste.
Around one in every 10 people may experience tingling or numbness that can last several weeks, while less than one in 100 people may have long-term complications that last more than a year.
The healing time after a wisdom tooth extraction can vary from person to person, but typically it takes about 7-10 days for the gum tissue to fully heal. However, if the blood clot that forms in the socket where the tooth was removed becomes dislodged or dissolves before the wound has healed, it exposes the bone and nerves in the socket, which can lead to infection, pain, and bad breath. This is a very painful condition known as dry socket.
The symptoms of dry socket usually appear 2-4 days after the tooth extraction and can last up to a week. They include severe pain that radiates to the ear, a bad taste in the mouth, and a foul odor. The socket may also appear empty, and you may see bone.
To avoid dry socket, it’s important to follow the aftercare instructions provided by your dentist or oral surgeon. This includes avoiding smoking, spitting, or using straws for at least 24 hours after the extraction. You should also avoid eating hard or crunchy foods and rinse your mouth gently with salt water to promote healing.
If you suspect that you have dry socket, you should contact your dentist or oral surgeon immediately. They may prescribe pain medication and may need to clean the socket and apply a medicated dressing to promote healing. In severe cases, they may need to perform a surgical procedure to fill the socket with a blood clot substitute. The healing time for dry socket varies depending on the severity of the case but can take up to several weeks.
While surgical wisdom tooth extraction is generally safe and well-tolerated, there is a risk of infection, and in rare cases, it can spread to other parts of the body, leading to serious complications.
During the extraction, the dentist or oral surgeon creates an incision in the gum tissue to access the tooth. After removing the tooth, the area is cleaned and may be sutured closed. However, bacteria can still enter the site through the incision or through an open socket where the tooth was removed.
If bacteria infect the extraction site, it can cause an infection. Symptoms of an infection may include pain, swelling, redness, and pus or discharge from the site. Infections can be treated with antibiotics, but in some cases, additional treatment or even a second extraction may be necessary.
To minimize the risk of infection and promote faster healing, it is important to follow post-operative instructions carefully. This may include keeping the area clean and avoiding certain foods or activities that can disrupt the healing process.
The maxillary sinuses are located near the upper wisdom teeth, and the removal of these teeth can sometimes cause sinus problems such as:
- Sinus perforation: This occurs when the thin wall of bone that separates the sinuses from the mouth is accidentally broken during the extraction process, leading to a hole that connects the sinus cavity to the mouth.
- Sinus infection: The bacteria that can enter the hole created during the extraction can cause a sinus infection, which can cause symptoms such as pain, pressure, and congestion.
- Sinusitis: Inflammation of the sinus lining can occur due to the pressure changes that result from the extraction, leading to sinusitis.
- Sinus headache: The changes in pressure and inflammation caused by the extraction can lead to sinus headaches, which can be severe and long-lasting.
Changes in bite or jaw alignment
If the wisdom teeth are causing crowding or misalignment, their removal can alter the bite or jaw alignment, which may require further orthodontic treatment.
Some of the reported cases involve:
- Anterior open bite (where the front teeth don’t meet properly) and posterior crossbite (where the back teeth don’t align properly).
- Changes in the occlusal relationship (how their teeth fit together when they bite down).
- Mandibular anterior crowding (where the lower front teeth become crowded together).
Temporomandibular joint (TMJ) problems
The removal of wisdom teeth can sometimes affect the TMJ, which can cause pain or discomfort in the jaw or ear. Other symptoms of TMJ problems include:
- Muscle spasms and pain in the jaw and face
- Limited jaw movement or difficulty opening the mouth fully
- Clicking or popping sounds in the jaw when opening or closing the mouth
- Uneven bite or changes in the way teeth fit together
- Development of a TMJ disorder, which can lead to chronic pain and limited jaw function over time.
These complications are rare, and even when they occur, they tend to be temporary and can be managed with conservative treatments like physical therapy, pain medication, and jaw exercises.
Damage to adjacent teeth and soft tissues
During the extraction process, adjacent teeth and soft tissues (gums, cheeks, tongue) may become damaged or injured, which can result in additional dental work. Some kinds of damage include:
- Shifting of adjacent teeth, which can cause overcrowding and bite problems: This can occur due to the loss of support that the wisdom teeth provided to the adjacent teeth.
- Tooth fracture: Adjacent teeth can be damaged if there is accidental trauma to the surrounding tissue, especially if the extraction requires the use of forceps or other instruments.
- Loose teeth: The formation of a cyst or tumor following the extraction of the wisdom teeth can apply pressure on adjacent teeth, causing them to shift and become loose, as well as resorption (dissolving) of the roots of nearby teeth, leading to tooth loss.
Whether or not to extract wisdom teeth depends on each individual’s situation. If the wisdom teeth are healthy, fully erupted, positioned correctly, and can be cleaned properly, then they may not need to be removed.
However, if they are causing damage to other teeth, leading to jaw problems, sinus issues, inflamed gums, cavities, or alignment problems, then it may be worth considering extraction.
The decision to extract wisdom teeth should be made in consultation with a dentist or oral surgeon, taking into account the potential risks and benefits of the procedure and the individual’s specific circumstances.
To prevent situations that may lead to emergency tooth extraction, it’s important that you practice good oral hygiene and schedule regular dental check-ups. You should also visit a dentist as soon as you experience any unusual tooth pain as it could be an early sign of dental problems.
Lastly, take the necessary precautions to protect your mouth from injury, like wearing a helmet, mouth guard, and seat belt.